New York Presbyterian Hospital/Columbia University
Fellowship Program in Pediatric Gastroenterology, Hepatology, and Nutrition
Educational Goals and Objectives
The general goals and objectives of the Pediatric Gastroenterology Hepatology and
Nutrition Fellowship Program are found in the Pediatrics-Gastroenterology, Hepatology and
Nutrition Fellowship Program binder.
During the three years of training our Pediatric-GI fellows will gain progressive clinical
mastery including a more extensive breadth and depth of knowledge that encompasses the core
compliances. Fellows consult on a broad range of clinical gastroenterological problems
including a wide range of general GI diseases, liver diseases, liver and small bowel
transplantations, intestinal rehabilitation as well as a wide range of nutritional disorders. Fellows
will interact with general pediatric residents and faculty as well as fellows and faculty from other
subspecialty divisions within Pediatrics, Radiology, Pathology and Surgery. Fellows will develop
diagnostic and therapeutic expertise in the areas of gastrointestinal, hepatologic and nutritional
disorders. Fellows will always behave responsibly and respectfully, with high quality
interactions with patients’ families, healthcare workers, physicians, nurses and ancillary staff.
The Pediatric-Gastroenterology, Hepatology and Nutrition fellows will gain proficiency in
the procedural skills of gastroenterology including upper endoscopy, colonoscopy, polypectomy,
biopsy techniques of the intestine, cauterization and injection of bleeding intestinal lesions,
sclerotherapy, band ligation, percutaneous gastrostomy tube placement, liver biopsy, intestinal
stricture dilatations, foreign body retrieval and ph probe placement. By the completion of the
three years of training the Fellow will have achieved competence and independence to practice
Pediatric Gastroenterology, Hepatology and Nutrition in the community.
INDEX OF COMPETENCIES:
PC=Patient Care; MK=Medical Knowledge; PBLI=Practice-Based Learning & Improvement; ICS=Interpersonal &
Communication Skills; PROF=Professionalism; SBP=Systems-Based Practice
The Fellow will:
Objective 1: (MK, ICS) Acquire and demonstrate knowledge about core areas in pediatric
gastroenterology, hepatology, and nutrition by:
Year 1
 Participating in daily multi-disciplinary Pediatric GI/Liver Attending rounds
 Attending pediatric GI didactic Fellows’ conferences, GI Grand Rounds, radiology and
pathology conferences and GI Journal Clubs.
 Teaching sessions with pediatric residents and students
 Attending and/or participating in General Pediatric Grand Rounds and Chief of service
rounds
 Demonstrating independent directed reading.
Year 2 – as above with the following additions:
 Preparing and presenting at GI Grand Rounds, GI Journal Club, GI didactic Fellows’
conference and Chief of service rounds
 Preparing and presenting at GI Combined Pediatric and Adult Gastroenterology
conference
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Preparing and presenting abstract submissions to local, national and international
conferences
Preparing and presenting IRB submissions for clinical studies
Year 3 – as above with the following additions:
 Preparing and presenting products of independent research
 Mentoring junior Fellows
Objective 2: (MK, PC, ICS, PBLI) Develop and demonstrate patient history-taking,
diagnostic, and management-planning knowledge and skills by:
Year 1
 Learning to take a focused history with emphasis on factors affecting GI/Liver/Nutrition
health and disorders in both the inpatient and outpatient setting
 Learning to recognize presentations of various gastroenterological liver and nutritional
diseases
 Learning to recognize modalities for diagnoses and treatment
 Learning to generate a differential diagnoses
 Learning to develop treatment plans in unison with the GI/Liver Attending
 Learning to effectively communicate treatment plan to pediatric residents, patient
families, nursing staff and other team members.
 Learning to communication the progression and outcomes of needed diagnostic and
therapeutic interventions
 Coordinating consultations with other pediatric and surgical subspecialties
 Coordinating discharge planning with social work and nursing staff
 Attending weekly Fellow continuity outpatient clinic
Year 2 – as above with the following additions:
 Honing skills acquired during the first year
 Developing greater independence with continued guidance by Attending Physician
Year 3 – as above with the following additions:
 Teaching and mentoring junior Fellows in the development of the skills perfected
throughout the fellowship
Objective 3: (PC, ICS, PBLI) Acquire and demonstrate patient management skills for
patients with acute and chronic diseases of the digestive system and liver by:
Year 1
 Learning through direct interaction and observation of the Attending Physician with
patient, family and staff
 Learning through assessment, presentation and discussion with the continuity clinic
Attending Physician
 Learning to recognize, prioritize, and act based on diagnostic and therapeutic needs
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Learning to describe the appropriate treatment interventions with emphasis on timing
and evolution of patient needs
Learning to make treatment recommendations in concert with Attending Physician and
associated treating health care workers
Coordinating patient care and discharge planning with pediatric housestaff, subspecialty
services, nursing, social work, family, referring physician and home care companies
Year 2 – as above with the following additions:
 Honing skills acquired during the first year
 Developing greater independence with continued guidance by Attending Physician
Year 3 – as above with the following additions:
 Teaching and mentoring junior Fellows in the development of the skills perfected
throughout the fellowship
Objective 4 (PC, MK, PBLI): Acquire and demonstrate the ability to perform
gastroenterology procedures by:
Year 1
 Learning the following procedural skills with close supervision provided by GI attending
physicians:
o upper endoscopy
o colonoscopy
o polypectomy
o biopsy techniques of the intestine
o cauterization and injection of bleeding intestinal lesions
o sclerotherapy
o band ligation
o percutaneous gastrostomy tube placement
o liver biopsy
o intestinal stricture dilatations
o foreign body retrieval
o ph probe placement
Year 2
 Continuing to improve clinical and procedural skills, mentioned above, through continuity
clinic, 2-3 week inpatient coverage, and participation in advance procedure rotations
Year 3
 Solidifying clinical skills through continuity clinic, 2-3 week inpatient coverage, and
participation in advance procedure rotations.
 Honing procedural skills through continued participation in the advanced procedure
rotation and performance of procedures on continuity clinic patients.
Objective 5 (ICS, Prof, SBP): Acquire and demonstrate ability to communicate in high
quality interactions with patients, families, and healthcare workers as well as physician,
nursing, and ancillary staff by:
Year 1
 Learning to provide patients and families with information in a way that is easy to
understand and culturally sensitive
 Demonstrating responsible and respectful behavior with patients and families.
 Learning to interact with general pediatric residents and faculty
 Learning to interact with faculty from other subspecialty divisions within Pediatrics,
Radiology, Pathology, and Surgery.
 Learning to communicate effectively with referring physicians and outside institutions
through correspondence, HIPPA compliant electronic communications and direct phone
contact
 Learning to field questions, gather information from outside sources, interpret data and
offer preliminary advise for further discussion with Attending physician
 Learning to limit discussions regarding patients and families to appropriate faculty and
staff in the appropriate and private venue
Year 2
 Continuing to develop and demonstrate competency in the above areas
 To model appropriate behavior and skills for junior Fellows
Year 3
 Solidifying and honing communication skills through continued adherence to the
developed standards
 Assuming a leadership and mentoring role for junior Fellows
Objective 6 (MK, PBLI): Acquire and demonstrate the ability to support one’s own
education and provide accessible information to patients by:
Year 1
 Learning to participate in the education of patients, families, medical students, residents,
and other fellows
 Learning to accept and use feedback to identify areas of need and set goals for
improvement
 Developing effective and efficient self-learning skills that include electronic resources,
published data and evidence-based practice
Year 2
 Demonstrating the ability to effectively teach patients and families within a learned scope
of practice supported by available data
 Demonstrating the ability to use feedback to set goals for improvement.
 Demonstrating the ability to teach medical students, residents, other fellows through
journal clubs and combined Pediatric/Adult GI clinical conferences.
 Demonstrating the ability to effectively lecture during Chief of Service Rounds, didactic
Fellows’ conference and GI Grand Rounds
Year 3
 Continuing to teach students, residents, GI Fellows, and in-rotating Fellows in formal
electives, through journal clubs and case conferences
Objective 7 (SBP): Demonstrate knowledge of important systems and regulatory
requirements of medical training and practice; and demonstrate adeptness in using the
system of care in a way that is beneficial and vital for excellent patient care by:
Year 1
 Active knowledge and participation in the hospital policy and procedures related to
medical errors and medication reconciliation with an understanding of reported problem
resolution
 Knowing and complying with rules and regulations of hospital/HIPAA policies
 Knowing and complying with rules and regulations of institution/Division/ACGME in
regards to moonlighting, duty hours, substance abuse and stress management
 Familiarity with American Board of Pediatrics guidelines for fellowship accreditation
 Knowing and complying with ongoing faculty and program evaluation
 Developing awareness/consideration of cost and risk benefit analysis in rendering
patient care decisions with understanding of resource allocation
 Recognizing the rules and regulations of the institution and governing bodies concerning
conflict of interest in medical decision making
Year 2
 Continuing to develop and demonstrate competency in the above areas
 Modeling appropriate behavior and skills for junior Fellows
 Developing familiarity with rules and regulations of the institutional IRB and Federal
regulatory commissions concerning basic science, clinical and animal research
 Recognizing the rules and regulations of the institution and governing bodies concerning
conflict of interest in medical research
Year 3
 Solidifying and honing skills learned in year one and two
 Assuming a leadership and mentoring role for junior Fellows
 Developing familiarity with rules and regulations regarding funding opportunities to
support research interests
Objective 8 (MK): Demonstrate the ability to work on original research by:
Year 1
 Indentifying a particular area of interest and the appropriate mentor for a research
project
 Formulating and initiating plans for future research (basic, clinical, or translational) under
the guidance of a selected mentor
 Reviewing the available literature and back ground pertaining to the area of research
and identifying gaps in knowledge to focus a research project with mentor guidance
 Presenting research ideas to the Scholarly Oversight Committee (SOC) in accordance
with the American Board of Pediatrics guidelines
 Using the critiques of the SOC to modify the focus and particulars of the proposed
research
Year 2
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Designing a project that is hypothesis driven with identified resource needs and that is
feasible in the remaining 2 years of Fellowship to produce a meaningful end-product
worthy of publication
Considering the elements of data collection guided by the foreseen statistical analyses
to be employed
Submitting the needed IRB support documents
Initiating the research project
Updating research progress to the Scholarly Oversight Committee (SOC) in accordance
with the American Board of Pediatrics guidelines
Year 3
 Completing the research project
 First authoring a paper, chapter, case report, and/or case series
 Submitting an abstract to a national meeting such as NASPGHN, AASLD, DDW and
ATC
 Presenting research as a poster or oral presentation at national meeting such as
NASPGHN, AASLD, DDW and ATC
 Presenting final research intra-departmentally and/or intra-institutionally
 Presenting final research to SOC for approval of scholarly work
 Guiding junior Fellows in the early stages of research development with lessons learned