Advanced Inflammatory Bowel Disease Fellowship

Program Description

The Inflammatory Bowel Disease Center at BMC offers an advanced IBD fellowship training program to qualified candidates. The management of IBD is increasingly complex and marked by delays in diagnosis and wide treatment variation, attributable in part to gaps in knowledge of the range of available diagnostic and treatment options, including efficacy, safety, and side effects. Furthermore, the disease state often requires individualized management comprised of a combination of surgical and medical therapies, with emerging therapies currently under investigation. This experiential training exposes fellows to an additional year of research and patient care, which is essential to help prepare a gastroenterology fellow with the necessary skills for a career as a practicing clinician or as an academician/clinical investigator.

This one-year fellowship will include three days of outpatient and inpatient care and two days of time allocated to a research project. The fellow will participate in weekly GI grand rounds, weekly fellow rounds including monthly journal club, weekly IBD Live with the University of Pittsburg (via video link), biweekly radiology conference, and pathology conferences.

The Inflammatory Bowel Disease Center, led by Dr. Francis A. Farraye, offers specialized multidisciplinary care to patients suffering from Crohn’s disease or ulcerative colitis. More than 1850 unique IBD patients have been seen in the Center over the past three years. The IBD center team includes gastroenterologists, colorectal surgeons, nurse practitioners, radiologists, pathologists, rheumatologists, psychiatrists, obstetricians and gynecologists, and nutritionists. This includes three gastroenterologists and one NP with expertise in IBD, two colorectal surgeons, four GI radiologists, three GI pathologists, two dermatologists, two RNs, as well as a Pharm D and staff from OB/GYN, nutrition, behavioral health, and rheumatology. Our two colorectal surgeons see patients in the same physical space as the IBD staff allowing immediate access to consultations between the two services.

Research

Our faculty have successfully participated in CCFA Research Alliance studies, multiple investigator initiated studies and large pharmaceutical trials. IBD investigators collaborate with statisticians at the Boston University School of Public Health, basic scientists in the Boston University School of Medicine as well social scientists at the undergraduate campus at Boston University.

Present investigator-initiated studies include Clostridium difficle infection in IBD patients, health literacy in IBD patients, use of social media by IBD patients, subclinical liver fibrosis in IBD patients on thiopurines and methotrexate, immune responses to vaccination in patients on biologic agents, micro RNA profiles from IBD patients with and without colorectal neoplasia, Hepatitis B serologic profiles in patients on biologic agents, treatment of ileal pouch patients with serum-derived bovine immunoglobulin protein isolate and venous thromboembolism in IBD patients.

Program Goals

The goal of the advanced IBD fellow is to become an independent clinician and clinical investigator in the area of inflammatory bowel disease.

Clinical Goals (3 Days of Direct Patient Care – Comprises 60% of Fellowship)

  • Diagnose and treat patients with Crohn’s Disease and ulcerative colitis.
  • Manage the unique needs of the hospitalized IBD patient.
  • Diagnosis and management of hepatobiliary, cutaneous, joint and ophthalmologic manifestations of IBD.
  • Diagnosis and management of disease and treatment related adverse effects in IBD patients.
  • Management of patients with an ileostomy and after IPAA.
  • Treatment of the post-operative IBD patient.
  • Proper use of endoscopic and radiologic procedures to assess and monitor IBD patients.
  • Competence in endoscopy for the IBD patient including dysplasia screening, balloon dilation and chromo endoscopy.
  • Understand the importance of nutritional therapies for the IBD patient.
  • Comprehensive understanding of treatment regimens for patients with IBD, including anti-inflammatory agents, immune modulators and biologic agents.
  • Understanding anticipated future treatments for patients with IBD and where they will fit in the algorithm of IBD treatment.
  • Be cognizant of the costs in the diagnosis and management of the IBD patient.

Research Goals (2 Days Allocated as Research Time – Comprises 40% of Fellowship)

  • Initiate and complete a clinical research project in IBD.
  • Participate in ongoing clinical trials.

Evaluation

The Advanced IBD Fellow will meet monthly with Dr. Farraye and other members of the leadership to discuss progress and set goals for the remainder of the training. Quarterly, an ACGME Milestones Report will be generated and reviewed with the applicant, which encompasses the six core ACGME domains of Patient Care, Medical Knowledge, Practice Based Learning and Improvement, Systems-Based Practice, Professionalism, and Interpersonal Skills and Communication. The Milestone Report is based on the Internal Medicine Subspecialty Milestones Project. Deliverables of the Advanced IBD Fellow may include, but are not limited to: Presentations at national meetings including ACG, DDW and CCFA meetings, publications and academic IBD appointment.

Prerequisites

Candidates for the Advanced IBD Fellowship will have successfully completed and participated in a clinical project in Inflammatory Bowel Disease during their fellowship. The selection committee will reach out personally to the applicant’s mentor and fellowship director to discuss their performance as a GI fellow and potential for a career as an independent IBD clinician and investigator. Applicants with participation in a CCFA-endorsed IBD rotation as a fellow are encouraged, but not required.

How to Apply

Interested individuals can contact Dr. Farraye directly by email Francis.Farraye@bmc.org or phone 617.638.8339.