Rolling admission · Istanbul · Delivered in English
Follow how a university gastroenterology unit decides when ERCP is needed, works under fluoroscopy and plans biliary drainage with surgeons and oncologists — with no procedural role, where ERCP is on the unit's schedule during your dates.
What you see depends on the department's clinical calendar during your placement; the list below describes the department's usual scope, not a guaranteed programme.
Diagnostic questions about the bile duct are now largely answered by MRCP or endoscopic ultrasound, so ERCP is reserved mainly for treatment. The decision usually begins with risk stratification: a patient with a high likelihood of a common bile duct stone may proceed directly, while an intermediate likelihood generally calls for less invasive imaging beforehand. Cholangitis shifts the question from whether to when, with the timing of drainage driven by severity. In gallstone pancreatitis, ERCP is kept for coexisting cholangitis or persisting obstruction rather than offered routinely. Observers hear this reasoning in the pre-procedure discussion, where imaging and blood results are reviewed together.
Malignant obstruction raises different questions. For a distal stricture caused by a potentially resectable pancreatic tumour, the team weighs pre-operative drainage against proceeding straight to resection; drainage is generally reserved for cholangitis, an expected delay to surgery or planned neoadjuvant therapy, and is agreed with the surgeons. Hilar strictures demand planning from cross-sectional imaging so that drainage targets the liver segments that matter. Indeterminate strictures prompt a discussion of how tissue will be obtained and how far a negative result can be trusted. Stent type — plastic or self-expanding metal — follows from the diagnosis and the treatment that comes next.
Inside the room, ERCP is a team procedure under fluoroscopy. Patients are commonly positioned prone or semi-prone under deep sedation or general anaesthesia; the endoscopy nurses manage guidewires and accessories in step with the endoscopist; and everyone works within the unit's radiation-protection rules. Risk is weighed before the procedure begins: post-ERCP pancreatitis is the commonest serious complication, so prophylaxis, bleeding risk after sphincterotomy and anticoagulant plans are settled in advance. An observer who follows a case from referral to recovery sees how these decisions connect.
This page covers ERCP alone — the therapeutic, fluoroscopy-guided side of pancreaticobiliary endoscopy — whereas the parent gastroenterology page spans the entire department, and the endoscopic ultrasound page covers imaging-led lesion assessment, staging and tissue sampling. Liver, pancreatic and biliary resection, where surgical decisions are carried through, is a separate general surgery focus.
Graduate physicians and internal medicine or gastroenterology trainees who already know diagnostic endoscopy and want to understand how ERCP decisions are made; clinical-year students are eligible but usually gain more from the wider department.
Gastroenterologists with a specialist qualification who state pancreaticobiliary endoscopy as their interest within the gastroenterology department; the department decides allocation, and ERCP is followed alongside its other endoscopy, clinic and inpatient work.
Both routes are strictly observational: observers attend theatre and clinic without patient contact, do not scrub or assist, and are not assessed on any procedure.
| Clinical Observership | Clinical Fellowship | |
|---|---|---|
| Duration | 1, 2 or 4 weeks (extension possible on request) | 12 to 24 months, agreed with the host department |
| Who it is for | Medical students in clinical years and graduate physicians from outside Turkey | Recognised specialists and family physicians seeking advanced exposure beyond standard specialty training |
| Format | Full-time, strictly observational — outpatient clinics, operating theatre, ward rounds, case discussions | Extended observational attachment to one department: daily practice, service structure and specific techniques |
| Certificate | Certificate of attendance issued by the host hospital and signed by its Medical Director | Certificate on completion issued under the accreditation of the affiliated university school of medicine |
| Start | Rotations typically begin on a Monday; dates are agreed individually | Start date planned around the date you request and the department's capacity |
One online application for both routes. State ERCP as your focus in your objectives; ATDERA reviews the file and prepares it for the Gastroenterology department, then replies with next steps, typically within two working days.
Already started? The application page picks up where you left off.
ATDERA Global Limited (Companies House No. 17173428, registered in England and Wales) coordinates this programme for a university teaching hospital in Istanbul. ATDERA is not a hospital and does not provide clinical care; admission decisions and certificates are the host hospital's.
One online application covers both routes and all twenty-one specialties — details, programme choice and documents in five short steps. ATDERA reviews the file and replies with next steps, typically within two working days.
