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Education & Training

The gastroenterology and nutrition fellowship program offers the opportunity to work with a respected team of highly qualified physicians who have made contributions in areas such as liver disease and transplantation, inflammatory bowel disease, therapeutic endoscopy, short bowel syndrome and clinical translational research. This program is based on clinical learning, and augmented by didactic sessions and individual teaching/feedback.

Outpatients: Our ambulatory subspecialty practice is central to developing an understanding of acute and chronic diseases of the gastrointestinal tract, liver and pancreas; the impact of nutrition on growth and development; and psychosocial interactions that impact health and growth. It allows us to emphasize the interplay between different childhood development stages and manifestations of gastrointestinal disease, as well as the impact of social and emotional development, cultural/ethnic diversity, gender issues, health promotion, and disease prevention. First-year subspecialty residents see patients in person, present them to attending faculty, and receive individual instruction. Second- and third-year fellows also have direct patient contact.

Inpatients: First-year fellows will gain about 10 months of inpatient responsibility. This includes caring for gastrointestinal patients, as well as consulting on general pediatric patients and others. Referrals from subspecialty services, the Pediatric Critical Care Unit, and the Neonatal Intensive Care Unit often involve consideration of multiple, complex, medical issues. Second- and third-year fellows, respectively, have eight and four weeks of inpatient responsibility.

Procedural sessions: These activities include a wide range of commonly performed procedures, including upper endoscopy, colonoscopy, foreign body removal, liver biopsy, paracentesis, esophageal and rectal manometry, pH probe, lactose breath testing, and rectal biopsy.

Other advanced endoscopic procedures such as esophageal variceal banding/sclerosis, percutaneous gastrostomy tube placement, esophageal dilatation, and capsule endoscopy will be experienced. The principles of endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound, pancreatic stimulation tests, laser therapy, esophageal stenting, and other procedures will be taught.

Patient Conferences: In-person attendance at pathology and radiology conferences provides an opportunity to correlate clinical, endoscopic, pathological, and radiological findings in patients with a broad range of gastrointestinal and liver conditions.

Nutrition: A working knowledge of pediatric nutritional issues is a critical component of our training. In both outpatient and inpatient settings, fellows will gain practical experience determining normal needs, growth failure, malabsorptive conditions, deficiency syndromes, and nutritional needs of special populations. In addition, they will learn the principles of, and gain practice providing, enteral and parenteral nutrition.

Research and Quality Improvement: The fellows have expanded access to the highest quality research opportunities at CHAM and Albert Einstein College of Medicine (AECOM). For example, fellows have performed cutting edge research into basic hepatocellular pathophysiology. In partnership with the Marian Bessin Liver center for Research at Einstein, the fellows are working to understand the cellular processes and signaling networks that mediate liver injury from various causes, including drug toxicity and oxidative stress. Other research efforts focus on generating innovative approaches to pathophysiology, diagnosis, treatment and prevention of liver disease and investigating genetic mechanisms that may help predict individual responses to injury so that pharmacotherapy may be tailored to the patient’s anticipated clinical course. Current fellows have successfully studied the role of diet in intestinal stem cell biology. Translational research is also active with fellows studying the epidemiology of pediatric fatty liver disease and diagnostic accuracy various modalities of H. Pylori gastritis.

The Division of Pediatric Gastroenterology is part of a national quality improvement network called ImproveCareNow, which focuses on improving outcomes in patients with inflammatory bowel disease. Fellows participate in this innovative, teambased approach to medical care, helping to shorten recovery times and improve both medical outcomes and quality of life.

The current fellows and recent graduates of the fellowship program have been invited to present their research product –both translational and clinical- in many national and international meeting including Digestive Disease Week, American Association for the Study of Liver Diseases, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (National Meeting and World Congress) This recognition highlights the diverse and vibrant research opportunities for fellows.

CONTACT US TO LEARN MORE

Yolanda Rivas, MD
Director of Endoscopy
Director, Pediatric Gastroenterology and Nutrition Fellowship Program, The Children’s Hospital at Montefiore
Assistant Professor, Albert Einstein College of Medicine
Phone: 718.741.2450



Contact Gastroenterology & Nutrition at CHAM