The Educational Program
In general, the first year of training focuses on developing clinical judgment and procedural skills. Potential research projects and preliminary research work is also explored during this time, based on the fellow’s interests and goals. Scholarly activities are emphasized during the second and third years of training. A Scholarship Oversight Committee, in conjunction with the trainee, the mentor, and the program director will determine whether a specific research activity is appropriate to meet the ABP/RRC guidelines for scholarly activity. The research plan is formalized and work towards its completion is begun in the second year. To optimize this phase of the training, the clinical duties are flexible and can be modified to allow for individual goals, interests and progress.
Programmatic supervision lines are well defined (See box below). The subspecialty residents in pediatric gastroenterology are always supervised by faculty attending. However, the fellow’s experience includes graded responsibility for patient care in the outpatient and inpatient clinical setting. It is the fellow’s responsibility to educate the resident about the patients’ condition, plan for overall care of the patient and function as the gastroenterology/hepatology consultant. Residents and fellows impart knowledge to each other, especially to younger colleagues including medical students.
A. Inpatient Experience
The first year fellow is on the inpatient service for eleven months. The fellow is always on the clinical service with a faculty attending. The fellow and attending evaluate all patients on the gastroenterology (GI) and hepatology (Liver) inpatient services during rounds each morning. As long as the patient is not acutely ill, consultations are completed later in the day, after the fellow has had an opportunity to independently assess the patient. The fellow then communicates the plan to the physicians who requested the consultation. During rounds the fellow presents each patient to the attending and formulates the diagnostic and therapeutic plans. The fellow also is the person who communicates with the pediatric residents and medical students. The fellow is responsible for all patients admitted to the pediatric GI and Liver inpatient services in addition to the pediatric and neonatal intensive care units. In these latter settings, the subspecialty fellow communicates with the Critical Care Medicine and Neonatal Unit physicians after discussion of the acutely ill patient with the gastroenterology/hepatology faculty.
The third year fellow, on the clinical rotation for one month of that year, assumes greater responsibility for the inpatient service. However, the fellow makes formal rounds with the faculty attending on a daily basis including review of consults. Also, the faculty gastroenterologist/hepatologist attends all procedures with the third year fellow (as is done during the PL-4 and PL-5 years). The greater independence given to the third year fellow involves all patient care activities in addition to supervision and teaching of residents and medical students.
B. Outpatient Experience
The fellow attends the pediatric gastroenterology clinic for one session per week. The fellow has the opportunity to select new and return patients who have a variety of gastroenterologic, hepatic and pancreatic diseases. The fellow will follow these patients for the duration of the training. It is the responsibility of the fellow to formulate a plan of evaluation and care, which is discussed with the faculty attending. The fellow also has the responsibility to interact with the ancillary staff that works with the members of the gastroenterology training program, including Nurse Clinicians, Nurse Practitioners, Physician Assistants, Pediatric Nutritionists, Clinical Pharmacists, and Pediatric Social Workers.
C. Research Program
Research training is an important component of the pediatric gastroenterology/ hepatology fellowship program. The fellow is expected to identify and area of research interest by the end of the first year. The program director and other faculty members then identify a mentor and Scholarship Oversight Committee (SOC) to assist the fellow in the creation of a structured research experience. Research progress is monitored by the SOC. It is expected that the project(s) will be completed by the middle of the third year of training in order to analyze data and prepare manuscript(s). It is also expected that abstracts are written and submitted to national scientific meetings for peer review at the beginning of the third year of fellowship training.
The Department of Pediatrics at the University of Florida ensures a meaningful research experience for trainees via the following special programs:
Faculty Research Seminar: This department seminar occurs once each month. Second/ third year fellows are expected to attend, and present research in progress.
Pediatric Science Day: This research day occurs once each year. Junior faculty, fellows, residents and medical students present research material in the same abstract form as used at national scientific meetings.
Visiting Professor Program: An outside reviewer evaluates the fellow’s research once each year. This is a pediatric scientist who is invited for two days to assess the research of all completed data or work-in-progress of all subspecialty trainees. The Visiting Professor Program is an opportunity for the subspecialty fellows to learn about each other’s research and to critically evaluate the investigative efforts of their peers.
Fellows in pediatric GI/Liver are expected to attend a core series offered through the Department of Pediatrics. This interdisciplinary core lecture series is taught by members of the College of Medicine in order to address important research issues including study design and methodology, data analysis, statistical methods, grant writing, and ethical issues. Subspecialty fellows sometime elect to formally matriculate in graduate courses such as molecular biology and pharmacogenomics depending on their research area of interest. They occasionally participate in the University of Florida’s Master’s Degree program, especially the Advanced Postgraduate Program in Clinical Investigation.
Fellows Conference: Present ongoing data