Curriculum: Fellowship year 1

Our clinical programs provide care to children from Boston, New England, and around the world. In addition to participating in a busy ambulatory program in general gastroenterology, first-year fellows also work with faculty in established sub-specialty clinical programs, including inflammatory bowel disease, hepatology, llver and small bowel transplantation, endoscopy, nutrition, short bowel syndrome and intestinal failure, celiac disease, aerodigestive disorders, and motility.

The first year of fellowship is devoted almost entirely to building a core proficiency in clinical medicine. The year is divided into approximately 13 blocks of four weeks each. Each fellow completes rotations on the Consult, Inpatient, Hepatology, and Nutrition programs at Boston Children’s. One rotation is dedicated entirely to endoscopic proficiency. Two rotations are dedicated to education in parenteral and enteral nutrition on the Clinical Nutrition Service.

All fellows participate one half-day per week in an ambulatory teaching clinic, where they are precepted by experienced clinical faculty in diagnosing and managing pediatric patients referred for evaluation and management of a variety of acute and chronic GI conditions. First-year fellows also spend one-half day per week in our procedure unit.

Curriculum: Fellowship years 2 and 3

All fellows continue their weekly half-day ambulatory teaching clinic during years two and three of training. To broaden their training experience, fellows are permitted to substitute subspecialty clinics in place of their general teaching clinics up to twice per month during their second and third years of training. This allows fellows to customize their training contingent upon their career interests by choosing from multidisciplinary programs.

Second- and third-year fellows typically cover the clinical rotations for four to six weeks each year. All fellows are afforded substantive protected time to pursue research and career development opportunities.

Clinical didactics and conferences

Teaching conferences are available throughout the week within the division and on the wider Harvard/Longwood Campus. Dedicated teaching conferences for fellows include a Tuesday morning fellows conference series based on a core curriculum of pediatric gastroenterology, hepatology, and nutrition outlined by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN). This is a fellows-only conference that features teaching from guest faculty. On alternating Thursday afternoons, fellows participate in the Longwood Conference, during which GI trainees from Boston Children’s, Brigham and Women’s Hospital, and Beth Israel Deaconess Medical Center present interesting cases from their respective services. There is also a fellows boards review/pub trivia conference on alternate Thursday afternoons, providing a more casual opportunity for fellows to congregate. In addition, there are twice-weekly pathology conferences to discuss ambulatory and inpatient cases. Bimonthly conferences highlight ongoing basic or clinical research within the division and expose fellows to potential areas of investigation they may wish to consider during their second and third years of training.

Research curriculum: Training as an academic physician

All fellows graduate from our program with the clinical skill set and career development experience that will enable them to succeed in any large academic tertiary clinical program.

Training resources and opportunities

Fellows are provided with state-of-the-art training and career development pathways that are diverse and based on fellow interests.

Fellows interested in pursuing basic research are given the training and mentorship that will enable them to conceptualize, plan, and conduct hypothesis-driven research as independent investigators.
Basic research training underway in our division is drawn from a full spectrum of interrelated fields in intestinal biology that form the underpinnings of most acute and chronic intestinal diseases, including:

• epithelial cell and developmental biology
• innate and acquired mucosal immunology
• intestinal epithelial-microbial pathogenesis

Fellows interested in patient-oriented (translational) research receive mentorship and support to enable them to successfully pursue careers in areas such as:

• clinical trials
• global health
• intestinal and nutritional epidemiology
• outcomes research
• translational research in basic pharmacology

The Boston Children’s Hospital Institutional Center for Clinical and Translational Research (ICCTR) provides funding for translational research and infrastructure support. Support is also available to applicants with interests in other fields of GI-related basic or clinical research.

Fellows interested in qualitative and quantitative sciences receive mentorship and support to pursue careers in areas such as:

• development of evidence-based treatment algorithms
• medical education
• public policy and advocacy
• quality improvement
• systematic review of clinical practice

Formal course work and seminars

All trainees have opportunities to complete coursework relevant to their fields of interest.

Trainees in the basic sciences may choose to audit courses offered through graduate programs at Harvard Medical School and Harvard T.H. Chan School of Public Health. Trainees in clinical science typically complete academic coursework relevant to their research in basic epidemiology, study design, bioethics, and biostatistics. This can be obtained by enrolling in one of several degree programs at Harvard T.H. Chan School of Public Health or Harvard Medical School to obtain a Master of Science or Master of Public Health. Alternately, many web-based asynchronous educational opportunities are available through the Harvard Catalyst.

Trainees interested in pursuing careers in medical education can participate in one of the longitudinal educational programs available on the Longwood Medical Campus, including the Rabkin Fellowship in Medical Education (offered through the Shapiro Institute for Education and Research), the Macy Institute at Harvard Medical School, and the Harvard Medical School Academy Center for Teaching and Learning. Clinician-innovators may attend the Summer Program in Clinical Effectiveness, offered through the Harvard T.H. Chan School of Public Health. Several degree-granting programs are also available through competitive applications on the Harvard Medical School campus.

Mentoring and career development

All fellows receive individualized faculty mentoring and support during and beyond the three formal years of fellowship training.

A formal scholarly oversight committee (SOC) is assembled for each trainee starting in their first research year. The SOC includes a member of the training program steering committee as chair, the trainee’s primary mentor, and one to two invited faculty in the field relevant to the trainee’s academic program. The SOC acts analogous to a “thesis committee” and is charged with providing individualized guidance to each trainee. The SOC meets formally with the trainee twice each year and continues as a primary mentoring resource during the transition from fellow to faculty.