Pediatric GI Fellowship – First Year
Four months of Hopkins GI inpatient service and four months of Hopkins GI Consultation Service — This includes Outpatient clinic, where the fellow is involved in the care of a large number of children with gastrointestinal, hepatobiliary, pancreatic and nutritional disorders. Examples include children undergoing liver transplantation, or with inflammatory bowel disease, short gut syndrome, cystic fibrosis, feeding difficulties or graft vs. host disease. One-half day a week the fellow will be taught the standard pediatric gastroenterology procedures (upper and lower endoscopy, percutaneous endoscopic gastrostomy, percutaneous liver biopsy and diagnostic aerodigestive procedures).
One month — Research Planning — The fellow meets with various faculty members and reviews research possibilities, either working with the particular faculty member or asking the faculty member’s help in identifying other potential research mentors outside the division. The goal is to identify the research project, mentor and general plan for accomplishing the research in a three-year period. In the fourth or fifth month of the clinical year, after the fellow has been exposed to a wide variety of clinical problems in pediatric gastroenterology and nutrition, the fellow is given one month in which to pursue various options for in depth research focus in the second and third year. In this protected month, the fellow is introduced to a variety of potential mentors by one of the faculty members and is encouraged to do in-depth reading and formulation of a specific research focus.
Once the research subject is selected, the fellow is asked to formulate testable hypotheses and to do a formal presentation to the rest of the members of the division concerning the chosen research, so that the faculty may assist in definition of research goals.
One month — Nutrition Rotation — Attend Weigh Smart and Metabolic clinic at Mount Washington Pediatric Hospital, Cystic Fibrosis Clinic and Lipid Clinic in the Johns Hopkins Pediatric Specialty Clinic, and Celiac Clinic at The University of Maryland. Also attend Nutrition Rounds. Select clinically-oriented reading related to curriculum requirements.
One month — Aerodigestive Rotation — The fellow will be responsible for reading the pH/impedance probe for any inpatient consult. Participate in esophageal dilations and intraoperative placement of pH/impedance probe. Observe at least one fundoplication procedure with the general pediatric surgeon in the operating room. Participate in one procedure day with aerodigestive clinic team of endoscopists (ped GI, ENT and pulmonary).
The fellow will participate in the Aerodigestive Clinic that starts with preclinic conference at 12:30 p.m. and clinic from 1:00 p.m. – 5:30 p.m. Attend at least one clinic with Dr. Maureen Lefton-Greif, Ph.D., swallowing disorders diagnostician. Attend half-day in Radiology where Video Fluoroscopic Swallowing Study is done with Dr. Lefton-Greif, Ph.D. Attend FEES clinic with Drs. Ishman and Lefton-Greif when available during the rotation.
One month — GI pathology/radiology — The fellow reads GI and liver histology on a daily basis with staff pathologist and also reviews a set of teaching slides. The radiology part of this month is spent reviewing relevant GI radiographs and radiologic procedures with the pediatric radiology faculty.
One month — Liver transplant — Attend Adult liver transplant Rounds, Pediatric Liver Clinic and General Pediatric Surgery Clinic. Begin formal transplant rounds with transplant coordinator, Pediatric Surgery chief resident and Dr. Schwarz (hepatologist), and give a talk at the end of the month. This would be the second half of the first year.
One month — Adult Gastroenterology — Observe procedures (esophageal banding, ERCPs). Follow pediatric patients to ERCP. Also observe colonoscopies, EGDs and polypectomies on adult patients, which correlate to older adolescents (18-21). This would be in the second half of the year.
Pediatric GI Clinics — Half-day per week general pediatric Gastroenterology — During the weekly clinics the fellows will see four to seven new and/or follow-up patients, take a detailed history and perform a physical examination, formulate a management plan, then present the patient to the attending faculty. Fellows are responsible for following up on diagnostic testing and generally perform appropriate gastrointestinal procedures on their patients if possible, under the supervision of an attending physician.
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