Pediatric Gastroenterology, Nutrition and Liver Diseases
Fellowship Training Program in Pediatric Gastroenterology
The Pediatric Gastroenterology Fellowship Training Program of The Warren Alpert Medical School of Brown University is based at Hasbro Children’s Hospital, which is the pediatric division of Rhode Island Hospital. The program began in 1991 and has been continuously accredited by the Accreditation Council for Graduate Medical Education (ACGME) for the last 23 years.
The program’s mission is to provide future leaders in gastrointestinal health care with comprehensive clinical and research experience in a caring, encouraging and supportive manner. The program is structured so that three years are devoted to clinical care and hypothesis-driven investigation relevant to the gastrointestinal, hepatic and nutritional problems of infants and children, with responsibilities increasing over the three years.
Goals and Objectives
The goals and objectives of the program are aligned with the requirements of The American Board of Pediatrics for certification in pediatric gastroenterology, the ACGME, and the guidelines of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) regarding training and education: Leichtner AM, et al, (2013) NASPGHAN Guidelines for Training in Pediatric Gastroenterology. NASPGHAN Training Committee. J Pediatr Gastroenterol Nutr 56 Suppl 1: S1-38.
Skills in clinical gastroenterology, hepatology and nutrition are learned through experience with the diagnosis and management of the wide range of acute and chronic, and major and minor conditions that characterize the specialty. Skills are also mastered through increasing responsibilities over the course of the training program.
- Fellowship Year 1 is generally focused on acquiring clinical skills. The first-year fellow generally spends (exclusive of 4 weeks of vacation) 50 to 60 percent of his or her time and effort caring for inpatients, including consultations, and 30 to 40 percent caring for outpatients. Procedural skills are acquired while on the inpatient and outpatient clinical services. Generally, 20 percent of the time is available for electives and research. Year 1, while focused on acquiring clinical skills, is critical for providing a platform for fellows to launch their research projects. The fellows are expected to begin the process of acquiring competence in research by speaking to senior fellows and interacting with the faculty and academic community at large. The fellows are expected to take initiative to learn about opportunities, and through regular meetings with their mentors determine whether their research effort should be in the clinical or basic-laboratory research realm. They are expected to identify potential projects and to meet with potential research mentors. By the end of their first year, they should have identified a research question and formulated a potential hypothesis for research. This process should be prepared for presentation to the Scholarship Oversight Committee (SOC), which will be appointed toward the end of year 1.
- Fellowship Year 2 is generally devoted to research (~70 percent). The clinical experience of the fellow is refined through focused exposures in our subspecialty clinics, which include the Inflammatory Bowel Disease Center, Liver Diseases Center, Feeding Program and electives in pediatric surgery, pathology/radiology, and a required solid organ rotation outside of our institution, as well as their own longitudinal follow-up clinic. Year 2 (and year 3) is focused on accomplishing the fellow’s research objective. By the end of the first six months of year 2 (18 months into the fellowship), the fellow is expected to have identified an acceptable research project, performed preliminary work, presented a hypothesis-driven project to his or her SOC, and to be ready to devote the next 12 months to completion of that project.
- Fellowship Year 3 is focused on completion of the fellow’s research. Opportunities to gain additional clinical experience are similar to those available in Year 2. The program director guides the fellow to make certain that all clinical competencies have been successfully met before completion of training. Year 3 (like year 2) is focused on accomplishing the fellow’s hypothesis-driven research project. The fellow is expected to make progress at a rate satisfactory to both his or her research mentor and his or her SOC. By the autumn of year 3, the fellow should have prepared an abstract for submission and presentation at a national meeting of one of our academic societies. The fellow is expected to complete all or most of his or her laboratory research by December and devote the last six months of fellowship training to writing his or her research results for publication in a major journal, for preparing a national presentation, and (optional) preparing a federal grant proposal.
Throughout the three years, as fellows obtain increased experience and knowledge, their maturation as subspecialists is fostered by the faculty who promote and expect each fellow to demonstrate and assume increasing responsibility. This allows the fellow to develop increasing autonomy regarding the development of the skills and knowledge necessary for them to successfully pursue their own careers. The program provides the fellow with the supervision, guidance, and mentoring to become competent subspecialists who are expected to develop clinical judgments and skills, medical knowledge, humanistic qualities, and professional attitudes and behaviors necessary to become successful members of the health care community and team.
The faculty of the Department of Pediatrics provides general and subspecialty care from a wide range of disciplines at Hasbro Children’s Hospital. The Division of Pediatric Gastroenterology has a close and collegial working relationship with various specialists in pediatrics. Within the division, there are programs and centers of excellence such as the Inflammatory Bowel Disease Center, the Celiac Disease Center, the Feeding Program, the Liver Diseases Center, the Eosinophilic GI Disorders Program, and the CHANGES Program—Creating Healthy Attitudes, Nutrition Goals, and Exercise Strength—which is a pediatric and adolescent weight management program. These programs allow us to provide the best gastrointestinal care and provide our fellows with focused training in particular areas of the discipline.
Most of the clinical training is spent at Hasbro Children’s Hospital. The fellows are credentialed at Women and Infants Hospital, a teaching affiliate of The Warren Alpert Medical School of Brown University, and provide consultation in the neonatal unit. Fellows participate in laboratory, translational and clinical research at the Rhode Island Hospital campus and at Brown University’s research campus. The fellows may participate in research that is based in another institution with approval from the program director and the scientific oversight committee.
Fellows’ Clinics, Endoscopy and Conferences
Throughout the three years, fellows carry their own patient panel and participate in the ambulatory clinics for two half-days a week (Wednesday and Fridays). In addition, they rotate to take care of sick/urgent patients on Thursday afternoons. The fellows are supervised and precepted by an experienced clinical faculty during clinics.
The fellows have daily opportunities to perform endoscopy and other procedures while closely supervised by an experienced endoscopist. All fellows are required to have at least one endoscopy day weekly. The program has a close collaboration with the adult GI team who are available for advanced endoscopic procedures (for example, ERCP).
Didactics and conferences are spread throughout the week:
Monday: 4 p.m. – Pathology Conference
Tuesday and Thursday: noon – Case Management Conference/Liver Conference/M&M
Wednesday: 8 a.m. – IBD Conference
Wednesday: first of the month – Radiology Case Conference
Wednesday: noon – Fellow’s Teaching Conference/Journal Club
Thursday: 8 a.m. – Research Conference Bi-monthly
Thursday: 9 a.m. – Inpatient Conference
Friday: 8:30 a.m. – Pediatric Grand Rounds
Rhode Island Hospital offers a competitive salary and benefits package to all its house staff. Stipends are reviewed annually and recommendations are made by the Graduate Medical Education Committee.
Stipend as of July 2017:
- PGY 4 (Year 1) - $65,000
- PGY 5 (Year 2) - $67,500
- PGY 6 (Year 3) - $71,000
Vacation: 4 weeks paid
- Professional Liability Insurance: Malpractice coverage for 3 years provided
- Medical and Dental Benefits: Provided via Tufts Healthcare and Delta Dental
- Long Term Disability Insurance (LTD)
- Fitness and Wellness Program (Coastline Employee Assistance Program)
- Employee Health Services
- Temporary Disability Insurance (TDI)
- On-Call Accommodations
- Lab Coats and Scrubs
- On-Campus Day Care Center: Bright Horizon Children’s Center
- Paid and Unpaid Leave of Absence
- Free Employee Parking
- Courtesy Shuttle Service to the Parking Lots and Other Facilities
Please note that Rhode Island Hospital, as a Lifespan partner hospital, does not hire users of tobacco products, illegal drugs, or nonmedical marijuana, and conducts pre-employment drug and nicotine testing for candidates who have received a conditional offer of employment.
Application to the Fellowship Program
Applications should be sent through Electronic Residency Application Services (www.aamc.org/services/eras). We participate in the National Residency Matching Program. For additional information, please contact Beth Pinkos, program coordinator, at email@example.com or call 401-444-3360.
Program Contact Information
Michael Herzlinger MD, Program Director
Beth Pinkos, RD, MS, Program Coordinator