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With over 15 years of experience in high-volume interventional endoscopy, my career is…
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Mankanwal Sachdev shared thisMankanwal Sachdev shared thisGreat evening at the multi-specialty journal club hosted by the Creighton University School of Medicine Phoenix Internal Medicine program. The medicine residents did a fantastic job presenting two landmark trials: ESSENCE Trial (Sanyal et al., NEJM 2025) — A Phase 3 trial looking at the efficacy of semaglutide in metabolic dysfunction-associated steatohepatitis (MASH). Crucial insights as medical therapy rapidly evolves in the #hepatology space. CARVE-AS Trial (Khajuria, Jindal et al., Am J Gastroenterol 2026) — Evaluating the efficacy and safety of carvedilol in patients with cirrhosis presenting with new-onset, uncomplicated ascites. Our #GI team was on hand to offer commentary and break down the clinical nuances. Cross-specialty discussions like this elevate patient care and keep academic medicine sharp. #Gastroenterology #InternalMedicine #Hepatology #MedicalEducation
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Mankanwal Sachdev shared thisIs the hospital always the right place for therapeutic endoscopy? I had the absolute privilege of interviewing a true pioneer and mentor in our field, Dr. Isaac Raijman, for the latest episode of The Interventional Endoscopist Podcast. Back in 2010, early in my interventional career, I attended a lecture Dr. Raijman gave in Phoenix on #cholangioscopy to learn firsthand about his approach to advanced biliary endotherapy. Over a decade later, we sat down to discuss the next major shift in our field: taking #EUS, #ERCP, #cholangioscopy, and #endobariatrics into the Ambulatory Surgical Center (#ASC). We dive deep into: 🔹 Financial Realities: Negotiating disposable costs, understanding facility fees, and making EUS/ERCP economically viable in the ASC. 🔹 Guardrails & Safety: Patient selection, ASA/BMI cutoffs, and managing complications without hospital overhead. 🔹 Career Blueprint for Fellows: Why the modern interventionalist needs to understand outpatient economics just as much as endoscopic technique. If you are a GI fellow or practicing interventional endoscopist, this episode is full of practical insights you can apply directly to your practice. 🎧 Listen to the full episode here: https://lnkd.in/evs-pmCS #Gastroenterology #InterventionalEndoscopy #ERCP #EUS #ASC #MedicalEducation #TheInterventionalEndoscopistEpisode 45: Bringing ERCP and EUS to the ASC: Dr. Isaac Raijman on the Future of Interventional EndoscopyEpisode 45: Bringing ERCP and EUS to the ASC: Dr. Isaac Raijman on the Future of Interventional Endoscopy
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Mankanwal Sachdev shared thisAnd it never ends. Board exams. Privileges. Credentialing paperwork. Malpractice insurance. Society fees. Pay ro.publish. pay to play i guess?Mankanwal Sachdev shared thisSubmit ERAS application. Pay $500+. Breathe. I just officially submitted my ERAS application for residency and it is truly an amazing feeling to see my four years of medical school, one public health masters year, research, and clinical rotations neatly packaged into one application. But let me tell you how shocked I was for the bill at the end. Like many medical students, I am navigating the “application arms race.” To secure a reasonable chance at matching, the data tells us we need to apply broadly. But at $30 per program after the first 30, the costs skyrocket instantly. We are a demographic carrying massive educational debt and zero income, yet we are required to put a grand (or more) on our credit cards just for the opportunity to interview for a job. That’s right…my credit card. I’m a student who has had to hold part-time and full-time jobs just to stay afloat since college, using as many scholarships, loans and credit cards as I can get, just to make it to my end goal: becoming a physician. And the ERAS fee is just the tip of the iceberg in a medical training system that routinely runs on the free, unacknowledged labor of trainees. Students face housing instability, food instability among other issues. We are continuously expected to sacrifice our time and our financial stability just for a seat at the table, actually paying for the privilege of working. And it absolutely is a privilege to be in this position, but I can’t help but think there is a better way to sustain our students. Our future physicians. Getting to this milestone has reinforced a promise I made to myself when I got in to medical school, that I will continue to help dismantle these barriers. I want to build a career where I can make clinical and mentorship opportunities genuinely accessible and financially supported. I hope to give back to my community by funding scholarships so that the next generation of students can focus on becoming excellent doctors, rather than worrying about how they will afford the basic right to apply. This process asks for our absolute best, but it also asks for everything in our wallets. I’m sending strength to all my fellow applicants this week who are feeling both the immense pride of hitting "submit" and the immediate anxiety of the ERAS receipt. We’ve got this! #MedStudentLinkedIn #ERAS #ResidencyMatch #FutureDoc
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Mankanwal Sachdev reposted thisMankanwal Sachdev reposted thisAlmost every EUS-GE misdeployment traces back to one of two things. A target loop that was never good enough, or a stent pulled back before the distal flange finished opening. The loop first. A short, circular segment that happens to sit close to the stomach is a trap. It looks easy and it rolls the moment the cautery tip touches. What you want is a longitudinal loop with a runway around 40 mm and less than 10 mm between the walls. If the runway is under 25 mm, do not free-hand it. Switch to incremental deployment or move to a better segment. Better still, be honest about the loop before you puncture, not after. Then the hand. Cautery gets you across the wall, and the echogenic bubbles tell you when you are in. That is the moment to stop the current. Advancing with cautery on is how a LAMS transfixes the far wall. Go in 3 to 4 cm, let the distal flange open completely, and only then draw it back to the gastric wall. The two mistakes that produce a Type II are pulling on a flange that has not finished opening and releasing the proximal flange early to save time. One last thing. If dye or contrast does not come back through the stent, you do not have an anastomosis. Do not end the case. Full checklist is in Table 3 of our paper, link in the comments. Misdeployment used to be the argument against EUS-GE. With a good loop and a trained endoscopist, it is now a rare event with a known fix. Radhika Chavan Sridhar Sundaram SANJAY Rajput #InterventionalEndoscopy #EUS #AdvancedEndoscopy
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Mankanwal Sachdev shared thisattn ibd lovers!! I would love some company! Come work with me
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Mankanwal Sachdev reposted thisa few more observations from application season: outreach via family members: having a spouse or relative email leadership creates an uncomfortable dynamic and immediately raises boundary concerns. stick strictly to standard, professional channels. Not to mention that we dont want to know your marital status, gender or sexual orientation. advocacy calls & pitches without an active application: asking a mentor to call or pitch a PD on your behalf for a program you didn’t signal (or haven't even formally applied to in ERAS yet) puts them in a tough spot. programs can't evaluate candidates outside the system, and if an advocate spends political capital only for leadership to see no signal or file, it damages credibility on both sides. feeding my own words back to me via LLMs: AI tools are fine for drafting (i use them a lot), but taking a PD's web statement or post, running it through ChatGPT, and emailing it back to me as your "Why Me" reason is instantly obvious. Generic, rephrased versions of our public statements, come off as lazy and disingenous. as mentioned in my last post on signaling—directness, alignment, and letting your true preferences carry a lot of weight. #GME #MedicalEducation #Gastroenterology #FellowshipMatch
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Mankanwal Sachdev reposted thisa few more observations from application season: outreach via family members: having a spouse or relative email leadership creates an uncomfortable dynamic and immediately raises boundary concerns. stick strictly to standard, professional channels. Not to mention that we dont want to know your marital status, gender or sexual orientation. advocacy calls & pitches without an active application: asking a mentor to call or pitch a PD on your behalf for a program you didn’t signal (or haven't even formally applied to in ERAS yet) puts them in a tough spot. programs can't evaluate candidates outside the system, and if an advocate spends political capital only for leadership to see no signal or file, it damages credibility on both sides. feeding my own words back to me via LLMs: AI tools are fine for drafting (i use them a lot), but taking a PD's web statement or post, running it through ChatGPT, and emailing it back to me as your "Why Me" reason is instantly obvious. Generic, rephrased versions of our public statements, come off as lazy and disingenous. as mentioned in my last post on signaling—directness, alignment, and letting your true preferences carry a lot of weight. #GME #MedicalEducation #Gastroenterology #FellowshipMatch
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Mankanwal Sachdev shared thisDefinitely a very lively chat!Mankanwal Sachdev shared thisAcademic Half Day always brings out the best clinical debates in our fellowship program. This week, our second-year fellow, Dr. Phillip Leff, presented a case that sparked a deep dive into post-ERCP pancreatitis (PEP) prophylaxis. It’s one of those topics where guidelines meet real-world practice, raising a few questions every program and clinical team has to navigate: • Cost vs. Accessibility: What practical, lower-cost alternatives to rectal indomethacin are clinicians actually utilizing in practice? • Protocol Standardization: Are you giving rectal NSAIDs to 100% of ERCP patients, or risk-stratifying? If it's universal, what workflow safeguards ensure it’s never missed in pre-procedure or recovery? • Risk Assessment: In modern interventional endoscopy, is there truly any such thing as a "low-risk" ERCP? Curious how other training programs and GI groups are operationalizing PEP prevention right now. What does your unit's protocol look like? #Gastroenterology #MedicalEducation #ERCP #Endoscopy #FellowshipTraining American Society for Gastrointestinal Endoscopy (ASGE) Creighton University School of Medicine Obligatory post-presentation photo:
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Mankanwal Sachdev posted thisa few more observations from application season: outreach via family members: having a spouse or relative email leadership creates an uncomfortable dynamic and immediately raises boundary concerns. stick strictly to standard, professional channels. Not to mention that we dont want to know your marital status, gender or sexual orientation. advocacy calls & pitches without an active application: asking a mentor to call or pitch a PD on your behalf for a program you didn’t signal (or haven't even formally applied to in ERAS yet) puts them in a tough spot. programs can't evaluate candidates outside the system, and if an advocate spends political capital only for leadership to see no signal or file, it damages credibility on both sides. feeding my own words back to me via LLMs: AI tools are fine for drafting (i use them a lot), but taking a PD's web statement or post, running it through ChatGPT, and emailing it back to me as your "Why Me" reason is instantly obvious. Generic, rephrased versions of our public statements, come off as lazy and disingenous. as mentioned in my last post on signaling—directness, alignment, and letting your true preferences carry a lot of weight. #GME #MedicalEducation #Gastroenterology #FellowshipMatch
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Omar Khokhar or as I like to ask people, why do you put your Tesla on auto drive? :-)
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Mankanwal Sachdev liked thisMankanwal Sachdev liked thisBack from a great week at our HQ in Brussels A few highlights: 🤝 Time with the home office team. Nothing replaces being in the room. We got real work done, aligned on what's next, and fit in a few long dinners (and plenty of moules-frites) along the way. 📈 A valuable, high-impact Board meeting, and appreciate Denis Gestin for leading from the front. I'm grateful for the insight, the support, and the doors our Board keeps opening through their network. That kind of backing speeds everything up. ✈️ Then the best part of the flight home: watching a live case at BEL-G from 35,000 feet. A big shoutout to Dr. Christopher Thompson, the first GI to use the next iteration of our endoscopic suturing platform. It was a proud moment to see it in the hands of one of the field's pioneers, live on the world stage. Momentum is real. Grateful for this team and excited for what's ahead. Endo Tools Therapeutics Christopher C. Thompson, MD MSc FASGE FACG AGAF #Endoscopy #GI #MedTech #BELG2026 #Innovation #Leadership
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Mankanwal Sachdev liked thisMankanwal Sachdev liked thisA Difficult Decision About Future Observerships This has been a rewarding year, and I am grateful to many IMGs who spent time observing with me. Most were professional, engaged, and genuinely committed to learning. Unfortunately, I also had several difficult experiences. Some individuals repeatedly confirmed their dates and then canceled at the last minute. A few had genuine and understandable circumstances, some offered explanations that were difficult to justify, and others provided no explanation or simply did not show up. An observership requires much more than a physician’s time. It involves scheduling, hospital coordination, administrative work, and accommodations by the entire clinical team. A late cancellation or no-show wastes these efforts and may take an opportunity away from another deserving applicant. It is also important to understand that an observership is neither a right nor something to which anyone is automatically entitled. It is a professional opportunity extended at the discretion of a physician and institution, based on mutual trust, courtesy, and commitment. It should be treated accordingly. For these reasons, I will not be accepting new observers for the time being. I may reconsider this decision in January or February 2027. If observership opportunities reopen, applicants will be considered only if they have: • Completed both USMLE Step 1 and Step 2 CK • A valid U.S. visa or appropriate immigration status • Confirmed availability for the agreed dates • A clear commitment to timely and professional communication I sincerely apologize, but I will not be able to respond to inquiries from potential observers before January or February 2027. After that time, I will respond only to applicants who clearly confirm that they meet all the requirements listed above. I fully understand that genuine emergencies and unexpected circumstances occur. The concern is not an unavoidable change of plans—it is failing to communicate responsibly or treating a confirmed observership as a tentative option. Medicine is a much smaller community than many applicants realize. Reputations are built early, and the way you communicate, honor commitments, and treat others today can follow you throughout your career. Believe it or not, unprofessional conduct now may return years later in ways you never anticipated.
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Mankanwal Sachdev liked thisMankanwal Sachdev liked thisFrom a remote area of Pakistan to Kentucky, USA. I was the first in my family to graduate from college, become a doctor, pass the USMLE, and now apply for the Match. It was never easy, but I never considered myself stopping. Outside the hospital, you'll find me taking long drives, doing calligraphy and painting, which has taught me that a steady hand and patience matter as much with ink as with patients. When at home, I love spoiling my cats with grooming and very "one-sided chats". To my parents, my sisters, my mentors, and everyone who believed in me before I believed in myself: this one is yours too. To anyone starting from far away: keep going. Next stop is interview season. If you've been through the Match, I'd love to hear your best advice in the comments. #Match2027 #FirstGeneration #WomenInMedicine #IMG
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Mankanwal Sachdev liked thisMankanwal Sachdev liked thisA strong Alcanza team is heading to SCRS Global - including a colorful new member you haven't met yet!* We always look forward to this annual reconnecting of partners and colleagues giving voice to the site perspective. If you’ll be attending, reach out to any of our team members: Carlos E. Orantes, CEO Karim C. Chalhoub, President & COO Casey Orvin, CCO Dori Sarkis, Partnerships Rachel Benz, Early Phase Rachel Lyons, Partnerships Alberto Blanco, Partnerships Ashley Rich, Partnerships Margaret White, Partnerships Neil Sheth, MD, FNLA, Regional Medical Director Susan Angel, MSN, APRN, Clinical Operations Nathan Morton, Former Owner, Coastal Carolina Research Dan Kearney, Former Owner, CNS Healthcare Please email bd@alcanzaclinical.com to arrange a personal meeting. *Hint: someone bold, bright, and a little unexpected is making the flight to Orlando this year. Visit our booth or keep an eye out walking through the exhibit hall - you'll know them when you see them! Society for Clinical Research Sites (SCRS) Global Orlando, FL | October 2026 | Booth 606 #SCRS2026 #SCRS
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