Pediatric GI

Pediatric Rotation
Tampa general Hospital


Goals and Objectives
Medical Knowledge:
    1. A knowledge of the effect of age on the pathophysiology of gastrointestinal disease and response to treatment. 
    2. An appreciation of the unique aspects of pediatric gastroenterology and an awareness of the clinical problems of pediatric gastroenterology. 
    3. A knowledge of the indications for and contraindications to endoscopic procedures in pediatric patients. 
    4. A knowledge of the indications for and contraindications to liver biopsy in pediatric patients. 
    5. A knowledge of nutritional assessment techniques and nutritional disorders in pediatric patients. 
Patient Care:
At the conclusion of the rotation the fellow will be able to:
  1. Obtain essential and accurate clinical information for decision making from patients and their families.
  2. Develop a thorough differential diagnosis.
  3. Diagnose and treat common pediatric disorders and perform standard endoscopic procedures in pediatric patients.
  4. Counsel and educate pediatric patients and their families.
  5. Provide preventative health care information to pediatric patients and their families.
Interpersonal and Communication Skills:
At the conclusion of the rotation, the gastroenterology fellow will:
  1. Be able to communicate accurate and concise information to pediatric patients and their families.
  2. Develop a sound therapeutic relationship with pediatric patients.
  3. Participate in and lead discussions with patient’s families.
The gastroenterology fellow will develop:
  1. A willingness to participate in a limited scope of care for pediatric patients when, in underserved areas, pediatric gastroenterology consultation is not available.
  2. The ability to interact with pediatric health care professionals including pediatricians, pediatric nurses, pediatric surgeons, and pediatric anesthesiologists.
  3. An appropriate sensitivity to age related issues.
  4. An understanding of the informed consent process and ability to apply this to obtaining informed consent for diagnostic procedures, and therapy in pediatric patients.
Practice Based Learning and Improvement:
The gastroenterology fellow will be able to:
  1. Educate himself/herself in issues related to the care of pediatric patients using available resources (online resources, books, library).
  2. Participate in the education of others including students, residents, and others in issues pertaining to the care of pediatric patients with gastrointestinal and liver disorders.
  3. Participate in quality assessment and quality improvement in the care of pediatric patients.
Systems Based Practice:
The gastroenterology fellow will:
  1. Strive to provide cost conscious care for pediatric patients.
  2. Consider patient’s health care coverage in developing a treatment polan.
  3. Determine the need for community involvement in care and the need for community support for both the patient and family.
  4. Act as a patient advocate.
  5. Suggest ancillary resources to assist with delivery of care including but not limited to dietary, social services, and support groups (CSA, Crohn’s and Colitis Foundation, ALF, etc).
  6. Advocate for systems improvement in the delivery of health care for all age groups.
Instructional Environment:
The pediatric elective rotation is based at Tampa General Hospital. It is under the supervision of Dr. Daniel McClenathan assisted by the other pediatric gastroenterology faculty. Gastroenterology fellows may rotate through this elective for one month in the third year of their training. This rotation will supplement the pediatric experience they obtain on the consultation rotations at Tampa General.
Tampa General Hospital is a USF affiliated tertiary care hospital with a 900 bed capacity. There is a separate pediatric unit and a pediatric ICU. Pediatric endoscopy is done in the Endoscopy Center. A full range of endoscopic procedures is done on pediatric patients including standard EGD and colonoscopy, ERCP, and motility studies.
Teaching Methods and Objectives:
The teaching program includes inpatient consultation, outpatient visits and endoscopic procedures. These are supervised by pediatric gastroenterology faculty with the exception of ERCP which is supervised by the adult gastroenterology faculty.
The rotation objective is to provide the gastroenterology fellow with training in the diagnosis and management of common pediatric gastrointestinal, liver, and nutritional problems. This is accomplished by seeing pediatric outpatients and inpatients under the supervision of a pediatric gastroenterologist. The experience will be primarily outpatient. However, selected inpatient consultations and follow-up visits , and and emergency consultations will also be seen. The fellow will also observe and actively participate in endoscopic procedures on pediatric patients.
While on the pediatric rotation, gastroenterology fellows will participate in regularly scheduled conferences, and prepare didactic presentations at the direction of the Chief of Pediatric Gastroenterology. Formal instruction obtained during the pediatric rotation will be supplemented by lectures given by the pediatric gastroenterologists during the regularly scheduled faculty lecture series at Tampa General Hospital.
Clinical Experience:
This rotation will emphasize age related physiological and psychological variables in children, and the unique aspects of gastrointestinal diseases in children. The resident will see, and evaluate patients with manifestations of commonly encountered problems including:
1. Abdominal pain
2. Constipation
3. Gastrointestinal bleeding
4. Diarrhea
5. Malabsorption
6. Pancreatic disorders including cystic fibrosis
7. Cholestatic syndromes
8. Congenital hepatobiliary syndromes
9. Hepatitis
The gastroenterology fellow will be evaluated by the pediatric gastroenterology attending during this rotation. Evaluation will be based on observation of the resident during rounds, procedures, and conferences. Skills will also be assessed by observation of the resident by the pediatric gastroenterology attending while taking histories, and during physical examinations. A formal written evaluation of the fellow will be submitted by the pediatric gastroenterology attending to the program director at the end of the rotation.
Pediatric Elective Rotation
Tampa general Hospital

Second and third year fellows completing a pediatric rotation will have a knowledge of the following:
1. Age related physiological and psychological variables of children
2. Unique aspects of GI disease in the pediatric patient
3. Manifestations of commonly encountered disease in the pediatric patient (abdominal pain, constipation, gastrointestinal bleeding, diarrhea and cystic
1. The ability to diagnose and initiate treatment for commonly encountered disease in the pediatric age group
2. The ability to perform upper gastrointestinal endoscopy and colonoscopy in pediatric patients

1. The resident must be aware of the clinical problems of pediatric gastroenterology and the fact that they require a different approach than adult problems.

2. The fellow must be prepared to participate in limited scope of care of pediatric patients when pediatric gastrointestinal consultation or endoscopic expertise is not available.