Fellowship Training Program in Pediatric Gastroenterology and Nutrition

The curriculum of the postdoctoral fellowship in pediatric gastroenterology and nutrition at The Children’s Hospital at Montefiore (CHAM) is based on clinical learning augmented by didactic sessions and individual teaching/feedback. The program received a five-year cycle accreditation by the Residency Review Committee in 2009.

The ambulatory subspecialty practice at CHAM is the critical experience for fellows to learn about physical and physiological changes associated with acute and chronic diseases of the gastrointestinal tract, liver and pancreas and the impact of nutrition on growth and development, and to understand the psychosocial interactions that impact on health and growth. An emphasis is placed on understanding the different stages of development and how they interplay with the manifestations of gastrointestinal diseases. And the impact of social and emotional development is taught, including cultural/ethnic diversity, gender issues, health promotion and disease prevention. First-year subspecialty residents directly see patients, present them to attending faculty and are taught individually. Second- and third-year fellows also have direct patient contact.

In addition to the clinical outpatient experience, the first-year fellow will have approximately 10 months of inpatient responsibility. This activity will include caring for patients on the gastrointestinal service as well as providing consultative services for patients in the hospital with gastrointestinal complaints/problems. This activity includes both general pediatric patients and those referred from subspecialty services, the Pediatric Critical Care Unit and the Neonatal Intensive Care Unit, where consideration of multiple complex medical issues is typically seen. Second- and third-year fellows respectively have eight and four weeks of inpatient responsibility.

These activities are supplemented by procedural sessions that include a wide range of commonly performed procedures, including upper endoscopy, colonoscopy, foreign body removal, liver biopsy, paracentesis, esophageal and rectal manometry, pH probe, lactose breath testing and rectal biopsy. Other advanced endoscopic procedures such as esophageal variceal banding/sclerosis, percutaneous gastrostomy tube placement, esophageal dilatation and capsule endoscopy will be experienced. The principles of endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound, pancreatic stimulation tests, laser therapy, esophageal stenting and other procedures will be taught. This experience is supplemented with regular pathology and radiology conferences to provide the opportunity to correlate the clinical, endoscopic, pathological and radiological findings in patients with a broad range of gastrointestinal and liver conditions.

A working knowledge of pediatric nutritional issues is a critical component of the training. In both the outpatient and inpatient settings, the fellows will learn clinical nutrition, including normal needs, growth failure, malabsorptive conditions, deficiency syndromes and nutritional needs of special populations. In addition, the fellows learn the principles and practice of providing enteral and parenteral nutrition.

Research

During the second and third year of training fellows are expected to focus on scholarly work with the expectation for a completed research product during their fellowship. Many options exist for the trainee including hypothesis-driven clinical research with one of the faculty members of the division and translational research in concert with the large and well-respected faculty of Montefiore and Albert Einstein College of Medicine. One excellent option is research in the highly regarded Marion Bessin Liver Center, where opporunities exist for trainees to compete for training grant positions.

The Marion Bessin Liver Center

The Center comprises four research core facilities to support research by 38 investigators in 12 departments of the medical school. These investigators have broad expertise touching on virtually all areas of biomedical research, including biochemistry, physiology, pharmacology, biophysics, cell and molecular biology, genetics, pathology and cell ultrastructure. The Center has a strong Pilot and Feasibility Study Program to support young investigators and develop new areas of research by established investigators. It is the focus of an active research-oriented education program (research seminars, visiting scientists, pathobiology sessions and work-in-progress discussion groups) and has extensive collaborative studies with investigators in other institutions. The educational and collaborative programs of the Center provide an ongoing structure for training future academicians in the pathobiology of liver disease. Core facilities include cell culture, morphology, molecular biology and special animal cores. Available equipment includes ultracentrifuges, rotors, electrophoresis equipment, computers, NMR facilities, liquid scintillation counters, gamma counters, liver perfusion apparatus, laminar flow hoods, cell culture facilities, recombinant DNA and cloning laboratory, electron microscopic facilities and scanning confocal microscopes. Educational activities for the faculty and trainees include weekly seminars and journal club conferences.

How to apply

Electronic Residency Application Service (ERAS) is the only way we receive and review applications to our program. For requirements and deadlines you may visit the ERAS website at www.aamc.org/eras. Our NRMP number is 11114125.

Why choose our program

The gastroenterology and nutrition fellowship training at CHAM offers opportunities to work with a respected team composed of eight highly qualified physicians who have made contributions in areas such as liver disease and transplantation, inflammatory bowel disease, therapeutic endoscopy, short bowel syndrome and clinical translational research. A myriad of other research possibilities is also available.