The goals of the gastroenterology rotation include assessment of patients with gastrointestinal complaints, the diagnosis and management of common gastrointestinal disorders, and introduction to endoscopy and other procedures unique to this specialty. Three junior residents rotate through the gastroenterology service at Children's Hospital Boston each month. The rotation consists of two inpatient blocks and one outpatient block, each lasting an average of ten days. All residents attend a didactic series that includes a weekly fellow-run seminar and 10 to 12 mini-lectures on basic subjects including gastroesophageal reflux disease, constipation, malabsorption, the pathogenesis of diarrhea, the diagnosis and treatment of inflammatory bowel disease, nutritional assessment, total parenteral nutrition, the approach to abdominal pain, neonatal cholestasis, and the evaluation of liver disease.
On the inpatient service, two residents, a first year fellow, a nurse practitioner, and a dedicated attending manage an average census of nine patients (range 5-20 patients) with a variety of severe gastrointestinal illnesses. Patient turnover is rapid on this service and an average of 60 patients are admitted each month. Rounds are held in the morning and include bedside teaching and a review of pertinent imaging studies.
Built into each month-long rotation is a 10 day, call-free outpatient block, during which residents attend clinic three mornings a week and observe endoscopic procedures on the other two mornings. In addition, residents attend outpatient cardiology clinics during this portion of the rotation.
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