Welcome from the Program Director:
Dear Applicants,
Welcome to our fellowship program!
There are many excellent fellowship programs in pediatric gastroenterology - each with its own characteristics, strengths and weaknesses. As you explore different programs and begin to envision where you see yourself spending the next three or more years of your life, I think you will notice that our program stands out as unique.
We aim to train the next generation of academic pediatric gastroenterologists, who feel equally comfortable at the bedside and at the bench. Our graduates have distinguished themselves in all aspects of academic pursuit - from clinical medicine to basic, clinical and translational research. This track record reflects the motivation and intellectual level of our incoming fellows, the superb clinical and research mentoring provided by our faculty, and the truly unique academic environment at Washington University.
The Washington University School of Medicine is a world renowned research institution, and has produced seventeen Nobel Laureates. Our fellows have the opportunity to interact with world-class scientists in the Division as well as in other divisions and basic science departments. These interactions form the basis for research opportunities that are difficult to find elsewhere.
Finally, a word about St. Louis. Whether or not you are a Cardinals fan (you probably will be by the time you complete your fellowship), you will find that this city is beautiful, affordable, and offers something for everybody. I moved to St. Louis from Miami for my fellowship, and I have remained here ever since.
Please take the time to read about the program, and to get a taste of what makes it so special.
I look forward to speaking with you.
Sincerely,
Yumirle Turmelle, M.D
Assistant Professor of Pediatrics, Washington University in St. Louis
Medical Director, Liver Care Center
Fellowship Program Director
Turmelle_Y@kids.wustl.edu
Overview of the Program:
The fellowship in pediatric gastroenterology and nutrition is a nationally recognized three-year program and one of seven pediatric gastrointestinal programs which currently receive federal funding support in the form of an NIH training grant for pediatric gastroenterology research. It is officially accredited by the American College for Graduate Medical Education. Up to two fellows matriculate each year.
The fellowship program provides comprehensive clinical exposure and outstanding research opportunities, with exceptional clinical and research mentors. The unique combination of a rigorous clinical experience and supportive faculty devoted to promoting fellow learning and academic growth make for an intense learning experience. The research experience at Washington University is unparalleled, presenting fellows with the opportunity of working in world-class facilities with nationally and internationally renowned researchers.
Clinical Training - St. Louis Children's Hospital
In the first year, each fellow enters an intensive, comprehensive clinical program in pediatric gastroenterology, hepatology and nutrition designed to complete the full clinical training requirement. This includes approximately six months supervising the inpatient service, and approximately six months on the outpatient and procedure service. During the first year, fellows also experience two week-long electives - one in Pediatric GI Radiology and one in Pediatric GI Pathology. Additional electives can be arranged, depending on trainee interest.
Fellows also devote much time in the first year to learning how to scientifically approach clinical questions and critically review relevant medical literature. This process takes place during the division’s clinical conferences, approximately half of which are prepared and presented by the fellows.
During the second and third year, which are devoted to research, clinical training takes the form of a weekly continuity clinic. In the third year, fellows receive additional opportunities to hone their procedural skills by spending time with the adult procedure service.
All clinical training takes place in the St. Louis Children’s Hospital. Founded in 1879, St. Louis Children's Hospital is the oldest pediatric hospital west of the Mississippi River and one of the premier children's hospitals in the United States. The hospital has served patients from all 50 states and 60 countries across the world. It was ranked #5 on Parent’s Magazine’s 2011 list of the best children’s hospitals in the country. The Gastroenterology, Hepatology and Nutrition division cares for a broad range of patients in various settings, and fellows play a pivotal role in a large proportion of these encounters. Clinical settings include:
Inpatient: includes a busy gastroenterology service and consultations on patients admitted to other services. Endoscopies and other procedures are performed as needed, and urgent procedures may be performed 7 days a week, at any time of day or night.
Outpatient: includes a busy outpatient clinic and a pediatric ambulatory procedure center, where two full days each week are devoted to a variety of GI procedures.
In fellowship year 2009-2010, our division cared for 675 patients admitted to the Pediatric Gastroenterology Service and performed 279 consultations on patients admitted to other services. We saw 7008 patients in the outpatient clinic, and performed 389 upper endoscopies, 262 colonoscopies and 48 liver biopsies.
Our Liver Care center cares for patients with a wide variety of liver diseases, and provides medical care for the liver transplant patients. The Liver Transplant Service is composed of a highly skilled team of dedicated pediatric transplant surgeons, hepatologists, a nurse practitioner, nurse coordinators and a social worker. Children from 19 different states have received transplants at our center; average waiting time is 1.9 months, compared to 13.6 months nationally. In 2009, 14 liver transplants were performed in St. Louis Children’s Hospital.
Research Training - Washington University School of Medicine
During the first year, with the advice of the Program Director, trainees begin planning for an individualized program in clinical or basic science investigation. The investigational program is conducted during the second and third year of fellowship under the guidance of a mentor in one of the laboratories or research groups at Washington University Medical Center. During the two years of research training, each fellow is expected to develop a project of his or her own and to present results at weekly laboratory meetings, at Divisional and departmental seminars and at a national meeting. The goal is the development of a plan for continued research training, to compete for extramural funding and ultimately to establish an independent academic career. To best focus an individual’s investigative efforts during this two-year period, the fellow's clinical responsibilities are limited to regularly scheduled Divisional conferences, plus a well-defined continuity experience. The fellowship program at Washington University is unique in the unusually strong emphasis placed on protecting fellows’ time during their research years and even during the first year when searching for a project, in order that fellows may spend their second and third years truly immersed in research.
A multitude of basic and clinical research opportunities are available at the Medical Center. Research facilities for preclinical and clinical departments include the School of Medicine, the Clinical Sciences Research Building, and the McDonnell Pediatric Research Building, all of which are adjacent to Children's and Barnes-Jewish Hospitals. This proximity facilitates the interaction among scientists within clinical and preclinical departments, as well as with clinical researcher. Three of the pediatric GI faculty members hold joint appointments in basic science departments, which enhance their interactions with these departments and therein enhances the opportunities of our trainees to participate in the activities of these departments. We also have a close relationship with the adult GI program at Washington University. Our trainees have multiple opportunities to interact with faculty and trainees of a parallel, complementary and strong scholarly group of gastroenterologists.
The Washington University School of Medicine is a world renowned research institution, and has produced seventeen Nobel Laureates. During the federal fiscal year of 2009-2010, the School of Medicine received $596 million in research grants and contracts.One of the highlights of Washington University’s world class research activity is the Genome Center. The Genome Center is one of only three NIH funded large-scale sequencing centers in the United States. It began as a key player in the Human Genome Project, ultimately contributing 25% of the finished sequence. Today, the Center is one of the world leaders in the Human Microbiome Project, devoted to sequencing the human bacterial genome and its interaction with humans in states of health and disease. Researchers from both pediatric and adult gastroenterology at Washington University are involved in collaborative projects with the Genome Center to study the human microbiome as it relates to diseases such as inflammatory bowel disease and necrotizing enterocolitis.
Conferences and Educational Opportunities
Fellows are invited to participate in the broad array of high quality teaching and research conferences that are held regularly in the Division and throughout the institution. The following is a list of the regular Division conferences:
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Title
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Frequency
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Speaker/s
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Content
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GI Noon Conference
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weekly
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50% 1st year fellows
50% attending and senior fellows
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In depth evidence-based review of pertinent clinical questions and topics, or presentation of senior fellows’ research
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Fellow’s Didactic Lecture Series
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weekly
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Fellows
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Focused presentation of GI, nutrition and hepatology topics with board-style questions, designed to cover all of the ABP sub-specialty exam topics every 2-3 years
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Pathology Conference
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weekly
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Fran White, M.D.
(pediatric pathologist)
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Review of all pathology specimens (upper and lower endoscopy, rectal suction biopsy, liver biopsy and surgical specimens) from the previous week, with emphasis on recognition of important pathological findings
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Feeding Team Meeting
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monthly
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James Keating, M.D., Speech therapists, Occupational Therapists, Dieticians
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Presentation of illustrative or complex patients with feeding problems and teaching of fundamental feeding and nutritional topics
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GI-Surgery Joint Conference
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Bimonthly
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GI fellow and Pediatric Surgery attending
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Presentation and discussion of medical and surgical aspects of conditions with multidisciplinary relevance
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Additional Educational Opportunities:
All pediatric fellows are required to participate in a weekly Department Forum. The first half of each year is devoted to presentation of research projects by second year fellows. The second half of the year covers a core curriculum in ethics, along with lectures on a host of additional topics including: professionalism, systems-based practice, biostatistics and introduction to the IRB.
Second and third year fellows may take a broad array of courses at Washington University in order to improve proficiency in subjects related to basic and clinical research. Tuition support is provided as part of the NIH training grant. For example, last year our fourth year fellow completed a Master’s degree in Computer Science at Washington University, which will complement his research in computational genomics.
Program Timeline
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Year 1: Clinical Service – 12 months
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Alternating two-week periods of inpatient and outpatient service
Twice-weekly procedure days during outpatient service
Two week-long rotations towards the end of the year in pathology and radiology
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Year 2: Research – 12 months (with 10% of time spent providing patient care)
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Basic, translational or clinical research project
Weekly half-day fellow’s continuity clinic
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Year 3: Research – 12 months (with 10% of time spent providing patient care)
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Basic, translational or clinical research project
Weekly half-day fellow’s continuity clinic
Approximately six pediatric procedure days and approximately ten with Adult GI
Three weeks of inpatient service as “attending” (with attending support)
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Meet the Fellows
Current Fellows:
1st year fellows 
Nisreen Soufi, M.D. finished medical school in Damascus University in Syria. She completed residency in Pediatrics at St. Louis Children’s Hospital and stayed at Washington University for her Pediatric Gastroenterology fellowship.She plans to spend the next two years doing basic science research involving liver pathology. (soufi_n@kids.wustl.edu)
Jessica McGhee, M.D. (mcghee_j@kids.wustl.edu)
2nd year fellows
Brian DeBosch, M.D., Ph.D. earned his MD and PhD in Molecular Cell Biology at the Medical Scientist Training Program at Washington University School of Medicine. After completing a fast-track residency in Pediatrics at St. Louis Children's Hospital, Brian stayed at Washington University for his Pediatric Gastroenterology fellowship. He plans to spend the next three years building a program in basic science and translational research, elucidating the molecular mechanisms underlying pediatric obesity and development of the metabolic syndrome. (debosch_b@kids.wustl.edu)
Shannon Joerger, M.D. received her M.D. from the University of Missouri – Columbia. She completed her pediatric residency at St. Louis Children’s Hospital, and stayed at Washington University for her Pediatric Gastroenterology fellowship. She is currently studying the role of human intestinal goblet cells in antigen acquisition, under the mentorship of Rodney Newberry, M.D. (joerger_s@kids.wustl.edu)
3rd year fellows
Amy Garcia, M.D., M.S. earned a Masters of Science in Biology with emphasis in Immunotoxicology from the New Mexico Institute of Mining and Technology and then went on to receive her M.D. from the University of New Mexico. She completed her pediatric residency at the University of New Mexico Children’s Hospital. Her current research, under the mentorship of Deborah Rubin, M.D., focuses on an animal model of short gut syndrome where she is trying to define some of the molecular mechanisms responsible for intestinal adaptation following surgical resection. After her fellowship, she will be joining the faculty of Oregon Health and Science University in Portland, OR where she hopes to combine her passion for clinical medicine and teaching with some clinically relevant research. (Garcia_A@kids.wustl.edu)
Raffi Lev-Tzion, M.D. grew up in New York City and moved to Israel after college. He earned his M.D. from Ben-Gurion University of the Negev in Beersheba, followed by a four-year stint as a military physician. He completed his pediatrics residency at the Ben-Gurion University – affiliated Soroka Medical Center. He is currently exploring the pathogenesis of Crohn’s Disease by studying the quantitative expression of Crohn’s disease risk alleles in the human gut, under the mentorship of Dr. Phillip Tarr. After fellowship, he will be joining the faculty of Shaare Zedek Medical Center and the Hebrew University of Jerusalem in Israel. He plans to divide his time between clinical work and research of IBD pathogenesis in a population with a high prevalence of Crohn’s disease. (lev-tzion_r@kids.wustl.edu)
Program Graduates
Graduates of our program have made many important academic achievements, and occupy key leadership roles in institutions around the country and overseas. These include fellowship program directors, hepatology directors, GI division directors and the current president of NASPGHAN.
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Name
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Dates of Training
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Current Position
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Meredith Hitch, M.D.
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7/08-7/11
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Assistant Professor, University of Alabama Birmingham School of Medicine
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William Bennett, M.D.
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7/07 -7/11
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Assistant Professor, Indiana University School of Medicine
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Lori Holtz, M.D.
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7/06-6/09
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Instructor, Washington University School of Medicine
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Bernadette Vitola, M.D.
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7/06-6/09
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Assistant Professor, Medical College of Wisconsin
Pediatric Transplant Hepatologist
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Alex Weymann, M.D.
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7/05-6/08
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Assistant Professor, Washington University School of Medicine
Pediatric Transplant Hepatologist
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Sheela Deivanayagam, M.D.
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7/04-6/07
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Pediatric Gastroenterologist, Rockford Health Physicians (Rockford, IL)
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Eyad M. Hanna, M.D.
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7/04-6/07
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Clinical Assistant Professor, University of Iowa Children’s Hospital
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Yumirle Turmelle, M.D.
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7/03-6/07
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Assistant Professor and Fellowship Program Director, Washington University School of Medicine
Pediatric Transplant Hepatologist and Medical Director, Liver Care Center, St. Louis Children's Hospital
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Elizabeth Utterson, M.D.
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7/02-6/05
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Instructor,Washington University School of Medicine
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Douglas Lindblad, M.D.
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7/02-6/05
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Assistant Professor, University of Pittsburgh School of Medicine
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Eyal Shteyer, M.D.
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7/01-6/05
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Pediatric Gastroenterologist and Transplant Hepatologist, Hadassah-Hebrew University Medical Center
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Dawn Ebach, M.D
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7/01-6/05
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Clinical Assistant Professor, University of Iowa Children’s Hospital
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Viraine Weerasooriya, M.D.
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7/00-6/03
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Affiliate Assistant Professor- University of South Florida
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Joseph Palermo, M.D. , Ph.D.
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7/00-6/03
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Assistant Professor, University of Cincinnati College of Medicine
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Jae-Koo An, M.D.
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7/99-6-02
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Pediatric Gastroenterologist, Digestive Health Associates, Dallas, TX
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Dedrick Moulton, M.D.
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7/99-6-02
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Assistant Professor and IBD Program Director, Vanderbilt University School of Medicine
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Kirk Thame, M.D.
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7/98-6/01
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Assistant Professor, University of Alabama at Birmingham School of Medicine
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Living in St. Louis
St Louis is a vibrant community which has much to offer. We encourage you to look at Washington University's information page on our city.
Applying to the Program:
We participate in the Pediatric Gastroenterology Fellowship Match program. Applications should be submitted via the Electronic Residency Application Service (ERAS, https://www.aamc.org/services/eras/) which provides the opportunity to submit the ERAS application, a CV, MSPE’s (med student performance evaluations), ECFMG status report (where appropriate), letters of recommendation, a personal statement, medical school transcript, and USMLE transcript. Applicants typically provide 3 letters of recommendation.
Please address questions to Ariana J. Jasarevic
Telephone: (314) 286-2848
E-mail: jasarevic_a@kids.wustl.edu