Pediatric Gastroenterology, Hepatology and Nutrition Fellowship

Inpatient Responsibilities

Inpatient duties of the first-year trainee include the care of patients (direct admissions and consultations) on a daily basis. Trainees are expected to see all consultations and patients admitted in the hospital, including but not limited to the Pediatric Gastroenterology & Nutrition service and intensive care units. They are also expected to supervise the residents and/or students rotating in Pediatric Gastroenterology.

The trainees have daily inpatient rounds and patient care rounds with the on call attending faculty, as well as a weekly presentation of selected inpatients to the faculty. Each of the full-time faculty members in the Pediatric Gastroenterology & Nutrition department serves as the primary inpatient teaching attending for a set period. Therefore, during their training experience, the fellows are exposed to different management styles and faculty with differing expertise within pediatric gastroenterology and nutrition.

Faculty members are available 24 hours a day, seven days a week during this rotation. Fellows are expected to see every patient seen by the fellow, to discuss every patient with the fellow daily and answer management questions as they arise. The faculty assumes ultimate responsibility for the care of the patients.

In the last month of their fellowship, the inpatient will act as “acting GI attending.” The fellow makes most of the decisions with minor surveillance from the faculty attending.

Outpatient Responsibilities

The fellows have direct responsibility for each of the patients they see during their required three-year outpatient continuity practice. The fellows prepare for these sessions by familiarizing themselves with the patient’s problems, as outlined in the electronic medical record. Fellows are responsible for the primary visit and for the initial decision-making. They present the patient problem and their decision making to the attending faculty, who then also sees the patient and works with the fellow to develop a management plan for the patient. Fellows are responsible for communicating with the primary care physician gathering any obtained laboratory studies and reaching further management decisions, under the direction of the supervising attending. Fellows will learn all aspects of outpatient care from the basics to today’s current hot topics, which includes contact with the patient and family regarding test results, medication appeals and denials, active drug monitoring.

An informal teaching session occurs before and/or after the outpatient visit session to discuss patient management issues or topics of particular interest. Each fellow is responsible for keeping log of all outpatients that he/she sees.