Gastroenterology and Hepatology

Components of Training

Core Training

• Clinical Gastroenterology
  Quality training should include a wide exposure to all gastroenterological diseases common in childhood. This should include hepatobiliary and pancreatic disease, clinical nutrition and cystic fibrosis. It is expected that you will gain first hand experience in the use and interpretation of commonly used laboratory tests of gastroenterological function.
  
• Desirable Options
  It is recommended that some experience is obtained in several subspecialty and related fields. These include, but are not limited to, infectious disease, anatomical pathology, immunology, cystic fibrosis, molecular biology, liver transplantation, diagnostic imaging and child psychiatry.
  
• Essential Procedural Skills
  Fibreoptic flexible upper gastrointestinal endoscopy and colonoscopy. You will be required to obtain Recognition of this experience through accreditation by the Conjoint Committee for recognition of Training in Gastrointestinal Endoscopy. It is also essential to obtain experience in liver biopsy techniques.
  
• Desirable (Optional) Procedural Skills
  Percutaneous Endoscopic Gastrostomy (PEG) and endoscopic placement of feeding tubes. Familiarity with Endoscopic Retrograde Cholangio-Pancreatography (ERCP) and stricture dilation is desirable, but practical competence is optional. The technique and interpretation of gastrointestinal manometry and oesophageal pH recording are both also important but optional skills.

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Research
It is strongly recommended that you undertake at least one year of full-time research. The purpose of this is to develop an understanding of appropriate research methodologies in laboratory and clinical settings, and the necessity for quality assurance. A mentor with an established research record should act as your supervisor.

Success in these activities will be demonstrated by publication, or proof of submission of, two or more significant projects to a journal of standing.
You are encouraged to gain recognition of your research activities by enrolling for a postgraduate degree such as an MD or PhD.

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Posts
Centres at which programs of Advanced Training in paediatric gastroenterology are undertaken should ideally have the following:

• Two or more full-time paediatric gastroenterologists or full-time equivalent in a tertiary paediatric hospital.
  
• Exposure to a broad clinical experience in gastroenterology, hepatobiliary disease and nutritional rehabilitation as well as relevant aspects of immunology, pathology, microbiology and pharmacology.
  
• Facilities for the safe performance of fibreoptic gastroscopy and colonoscopy, radiology ultrasound and nuclear medicine studies.
  
• A laboratory with facilities for functional assessment of the gastrointestinal tract. These should include breath testing, mucosal enzyme assays, pancreatic secretion studies, markers of intestinal malabsorption.
  
• A facility for the investigation of gastro-oesophageal reflux including prolonged oesophageal pH monitoring.
  
• Training posts should be evaluated at regular intervals and may be designated as suitable for limited periods.

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Assessment

• The general principles of assessment of Advanced Training have been outlined in the introduction
  
• You are to prepare and submit two or more articles for publication in a peer reviewed journal
  
• You are expected to attend or take part in at least one annual scientific meeting of the GE Society during the three years of training and also should attend, where possible, other meetings pertaining to your research
  
• You are required to maintain a log book which documents performance of skilful clinical procedures as required by the Conjoint Committee for Recognition of Training in Gastrointestinal Endoscopy
  
• A significant number of supervised gastroscopies and colonoscopies must be performed to allow you to develop competence and to gain accreditation from the Conjoint Committee.

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