With my goal of establishing a strong partnership with an academic institution in a resourcelimited setting, this is to be my second trip to Pune, India to work at BJ Hospital. I plan to spend this trip working on an observational study evaluating the types and frequency of clinical findings on upper endoscopy studies. This is hoped to be a preliminary study with the intention to uncover a unique clinical problem or area for quality improvement, to further explore in a follow up study. This study is currently being reviewed by the BJ Hospital IRB. I aim to to do a retrospective review of records obtained over the past year, as well as set up a prospective study for all upper endoscopies done for the following year. I also hope to use this opportunity to sharpen clinical skills in this setting, through inpatient clinical experiences, with the goal to explore unique cases and keep an eye out for possible case studies.