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Division Of Pediatric Gastroenterology, Hepatology And Nutrition
The Division of Pediatric Gastroenterology, Hepatology and Nutrition at Baylor College of Medicine consists of 45 faculty members and a support staff of 86 all dedicated to outstanding and compassionate patient care through evidence-based and expert practice achieved though research and education.
Expert state-of-the-art clinical care is provided for the entire range of diseases within Pediatric Gastroenterology, Hepatology, Nutrition, Pancreatology and Transplant Medicine focused in three hospital-based campuses – The Texas Medical Center, The West Campus and The Woodlands and multiple community based specialty centers. In 2019, the team conducted over 27,000 outpatient clinic visits, 3,700 endoscopic procedures (including 425 advanced procedures) and managed an in-patient hospital census of 20 to 40 patients. Multiple subspecialty clinical programs exist within the division including; aerodigestive diseases, celiac disease, eosinophilic gastrointestinal diseases, hepatology and liver transplantation, inflammatory bowel diseases, intestinal rehabilitation, neurogastroenterology and motility, pancreaticobiliary disease and viral hepatitis.
In addition, to the breadth and depth of the clinical care provided by the division of Pediatric Gastroenterology, Hepatology and Nutrition, the division has a strong tradition of academic and research excellence.
Clinical research activities include over 200 IRB approved protocols covering the spectrum of types of clinical research including randomized controlled trials, prospective observational studies, translational research, multi-centered database studies, expanded access protocols and various retrospective analyses. Clinical research is supported by a team of five highly skilled clinical research coordinators. Active collaboration in pharmaceutical supported studies brings novel therapies to the care of patients cared for by the division. A recently renovated basic and translational research facility houses state-of-the-art molecular investigations of biliary atresia, fatty liver disease, immune function, malnutrition and motility to name only a few of the active areas of investigation. The division is supported by numerous grants (including 1 T32, 2 U01, 3 K23, 1 K08 and 1 R03 awards from the NIH). The academic productivity of the division is highlighted by the publication of 84 peer-reviewed manuscripts in 2019.
Educational activities are critical to the successful completion of the mission of the Division of Pediatric Gastroenterology, Hepatology and Nutrition. Our team is involved in a wide range of educational programs with learners at all levels including medical students, residents, fellows and our clinical colleagues. Innovative approaches including the train-the-trainer program in endoscopy are characteristic of the divisions educational endeavors. A major training focus for the division is our Gastroenterology, Hepatology and Nutrition Fellowship along with our Pediatric Liver Transplant Medicine Fellowship. Innovative approaches to education exist in both of these programs including newly developed research training tracks. Advanced clinical skills (e.G. Advanced endoscopic procedures, inflammatory bowel diseases and neurogastroenterology /motility) may also be acquired in unique instructor level training programs.
Learn more about the Gastroenterology, Hepatology and Nutrition division at Texas Children's Hospital.
Pediatric Gastroenterology Fellowship Program
Our fellowship program is designed to provide subspecialty residents in gastroenterology with the background and experience to diagnose and manage patients with acute and chronic diseases of the digestive system (esophagus, stomach, intestines, liver, and pancreas), including those that are life threatening, and to conduct research in this specialized field. Residents will be guided in developing clinical judgment and procedural skills and in acquiring medical knowledge, humanistic qualities, and professional attitudes and behaviors that are appropriate for the pediatric gastroenterologist.
The goals of this program include developing decision making skills in cost-effective, efficient evaluation and management of a wide variety of presenting complaints; to train and develop skills in appropriate laboratory testing, procedures including indications, preparation, techniques and interpretations; and provide mentoring and opportunities for clinical or laboratory based research.
Our clinical curriculum involves broadly based experience with a wide range of pediatric patients having gastrointestinal problems. The patient population is sufficiently varied and complex diseases and volume ensure that residents have the opportunity to become clinically competent in the management of common as well as uncommon gastrointestinal, hepatobiliary, and pancreatic diseases in patients ranging from infancy through young adulthood. A strength of our program is that the subspecialty residents have their own set of patients that they follow continuously in clinic with rotating attendings, rather than rotating through clinics and seeing the patients of attendings. They have ongoing responsibility for the continuing care of patients with chronic gastrointestinal problems and have opportunities to provide consultation on a wide variety of patients to become familiar with the gastrointestinal manifestations of a broad spectrum of pediatric illnesses.
Program OverviewThe training component will include a core curriculum in the diagnosis, management and treatment of inpatients and outpatients with pediatric gastrointestinal, hepatic, pancreatic and nutritional disorders. The clinical procedural requirements are in alignment with North American Society for Pediatric Gastroenterology, Hepatology and Nutrition's minimum recommendations for achieving competence, to include EGDs, Colonoscopies, Liver Biopsies, Paracentesis; and exposure to other interventional procedures, i.E. PEGs, Sclerotherapy, Banding and Capsule Endoscopy.
The implementation of the curriculum will be through mentoring; inpatient care and consultations using the family-centered care model; GI procedures; formal didactic teaching and directed reading and discussion. The Fellow will spend at least one half day per week for the entire 3-year period in an ambulatory care clinic in which both new and continuing care patients are seen. There will also be the opportunity to work with a multidisciplinary team, consisting of; Faculty and support staff of PNP's, Nurses, GI Lab, Nutrition Support, Social Services, including interaction with Pediatric Surgery, Pathology, and Radiology services.
Breakdown of the 3-year fellowship1st Year Clinical- Inpatient rotation, outpatient clinical responsibility, procedural skill development.
2nd and 3rd years for development of research project leading to publication in a peer reviewed journal, ongoing outpatient continuity clinical responsibilities, and a rotation as attending in 3rd year.
10 months Inpatient GI
2 months elective
6 months General GI Clinic
6 months Subspecialty Clinic
Second Year10 months Research
2 months Inpatient GI
6 months General GI Clinic
6 months Subspecialty Clinic
Third Year10 months Research
6 weeks Inpatient GI
12 months General GI Clinic
Competency 1: Patient Care
Provide family-centered patient care that is development- and age-appropriate, compassionate, and effective for the treatment of health problems and the promotion of health.
Competency 2: Medical Knowledge
Understand the scope of established and evolving biomedical, clinical, epidemiological and social-behavioral knowledge needed by a pediatrician; demonstrate the ability to acquire, critically interpret and apply this knowledge in patient care.
Competency 3: Interpersonal Skills and Communication
Demonstrate interpersonal and communication skills that result in information exchange and partnering with patients, their families and professional associates.
Competency 4: Practice-based Learning and Improvement
Demonstrate knowledge, skills and attitudes needed for continuous self-assessment, using scientific methods and evidence to investigate, evaluate, and improve one's patient care practice.
Competency 5: Professionalism
Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diversity.
Competency 6: Systems-based Practice
Understand the role of members of the multidisciplinary health care team dealing with children with gastrointestinal problems.
Our clinical curriculum involves broadly based experience with a wide range of pediatric patients having gastrointestinal problems. The patient population is sufficiently varied with adequate volume to ensure that residents have the opportunity to become clinically competent in the management of common, as well as uncommon gastrointestinal, hepatobiliary, and pancreatic diseases. A strength of our program is that the Fellows have their own set of patients that they follow continuously in clinic with attending supervision, which allows for improved continuity and patient ownership. They have ongoing responsibility for the continuing care of patients with chronic gastrointestinal problems and have opportunities to provide consultation on a wide variety of patients to become familiar with the gastrointestinal manifestations of a broad spectrum of pediatric illnesses.
Multidisciplinary patient centered programs:
AeroDigestive Program
Colorectal Program
Gastrointestinal Eosinophilic Diseases Program
Hepatobiliary Program
Inflammatory Bowel Disorder Program
Intensive Feeding Program
Intestinal Rehabilitation Program
Liver Transplant Program
Weight Management Program
State of the art GI laboratory and endoscopy facilities perform number of diagnostic and therapeutic procedures which include:
Upper and lower endoscopy with biopsies
Polypectomies
Variceal Sclerotherapy and Banding
Foreign body removal from upper GI tract
PEG Placement
Dilatations
Percutaneous liver biopsies
PH/impedance study
Hydrogen Breath Testing
Anorectal Motility Testing
The Fellow will also have opportunities for intra-and extra departmental research and collaboration, especially with Adult GI program and Liver Transplant Program. There will be specialized rotations with Adult Gastroenterology and the Liver Transplant Service. The Fellow will have the opportunity to rotate through several multi-disciplinary clinics, including Eosinophilic disorders, Feeding Therapy, Inflammatory Bowel Disease, Colorectal Clinic, Intestinal Rehabilitation, Liver Transplant, and the AeroDigestive Program.
Teaching Staff:Jeanine Maclin, MD, MPH, Associate Professor, Fellowship Program Director
Mitchell B. Cohen, MD, Professor, Department Chair
Reed A. Dimmitt, MD, MSPH, Professor
Traci W. Jester, MD, RD,, Assistant Professor
Jose Mestre, MD, Professor
David Galloway, MD, Assistant Professor
Diana Montoya Melo, MD, Assistant Professor, Assistant Program Director
Nicholas CaJacob, MD, Assistant Professor
Cary Cavender, MD, Professor
Adam Cohen, MD, Assistant Professor
Helena Gutierrez, MD, Assistant Professor
Rachel Kassel, MD, PhD, Associate Professor
Sandeep Gupta, MD, Professor, Division Director
From the research perspective, the Fellow will learn basic research principles in which to develop a project, follow it through completion, and prepare the project for publication and presentation. The Fellow will have the opportunity to be both a student and teacher, as they will be involved in teaching residents and students. They will have supervised instruction in providing consultative services and communication with other physicians and other members of the healthcare team.
Division Research ActivitiesFaculty:
Simulation as a teaching tool in Pediatric Gastroenterology
Cohort Study of Disease Education and Medication Adherence in patients attending a specialized Pediatric Inflammatory Bowel Disease Clinic
Fellows:
Our fellowship program is designed to provide Fellows in gastroenterology with the background and experience to diagnose and manage patients with acute and chronic diseases of the digestive system (esophagus, stomach, intestines, liver, and pancreas), including those that are life-threatening, and to conduct research in this specialized field. Fellows will be guided in developing clinical judgment and skills and in acquiring medical knowledge, humanistic qualities, and professional attitudes and behaviors that are appropriate for the pediatric gastroenterologist.
The goals of this program include developing decision making skills in cost-effective methods, and efficient evaluation and management of a wide variety of diseases. We will groom Fellows to develop skills in appropriate laboratory testing procedures, including indications, preparation, techniques and interpretations. Our program provides mentoring and opportunities for clinical or laboratory based research as well.
Current Division QI ProjectsConstipation Project
No Show Project
OR Utilization
Journal ClubHeld monthly on Fridays
Pathology ConferenceHeld every Friday at 7:30 a.M.
Educational ConferenceHeld every Friday at 1p.M.
GI Radiology ConferenceHeld every other month on the 2nd Friday at 1:30 p.M.
Assistant Program Director
Pediatric Gastroenterology Fellowship - San Antonio
Content
The Pediatric Gastroenterology Fellowship in San Antonio is the first program of its kind in San Antonio. The Baylor College of Medicine Division of Pediatric Gastroenterology, Hepatology and Nutrition currently includes six faculty members and a support staff of 12.
The clinical training program is conducted under the auspices of CHRISTUS Children's and includes six clinical faculty members who perform more than 3,000 outpatient and more than 500 in-patient consultations annually. Research training will be supported by The Max and Minnie Tomerlin Voelcker Clinical Research Center and in association with the Texas Medical Center and benefits from abundant research resources of the center in general and of Baylor College of Medicine in particular. The division recruits one new fellow a year, for a total of three fellows in the program.
The goal of this training program is to educate pediatricians to become outstanding clinicians who can also compete at the cutting edge of clinical research in academia. The program is designed around the guidelines developed by the North American Society for Pediatric Gastroenterology and Nutrition, and is intended to allow trainees to meet the requirements for certification by the Sub-Board for Pediatric Gastroenterology of the American Board of Pediatrics.
All entrants must have completed the equivalent of three years of ACGME-accredited residency training in pediatrics and be board certified or board eligible in pediatrics from the American Board of Pediatrics.
See the curriculum page for more information about the program.
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