Curriculum
The Gastroenterology, Hepatology and Nutrition Fellowship Program combines clinical and research training designed to offer a progressive development of knowledge, skills, and independence each year. Fellows attend diverse educational activities and department conferences and meetings throughout training that further enhance their learning experience.
The geographic range that URMC brings in contributes the wide range of pathology that we see in this hospital. As fellows, we have numerous opportunities for procedures of all kinds and many faculty members to work with to get a variety of techniques and perspectives, which I think is vital during training.
Year 1
Clinical
The first year of training provides a focused clinical experience. Fellows develop competency in evaluating and managing children with gastroenterological and liver disease and in performing colonoscopy and upper GI endoscopy. On the inpatient service, fellows manage patients on the Pediatric Gastroenterology service and provide consults to other subspecialties.
Each fellow has at least one outpatient clinic per week, working in tandem with an attending. By the end of the first year, each fellow begins their own continuity clinic allowing them to follow patients longitudinally.
A one-month nutrition rotation is designed to develop competence in nutrition science as it relates to gastroenterology, affording a working knowledge of parenteral (intravenous) nutrition, estimation of energy and protein requirements, and specialty diets including gluten-free, essential for our patients with Crohn’s disease.
Research
During their first year of training, fellows explore opportunities in bench, translational and clinical research. Guided by the program director and division chief, each fellow identifies a topic that aligns with their research and career interests and chooses a primary mentor. The Associate Chair of Academic Affairs and the Chair of the Department of Pediatrics are also available to offer guidance.
Fellows proceed to formulate a research question, review background literature, develop a research proposal, and identify members of their Scholarship Oversight Committee (SOC), advisors that provide research and career guidance throughout training.
Years 2 and 3
Clinical
During years 2 and 3, fellows earn more independence and continue to increase their knowledge of inpatient and outpatient care. They continue perfecting routine procedures and perform more advanced interventional procedures such as variceal banding, polypectomies and balloon dilation. By the end of the third year, fellows are proficient in their clinical skills and in their ability to perform procedures independently.
Fellows spend one half day per week in their own continuity clinic exposing them to the progression of disease and assuring continuity of care for patients. To offer exposure to different attending styles, fellows participate in "swing" clinics when not on service.
During the month-long adult gastroenterology rotation, fellows perform multiple diagnostic colonoscopies to build their skills and observe more advanced procedures such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound, and double-balloon enteroscopy.
An additional rotation with adult GI is available in the third year with a focus on honing procedural skills and learning about the basic principles, indications, and risks of more advanced endoscopic procedures.
Previous fellows have been awarded funding to participate in advanced motility training through the American Neurogastroenterology and Motility Society (ANMS).
Research
Second and third year fellows spend more of their time in research, gaining experience in basic or clinical science research with the guidance of their primary mentor. They meet formally with their SOC to review their progress, identify possible resources, and explore funding opportunities and collaborations that may advance the project. The SOC ensures that fellows meet the American Board of Pediatrics research requirements to sit for the subspecialty board exam, including completing a scholarly work product by the end of the third year.
The Department of Pediatrics promotes career development and networking opportunities by providing support to fellows presenting their findings at regional and national meetings. Fellows are actively encouraged to submit abstracts for presentation and articles for publication in peer-reviewed journals. Third year fellows have an opportunity to present their research at Pediatric Grand Rounds.