Postgraduate Training Details
The Division of Pediatric Gastroenterology, Hepatology, and Nutrition at the University of California, San Francisco (UCSF) has had an NIH-funded training program in Pediatric Gastroenterology/Nutrition since 1973. The program allows trainees the opportunity to work with members throughout the UCSF campus and affiliated institutions (e.g., UC Berkeley), utilizing the immense resources and faculty of this world-renowned university.
Clinical training activities in pediatric gastroenterology, hepatology, pancreatology, nutrition, and (including an Inflammatory Bowel Disease Program and Liver and Intestinal Transplantation Services) are centered at the UCSF Benioff Children’s Hospital, San Francisco. Multidisciplinary ambulatory specialty clinics are held at UCSF and at regularly scheduled outreach specialty clinics conducted in various locations throughout northern and central California.
- Melvin B. Heyman, MD, MPH, Professor of Pediatrics; Director, Training Program in Pediatric Gastroenterology/Nutrition; Director, Pediatric IBD Program
- Sue Rhee, MD, Professor of Pediatrics; Division Chief, Pediatric Gastroenterology, Hepatology, Pancreatology and Nutrition; Director, Training Program in Transplant Hepatology; Co-Director, Pediatric Pancreas Program
- James Bayrer, MD, PhD, Assistant Professor of Pediatrics; Assistant Director of Basic Science Research, Training Program in Pediatric Gastroenterology/Nutrition
- Hassan Hamandi, MD, Assistant Professor of Pediatrics
- Marjorie McCracken, MD, PhD, Professor of Clinical Pediatrics
- Philip Rosenthal, MD,
Professor of Pediatrics; Associate Director, Training Program in Pediatric Gastroenterology/Nutrition; Director, Pediatric Hepatology Research Program
- Patrika Tsai, MD, MPH, Associate Professor of Pediatrics; Director, Nutrition Support Service; Director, Pediatric Obesity Program; Director, Pediatric Celiac Program
- Emily Perito, MD, MAS, Assistant Professor of Pediatrics and Epidemiology/Biostatistics; Assistant Director of Clinical Science Research, Training Program in Pediatric Gastroenterology/Nutrition; Co-Director, Pediatric Pancreas Program
- Walter Sipe, MD, Assistant Professor of Pediatrics
- Kathryn Smith, MD, Assistant Professor of Pediatrics
- Sofia Verstraete, MD, MAS, Assistant Professor of Pediatrics; Assistant Director, Pediatric IBD Program
- Yvette Wild, MD, MPH, MAS, Assistant Professor of Pediatrics; Director, EGID Program
- Janet Wojcicki, PhD, MPH, Associate Professor of Pediatrics
Our program is board-certified by the ACGME and is classified as a PL-4 program, providing three or four years of training. The curriculum is oriented toward physicians preparing for academic careers in pediatric gastroenterology, hepatology, pancreatology, and nutrition. We aim to promote scientific and teaching experience and necessary clinical skills to prepare the trainee for these academic careers.
During one year (usually the 1st year), the trainee concentrates on intensive clinical training, with emphasis on diagnostic skills and systematic approaches to gastrointestinal problems. Two to three years are then protected and devoted to investigative training, experience in teaching, and instruction in preparation of scientific communications and research proposals.
Considerable flexibility is offered in the research years to allow for differences in background, interests, and experience of individual trainees and to tailor the training program to meet the needs and desires of each trainee. This also facilitates admission of qualified trainees with varying background experiences and future goals. Our goal is to help fellows develop research skills and start on a career track that they feel passionate about.
Faculty and trainees are jointly responsible for the care of patients admitted to the Pediatric Gastroenterology, Liver, and Pancreas service and participate in consultations requested by pediatricians and other subspecialists. Trainees supervise pediatric and other house officers in the care of all patients with primary gastrointestinal, liver, pancreas, and nutritional disorders and participate in consultations from outside hospitals and physicians.
Clinical training provides intensive experience in gastrointestinal, liver, pancreatic, and nutritional disorders of infancy and childhood, combined with meaningful exposure to major related clinical areas. During their clinical training, trainees are stationed in the Department of Pediatrics at the UCSF Benioff Children's Hospital in San Francisco. During their clinical year, trainees cycle in 3 week blocks: 2 weeks on the inpatient/consult service followed by 1 week doing endoscopic procedures (2-2.5 days), attending clinic (1-1.5 days), and developing their research (1 day). Clinical fellows take overnight call from home during their inpatient/consult weeks (M-Th) and are call-free during their outpatient weeks. Clinics are a combination of the fellows’ own continuity clinic and sub-specialty clinics within the division. Further training opportunities are also available in the gastroenterology training program in the Department of Medicine.
Standard procedures (upper and lower endoscopy, esophageal pH/impedance monitoring, liver biopsy) are performed by clinical trainees under direct faculty supervision. Specialized procedures such as polypectomy, esophageal stricture dilatations, percutaneous endoscopic gastrostomy (PEG) placement, anorectal and esophageal motility studies, capsule endoscopy, and breath analyses are performed assistance from and eventually assumed by pediatric gastroenterology trainees with particular interest in the specific procedures, with oversight by faculty. Other procedures such as ERCP are also available, if deemed appropriate for the training experience.
The faculty and trainees in the division conduct ward rounds daily while assigned to inpatient services. Other conferences within the division include weekly formal presentations on major topics in pediatric gastroenterology, hepatology, pancreatology, and/or nutrition, a semiannual research seminar at which ongoing or planned projects are presented and discussed, and a weekly review of pathologic specimens obtained in management of children with gastrointestinal disorders. Pathology conferences are attended weekly by all fellows and faculty. Radiology/interventional radiology and nutrition experiences are incorporated into the clinical training.
Our division is well-supported by UCSF Information Technology Services enabling high quality telehealth medicine and engagement with trainees at training sites away from the main UCSF Benioff Children's Hospital campuses for all division conferences and lectures.
In addition to general gastroenterology continuity clinic, all fellows have attend a variety of sub-specialty clinics including:
• Inflammatory Bowel Disease Clinic (including VEO-IBD with immunology, Surgery with Pediatric Surgery)
• Pancreas Clinic (often multi-disciplinary, with Endocrine, Surgery, Nutrition)
• Eosinophilic Gastrointestinal Disease Clinic (multi-disciplinary, with Allergy/Immunology)
• Celiac Disease Clinic
• Liver Clinic
• Liver Transplant Clinic
• Pediatric Obesity/NAFLD Clinic (WATCH Clinic, multi-disciplinary, with Endocrinology, Nutrition)
• Intestinal Failure/Rehabilitation Clinic
• Aerodigestive Clinics (multi-disciplinary, with ENT)
• Cystic Fibrosis Clinic (multi-disciplinary, with Pulmonology)
• Fontan-associated Liver Disease Clinic (multi-disciplinary, with Cardiology)
Our training program is designed for candidates planning serious and productive academic careers. Accordingly, training in scientific investigation occupies a central position in the program and is designed to provide a broad scientific basis combined with practical research experience. Trainees on the clinical service are urged to define the clinical problems they encounter in terms of testable hypotheses and to concentrate on processes rather than phenomena.
Trainees entering into the research phase of their training are free to initiate new projects with appropriate faculty preceptors or may choose to participate in ongoing research in with any investigator or research group throughout UCSF. Trainees may choose a clinical or basic science focus.
Each trainee focuses on one or two major areas in the context of which he or she will acquire special expertise in advance methodology, experimental design, data collection, and analysis of results. Research training opportunities include investigations at molecular, cell, animal and clinical levels. Under this training program, the trainee will have the opportunity to focus the research training in either basic science or clinical research. The basic science opportunities vary from biochemical and molecular to the developmental biology and pathophysiology laboratories. Clinical research may be based on patient care issues or extend into health policy and outcomes research. A unique relationship of our program with the UCSF Department of Epidemiology and Biostatistics and the Institute for Health Policy Studies encourages this area of investigation. Clinical research training can be augmented and facilitated by the Advanced Training in Clinical Research Program at UCSF. Dedicated preceptors with varying interests and expertise are available and committed in all of the research areas offered.
Trainees have the opportunity to enroll in biostatistics, ethics, and other pertinent courses in the area(s) of interest and to attend informal seminars on the basics of scientific writing, oral presentation, and preparation of research proposals.
Trainees are actively involved in teaching rotating medical students and residents in pediatric gastroenterology, and presenting seminars at division grand rounds and journal clubs.
Clinical training activities in pediatric gastroenterology, hepatology, pancreatology, nutrition are centered at the UCSF Benioff Children’s Hospital, San Francisco. Our program will be expanding to offer fellowship training opportunities at UCSF Benioff Children’s Hospital, Oakland as well. Multidisciplinary ambulatory specialty clinics are held at UCSF and at regularly scheduled outreach specialty clinics conducted in various locations throughout northern and central California.
Nonacademic support staff includes pediatric nurse practitioners and clinical nurse specialists (specialized in parenteral and enteral feeding, pancreatology, inflammatory bowel disease, and hepatobiliary disease including liver transplant), feeding therapists, clinical nutritionists, and full-time social workers. Staff research associates and research study coordinators assist with clinical research programs.
Our program offers up to 3 gastroenterology and 1 hepatology (4th year) training position each year. Three are funded by a NIH T32 Training Program grant in Pediatric Gastroenterology and Nutrition; other positions are funded through other mechanisms including Cystic Fibrosis Foundation Clinical Fellowships. The research activities of the program are funded by grants to individual investigators in the program and their various departments and research institutes at UCSF.
For our NIH-sponsored research training, United States citizenship or permanent residency is required. Completion of three years of general pediatric training and Pediatric Board certification/eligibility are expected before beginning subspecialty training. However, this is not an absolute requirement, and exceptions may be made on an individual basis (e.g. for PhDs). Applications are made thru ERAS each summer (for the Fall Match). Please note the requirement for three or more letters of recommendation. Please also submit a short description of your career goals, as noted in the application. An interview will be arranged upon receipt of the completed form and letters of recommendation. Members of under-represented minorities are encouraged to apply.
Thank you for your interest in our program. Please contact us should you require additional information.
Interested applicants - please submit applications through ERAS (Electronic Residency Application Service)
James Bayrer, MD
Interviews are by invitation only.