Pediatric Gastroenterology And Nutrition Fellowship Training At The Uniformed Services University

The Fellowship

The pediatric gastroenterology and nutrition fellowship program of the Uniformed Services University of the Health Sciences is a three year ACGME-accredited program designed to train active duty pediatricians for competency and subspecialty board
eligibility in pediatric gastroenterology and nutrition. The program exists in affiliation with the National Capital Consortium pediatric residency program at Walter Reed Army Medical Center and National Naval Medical Center.
Clinical training in the fellowship program is based at the Walter Reed Army Medical Center and National Naval Medical Center in affiliation with the National Capital Consortium residency program in Pediatrics. WRAMC houses a large tertiary
care referral center having pediatric gastroenterology clinics, a pediatric inpatient service and a pediatric intensive care unit. NNMC houses a large NICU and newborn service. Both institutions also offer general pediatrics clinics, which form the basis of a widespread network of outlying clinics from which urgent and routine outpatient referrals are generated. The University provides administrative support, library services and support, and extensive laboratory research facilities. In addition, satellite pediatric gastroenterology clinics are held on a monthly basis at Ft. Belvoir, VA, Ft Bragg, NC, and Quantico Marine Base, VA. Pediatric GI fellows and staff evaluate over 1000 new subspecialty patients annually.
The fellowship consists of 12 months of clinical service and 24 months in which to design and implement a basic science or clinical research project. An ongoing series of clinical and didactic conferences completes the fellowship curriculum.
The clinical experience provides intensive exposure to all aspects of the practice of pediatric gastroenterology, including inpatient and outpatient evaluation of patients with a wide diversity of conditions. The pediatric GI service performs approximately 350 procedures annually including upper endoscopies, esophageal stricture dilations, esophageal motility studies, foreign body extractions, intraesophageal pH monitoring, breath hydrogen studies, gastric and small intestine biopsies, intestinal intubations, percutaneous endoscopic gastrostomies, percutaneous liver biopsies, colonoscopies, colonic and ileal biopsies, colonic polypectomies, sigmoidoscopies, anorectal manometries, and rectal biopsies. Interventional management of upper and lower GI bleeding, balloon dilatations, variceal sclerotherapy, and ERCP capability are performed with the support of the adult gastroenterology staff. Endoscopic procedural and teaching capabilities are enhanced by a dedicated pediatric endoscopy unit equipped with a state-of-the-art video endoscopy system. The pediatric procedural facilities are augmented by a pediatric sedation recovery unit staffed with dedicated nursing personnel. The pediatric GI service also has access to a large adult endoscopy unit including fluoroscopic capability and a fully staffed recovery area. A complete GI motility and manometry unit is available as well as a computerized ambulatory esophageal pH monitoring system. The attending pediatric GI service staff is augmented by a pediatric radiologist, a pediatric surgeon, a pathologist, A GI motility and research technician, two nutritionists, a pediatric nurse practitioner and an endoscopy technician.
Fellows are required to participate in the design and implementation of a research project. In addition to the clinical research opportunities afforded by the diversity of patients, basic science research opportunities exist at the Uniformed Services
University of the Health Sciences, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, and the University of Maryland.

Objectives

To train active duty BE/BC pediatricians for competency and subspecialty board eligibility in Pediatric Gastroenterology and Nutrition.
To foster development of teaching skills to enhance trainee preparation for faculty roles in military residency teaching programs.
To provide the support, means, and encouragement for the development of research interests and capabilities.

Format

The pediatric gastroenterology fellowship is closely allied with the fellowship in adult gastroenterology (integrated WRAMC and NNMC fellowship). This program, under the direction of Inku Hwang, LTC, MC, USA consists of twelve board certified gastroenterologists. They offer an impressive resource of research knowledge and productivity as well as clinical expertise. The fellows and staff in the pediatric gastroenterology program participate in a number of joint conferences with this
group. These include a weekly clinical conference, weekly grand rounds, weekly physiology conference and monthly citywide GI grand rounds.
Sample Schedule
First Year:
1. Seven months Pediatric GI inpatient service.
2. Five months research.
Second Year:
1. Three months Pediatric GI inpatient service.
2. Nine months research.

Third Year:
1. One month supervisory clinical fellow (junior attending).
2. Ten months research.
3. One month liver transplant selective.

Participating Institutions

Consolidated pediatric services in the National Capital Area are offered at Walter Reed Army Medical Center and the National Naval Medical Center. To avoid duplication of services and in support of the combined National Capital Consortium Pediatric residency, a single 22 bed inpatient ward exists at Walter Reed Army Medical Center along with a 12 bed combined MICU/PICU with 4 beds reserved for pediatric patients. A 24 bed level II-III NICU exists at the National Naval Medical Center. This facility accommodates the 1500 deliveries each year at NNMC as well as referrals from other military treatment facilities in the NCA.
Regarding outpatient services, both facilities offer a general pediatric clinic, but Pediatric Gastroenterology subspecialty clinic is offered exclusively at Walter Reed Army Medical Center.

The Uniformed Services University of the Health Sciences offers a complete medical school curriculum, as well as several graduate programs in the basic medical sciences. Research opportunities and mentorship exist both within the Department of
Pediatrics and in other departments such as Medicine and Physiology. Resources include state-of-the-art equipment and comprehensive computer and library facilities, including Internet access.

Research

Ongoing research projects and areas of interest of the Pediatric Gastroenterology faculty and fellows currently include:
Eosinophilic esophagitis in children
Mucosal transport regulation in inflammatory bowel disease
Vaccine development for enteric E coli infections
Adherence and virulence factors in Helicobacter pylori infections in children
Clinical aspects of pediatric inflammatory bowel disease

Faculty

Karla J. AuYeung, MAJ(P), MC, USA
Arthur J. deLorimier, LTC, MC, USA Chief Pediatric Gastroenterology
Philip L. Rogers, COL(RET), MC, USA
Carolyn A. Sullivan, COL, MC, USA Fellowship Program Director

Adjunct Faculty

Van Hubbard, MD, PhD - NIH
Terez Shea-Donohue, PhD - University of Maryland
Andre Dubois, MD, PhD - USUHS Department of Medicine

Qualifications and Application

Candidates must be board certified or board eligible in Pediatrics and be active duty members of one of the Uniformed Services (Navy, Army, Air Force, Public Health Service). Applicants must apply through and be sponsored for postdoctoral training by the Graduate Medical Education office of their respective branch of service. Requests for training should list the Pediatric Gastroenterology Program of the NCC at USUHS as their site of choice. Application deadlines are usually in September and are determined by the individual services. Where feasible applicants are encouraged to visit the USUHS facilities and arrange personal interviews with faculty members. If a visit is not practical, applicants should contact the program director and submit a recent curriculum vitae to the section office.

For Further information contact:

Carolyn A. Sullivan, MD, COL, MC, USA
Fellowship Director
Pediatric Gastroenterology and Nutrition
Department of Pediatrics, Room 2J49
Walter Reed Army Medical Center
6900 Georgia Avenue, NW
Washington, DC 20307
(202) 782-0056 or 202-782-9737
DSN 662-0056
Fax (202) 782-8136
Email: Carolyn.Sullivan@na.amedd.army.mil

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