GI Clinical Electives
During the first year, fellows from the Division of Gastroenterology, Hepatology and Nutrition at Cincinnati Children's Hospital Medical Center spend nine months on the clinical service and three months on electives. The first two electives will assist the fellow in chosing and developing a basic science or clinical research project and proposal. During the third elective month, fellows may plan for their research years and / or take one of these clinical electives.
Rural GI | Motility Disorders | Nutrition l Colorectal Center l Aerodigestive and Sleep Center l Endoscopy
Longitudinal Elective "Rural GI"
Faculty: Michael K. Farrell, MD
Minimum duration: Attend 4-6 monthly clinics in Portsmouth, OH
Brief description of the experience and expectations of the fellow:
On this elective, we focus on making diagnoses with limited resources. We will explore why some disorders are more common, e.g., H. pylori. Readings are included about the Appalachian culture, the organization of rural medicine, etc.
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GI Motility Disorders Elective
Faculty: Ajay Kaul, MD
Minimum duration: 4 weeks
Goals and objectives
The objective of this elective is to familiarize pediatric GI fellows with the evaluation and management of children with motility disorders.
Brief description of the experience and expectations of the fellow:
During this period the fellow's primary responsibility is to take every available opportunity to learn about motility disorders. They are expected to:
Attend the weekly motility meetings on Mondays from 2-3 pm. During this time, new referrals and current patients are reviewed, plans for patient care are developed and informal teaching takes place
Learn the basic principles of manometry and its indications and participate in the endoscopic and / or fluoroscopic placement of manometry catheters
Review and interpret manometry recordings and correlate the findings to the patient's symptoms. Based on the results, the fellow is expected to formulate a plan of care for the patient.
Assume primary responsibility for any patient admitted to the GI service for evaluation and management of motility disorders. The fellow will take this opportunity to teach the pediatric house staff taking care of the patient, as well as be the liaison to the primary GI inpatient service team.
Attend the monthly didactics (second Monday at noon) on GI motility disorders
Present cases during daily morning rounds, Lumen, Pathology and Radiology conferences
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Nutrition Elective
Faculty: Samuel A. Kocoshis, MD
Minimum duration: 2 weeks
Goals and objectives
Know how to assess nutritional status by anthropometrics, balance studies, body composition analysis and measurement of energy expenditure
Recognize the clinical and biochemical manifestations of nutrient deficiencies and nutrient excess
Understand the special nutritional needs of patients with IBD, short bowel syndrome, cholestatic liver disease, end stage liver disease, renal disease, neoplasia, immunodeficiency, and infection
Become competent in nutritionally rehabilitating patients who are undernourished
Brief description of the experience and expectations of the fellow:
The fellow will have an opportunity to learn pediatric nutrition by means of a combination of formal didactic exercises and informal bedside teaching. Problem-based, integrative case studies will constitute and important aspect of the didactic process. Hands-on experience answering nutrition consults, rounding with specialty dieticians, attending the Comprehensive Nutrition Center clinic, and observing both the outpatient HealthWorks! (obesity) clinic and the eating disorders program.
Didactic exercises
Hospital-wide nutrition rounds, first and third Mondays, 2-3 pm
Regional Center for Neonatal Intensive Care (RCNIC) rounds, second and fourth Mondays, 2-3 pm
Lumen rounds, Wednesdays, 12-1 pm
Integrated case studies with Dr. Kocoshis, Tuesdays and Fridays, 3-4 pm
Topics include nutritional assessment, nutrient biochemistry, macronutrient deficiency, micronutrient deficiency, short gut, IBD, liver disease, and renal failure / immunodeficiency
Clinical experiences
Round with subspecialty dietician (gastroenterology, cystic fibrosis, hematology-oncology, transplant, nephrology), to be determined weekly, Mondays, Tuesdays, Thursdays, Fridays early morning
Answer nutrition consultations to be precepted by dietician and Dr. Kocoshis, all week
HealthWorks!, Tuesday afternoons
Nutrition and Intestinal Care Center, Wednesdays all day
Eating Disorders Clinic, Thursday afternoons
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Colorectal Center Elective
Faculty: Alberto Peña, MD, Marc Levitt, MD (Division of General and Thoracic Surgery) and Mike Bates, MD, PhD
Minimum duration: 4 weeks
Goals and objectives
The goal of this elective is to provide experience with the evaluation and post-surgical management of patients with congenital disorders of the distal gastrointestinal tract, such as anorectal malformations and Hirschsprung disease.
Brief description of the experience and expectations of the fellow:
Fellows will participate in the activities of the Colorectal Center, in particular its outpatient clinics. They will learn about the evaluation and management of newly referred patients. Further, there will be experience in the post-hospital management of patients with surgically corrected colorectal disorders.
Fellows will participate in weekly conferences where new patients and basic and clinical research are discussed. There will be opportunities for operating room observation; video demonstrations of these procedures are also available for viewing.
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Aerodigestive and Sleep Center (ADSC) Elective
Faculty: Philip E. Putnam, MD and Ajay Kaul, MD
Minimum duration: 4 weeks
Goals and objectives
The objective of this elective is to acquaint pediatric GI fellows with the evaluation and management of complex patients (most with primary airway anomalies) who may have GI disorders that complicate or contribute to multi-system disease.
Brief description of the experience and expectations of the fellow:
Attend the
Aerodigestive and Sleep Center (ADSC) clinic (Tuesday afternoons, 2-5 pm) and see any other ADSC new patients who are scheduled outside of clinic time
Attend ADSC conferences, Wednesday mornings, 8:30-9 am
Participate in all ADSC-related endoscopies (diagnostic and therapeutic)
Attend Feeding Team clinic and conferences with Dr. Kaul (specific Tuesday and Thursday mornings)
Review and interpret results from all ADSC tests and procedures including radiology, histology, and pH and impedance probes from ADSC patients
Follow ADSC patients admitted for GI studies
Perform the GI portion of ADSC consults on in-house patients
Observe at least one Flexible Endoscopic Evaluation of Swallowing (FEES) study and one Video Swallowing Study (VSS) during the ADSC elective
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Endoscopy Elective
Faculty: Robert Weesner, MD
Minimum duration: 2 weeks
Goals and objectives
Improve skills in endoscopic technique in adult patients
Perform at least 10 colonoscopies over a two-week period
Brief description of the experience and expectations of the fellow:
Pediatric GI fellows may rotate through the outpatient clinics and the endoscopy suite at the Cincinnati Veterans Affairs Medical Center, which is a teaching hospital of the University of Cincinnati. During these rotations, fellows will be provided with additional training and endoscopy experience. Other elective experiences are also available. This elective must be scheduled 30-60 days in advance.
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