Boston University Medical Campus
Gastroenterology

Fellowship Introduction

The fellowship program consists of four components: clinical activities, procedural training, educational curriculum, and research experience. The first year is devoted to clinical training and is divided between Boston Medical Center and the Boston VA Medical Center. Fellows and senior staff rotate night and weekend coverage for emergency consultations and procedures. Owing to the academic nature of our program, fellows are encouraged to develop their own teaching skills through active participation at rounds, seminars, and conferences. A full range of clinical and research conferences are available at the hospitals, and every week include: a gastrointestinal radiology or gastrointestinal pathology conference; GI Grand Rounds, and GI-Surgical rounds. GI Research in Progress and journal club are held monthly. In addition, numerous expert academic gastroenterologists from throughout the country are invited to speak at the Medicine and Gastroenterology Grand Rounds.

The following chart illustrates the approximate division of clinical and research responsibilities for each year of the fellowship:

During the second and third years, fellows train under the guidance of one of the GI staff members and carry out a research project under his/her direction. The research commences during the second year, but fellows are encouraged to begin background reading and preliminary discussions during the first clinical year. Fellows present their research work at local research seminars and, when appropriate, at local and national meetings. All fellows are expected to become authors of scientific or clinical papers in excellent peer-reviewed journals.

Fellowship Coordinators
Drs. Wolfe and Lowe are responsible for coordinating the educational activities of postdoctoral fellows in the Section of Gastroenterology, including two didactic lecture series in which attending physicians within the Section provide trainees with contemporary information related to their respective areas of expertise. In addition, clinic assignments are carefully coordinated to match the fellows with supervising attendings who share common interests. The fellows have a monthly meeting with Drs. Wolfe and Lowe, as well as ad hoc meetings throughout the year, to discuss any issues that may arise. All attending physicians assist fellows in the preparation of clinical and research presentations, including those within Boston University, as well as local and national meetings. The training of fellows assumes a high priority at Boston University, and the welfare and future success of our trainees is of paramount import to Drs. Wolfe and Lowe and all the attending staff.

Fellowship Training at Boston Medical Center
Boston Medical Center was established in July 1996 as a merger between Boston City Hospital and Boston University Medical Center Hospital. Boston Medical Center is the centerpiece of the municipal health care system for the City of Boston. The neighborhood health centers and the ambulatory care centers at Boston Medical Center provide care for a significant proportion of the urban population of Boston and form the principal referral base for the Section of Gastroenterology. The combined hospital consists of two campuses corresponding to the prior separate institutions:

The Menino Pavilion, formerly known as Boston City Hospital, is a 300-bed hospital, which offers a state-of-the-art inpatient facility, with 40 intensive care unit beds and the major emergency services for the City of Boston. The clinical experience the Menino Pavilion is focused on gastrointestinal and variceal hemorrhage, chronic liver disease, portal hypertension, viral hepatitis, chronic pancreatitis, HIV infection in the GI and pancreaticobiliary tracts, and gallstone disease. Fellows in Gastroenterology are responsible for the inpatient consultation service and see approximately 80 consultations per month.

The Newton Pavilion, formerly known as the Boston University Hospital, is also a modern, acute-care general hospital with approximately 250 beds, which includes 120 medical beds, many of which are in intensive care units. Fellows in Gastroenterology are responsible for the inpatient consultation service at East Newton as well, and see approximately 60 consultations per month. The clinical experience includes various digestive disorders, such as biliary tract disease, acid-peptic disorders, neuroendocrine tumors, inflammatory bowel disease, gastrointestinal hemorrhage, and gastrointestinal manifestations of cardiovascular and metabolic disorders. The outpatient clinics are currently located in the Moakley Building, adjacent to the Menino Pavilion. This state-of-the-art facility, which opened in 2006 houses several interdisciplinary ambulatory services; including gastroenterology, surgery, and others involved in the management of individuals with digestive diseases. Fellows are assigned one half-day outpatient clinic each week for the duration of their fellowship. On average, fellows will see up to three new patients and three to six established patients scheduled per session.

The basic research expertise offered in the laboratories at Boston Medical Center in the Evans Biomedical Research Building includes several disciplines. Three staff members are heavily engaged in examining the physiological role of gastric inhibitory polypeptide, as well as determining the transcriptional regulation of its gene. Moreover, the laboratories have recently begun to focus their efforts on research examining the molecular regulation of the gastric inhibitory polypeptide receptor. Other areas of research include transcriptional regulation of the gastrin-releasing peptide receptor and the determination of molecular mechanisms involved with trophic factors that govern the regulation of colorectal cancer, the role of gastrin in promoting neoplastic growth in the GI tract, and examination of the physiological role of cyclooxygenase isoenzymes (COX-1 and COX-2) in the GI tract. In addition to gastrointestinal regulatory peptide research, other areas of biomedical investigation within the Section of Gastroenterology include the role of mucins in the GI and hepatobiliary tracts and in the salivary glands, the use of embryonic and adult stem cells for gene transfer in the small intestine, and the regulation of pH gradients and fluid within the colon and other areas of the GI tract.

In addition to basic biomedical research, faculty members within the Section of Gastroenterology are engaged in outcomes, epidemiologic, and clinical research. Areas include screening strategies for colorectal cancer, the investigation of new therapeutic modalities for inflammatory bowel disease and irritable bowel syndrome, optimal screening and treatment of Barrett’s esophagus, and the treatment of hepatitis C. Furthermore, Dr. Nunes is co-investigator of a NIH grant award to Boston Medical Center to investigate patients co-infected with hepatitis C and HIV.