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Curriculum

Clinical training

The Pediatric Gastroenterology Fellowship provides you with extensive clinical experience in general pediatric gastroenterology in both inpatient and outpatient ambulatory settings. Training in a variety of endoscopic procedures, as well as other diagnostic and therapeutic techniques, also is included. Length of research time depends on whether you choose the Clinical Scholar Track or the National Institutes of Health (NIH)-Sponsored Track.

Patient care

During the inpatient service, we serve as a consult service to our pediatric colleagues at Mayo Clinic Hospital, Saint Marys Campus. Requests typically come from the general floor, hematology/oncology, neonatal intensive care unit, pediatric intensive care unit, and coronary care unit, but may also come from our physical medicine and rehabilitation unit, newborn nursery, and psychiatric unit.

Fellows participate in the postoperative management of liver transplant patients. The fellow serves as a first assistant to the staff and learns how to manage many types of cases, from the straightforward to the complex. Procedures are performed on hospitalized patients.

During the progression of the Pediatric Gastroenterology Fellowship, fellows are expected to serve in a junior faculty-type role, directly supervising and guiding medical residents rotating on the team, together with the staff physician.

During the outpatient department rotation, fellows rotate through our subspecialty clinics — aerodigestive, celiac, liver and liver transplant, and inflammatory bowel disease (IBD) — where they work directly with expert staff gastroenterologists. In the outpatient practice, the same focus on pragmatic and scholarly approaches to diagnostic and therapeutic gastrointestinal problems exists. In all rotations, the fellow works directly with a supervising staff gastroenterologist. Additional rotations include pathology, radiology and nutrition.

Trainees are enrolled in several classes to enhance communication skills. The Mayo Clinic Multidisciplinary Simulation Center is used to practice scenarios unique to the care of our patients with complex gastrointestinal and liver diseases.

Procedures

All procedures are performed under the direct supervision of Mayo Clinic staff gastroenterologists. Procedural training includes upper endoscopy, esophageal dilation, variceal banding, esophageal pH readings and colonoscopy.

Through collaboration with our adult gastroenterology colleagues, the endoscopic experience includes exposure to electrocoagulation, hemoclip application, variceal banding and various stenting procedures, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound. Fellows also have opportunities to learn about gastrointestinal motility, the dynamic assessment of pancreatic, hepatobiliary and gastrointestinal function, and other procedures.

Didactic training

Clinical conferences, journal clubs and formal course work in the Center for Clinical and Translational Science, as well as one-on-one instruction, are integral parts of the Pediatric Gastroenterology Fellowship. Fellows work one-on-one with staff gastroenterologists during all aspects of their training. Bedside instruction and other informal teaching methods also are part of the fellowship.

Research training

The research experience is typically 12 to 18 months in the Clinical Scholar Track and is 24 months in the NIH-Sponsored Track.

At Mayo Clinic, research mentors closely supervise protocol development, the conduct of the study, data analysis and final manuscript preparation. Our division's statistician is available to review methodology and statistical considerations. Our fellows have been successful in publishing at least one first-authored manuscript and have typically presented several posters at national meetings.

Fellows interested in clinical research have the opportunity to obtain a diploma or master's degree through the Center for Clinical and Translational Science. The curriculum includes protocol development, epidemiology, statistics, ethics in pediatric research, survey development and much more. The Rochester Epidemiology Project provides opportunities for population-based research, as does our involvement in national IBD registries.

Fellows interested in pursuing an NIH-funded independent research career are mentored by an NIH-funded basic or translational mentor through collaboration with our adult gastroenterology or pediatric subspecialty colleagues.

Some major areas of research include:

  • Celiac disease
  • Eosinophilic esophagitis
  • Chronic liver disease
  • Enteric neurosciences
  • Fecal microbial transplant
  • Inflammatory bowel disease

Current new initiatives include epigenetics, microbial ecology, proteomics and genomics, and obesity.

Teaching opportunities

Fellows have the opportunity to teach Mayo Medical School students and pediatric residents through bedside instruction and formal didactic lectures. At the beginning of the Pediatric Gastroenterology Fellowship, fellows are taught how to give effective presentations, and feedback is provided after most presentations.

Conferences

A variety of conferences are held each week. A core curriculum is given early each academic year, and fellows are enrolled in formal course work in the Center for Clinical and Translational Science. The Division of Pediatric Gastroenterology and Hepatology holds a weekly conference, as do the Pediatric Inflammatory Bowel Disease Interest Group and Aerodigestive Interest Group.

Fellows may also find topics of special interest in other conferences sponsored by the Department of Pediatric and Adolescent Medicine, Division of Gastroenterology and Hepatology, and Department of Medical Genetics.

On a monthly basis, we have a combined pediatric gastroenterology, surgery and radiology conference highlighting challenging cases in a multidisciplinary fashion. Each month, fellows also attend a pediatric subspecialty conference focusing on aspects of improving communication and presentation skills, ethics, and aspects of pediatric research.

The weekly schedule may include:

Monday

  • Pediatric gastroenterology didactic conference*
  • Gastroenterology and Hepatology Grand Rounds

Tuesday

  • Pediatric IBD Interest Group*

Wednesday

  • Celiac Interest Group
  • IBD Interest Group
  • Liver transplant selection conference

Thursday

  • Liver pathology conference
  • Pediatric residency noon conference
  • Gastroenterology and Hepatology Grand Rounds

Friday

  • Pediatric Grand Rounds
  • Pediatric gastroenterology sign-out
  • Hepatobiliary Interest Group

*Fellows make presentations at these conferences.

Evaluation

To ensure our fellows gain proficiency and develop the corresponding technical skills, fellow performance is monitored throughout the Pediatric Gastroenterology Fellowship. Fellows are formally evaluated after completing each clinical rotation. The Clinical Competency Committee meets every six months to evaluate each fellow as well as the fellowship program.

The program director reviews these evaluations and meets with the fellows regularly. The Scholarly Oversight Committee meets with the fellows and their research mentors to ensure appropriate research training and successful completion of the required peer-reviewed manuscript to sit for the pediatric gastroenterology subsection of the American Board of Pediatrics. In addition, fellows regularly evaluate the faculty to ensure educational and career goals are being met.

  • June 25, 2014
  • ART235187