- Email: [email protected]
Pediatric gastroenterology evolves rapidly
Gastroenterology News Anil K. Rustgi, Section Editor
New Executive Vice President at FDHN he AGA’s Foundation for Digestive Health and Nutrition (FDHN) has appointed Carol M. Dreher as Executive Vice President. Dreher, who will spearhead FDHN fund-raising efforts, brings to the foundation more than 18 years of senior-level fund development experience at major health and educational institutions. These include Scripps Clinic and Research Foundation in La Jolla, California; the Neurosciences Institute in San Diego; the University of California at San Diego; and the Johnsson Comprehensive Cancer Center at the University of California, Los Angeles. An alumna of UCLA, Dreher is a veteran of 3 major institutional fundraising campaigns, each having met targets in excess of $150 million. “Given the numerous improvements that research has brought to the practice of gastroenterology, the AGA governing board decided last year to dramatically increase funding for all aspects of digestive health research and public health education. To accomplish this, AGA is supporting a much broader and more aggres-
T
Pediatric Gastroenterology Evolves Rapidly rom its beginnings in the 1960s, pediatric gastroenterology, a subspecialty of pediatrics, emerged largely from internal medicine gastroenterology programs, which explains why many of its “senior” practitioners trained in adult gastroenterology after a pediatric residency, said Dr. W. Allan Walker, Conrad Taff Professor and Chair of Nutrition and Professor of Pediatrics at Harvard Medical School. “Those of us who started in the field, like I did,
F
sive fund-raising strategy though its foundation, FDHN,” Dreher said. The foundation plans to establish regional offices that will coordinate “broad-based funding programs,” she added. “Critical to our success will be working with member physicians throughout the country and grateful patients.” According to Dreher, physicians can play “distinct roles to advance health care philanthropy.” Among these are volunteering on FDHN committees, participa-
Carol M. Dreher
in the late ‘60s or early ‘70s, took the principles learned in adult patients and adapted them to pediatric patients.” Walker noted several factors that underscored the development of a field separate from internal medicine. One particular catalyst was the introduction of new diagnostic techniques that required special skills. Another catalyst was the development of complex new therapies for children with GI disorders that required careful monitoring, particularly for their possible effect on growth and development.
tion in regional or local committees, and helping to identify prospective donors. “Physicians can participate in the fund-raising process without having to ask for money,” Dreher noted. “They can be guest speakers who can present a strong message. Physicians tend to underestimate their status with the donor public and don’t fully realize the opportunity they have to encourage philanthropy.” “Raising funds for research is one of the most important ways we can dramatically change lives for better,” Dreher said. “I look forward to working with AGA physicians and other interested individuals to meet this important goal.” Along with raising funds in support of AGA’s research agenda, FDHN administers grants on behalf of the organization. In digestive disease public education, largely through a variety of print material including fact sheets and monographs, the foundation educates consumers, policymakers, and health care professionals about prevention, early detection, and new treatments for ulcers, colorectal cancer, viral hepatitis, and functional GI disorders. For more details on FDHN, go to www.fdhn.org
“The profound impact that many chronic gastrointestinal diseases have upon growth and the onset of puberty demonstrate that such children should be under the care of subspecialists trained to deal with gastrointestinal disease in children, rather than adult gastroenterologists.” In addition, there were the unique gastrointestinal conditions that specifically affected infants and were not seen in older children and adults: the inborn errors in bilirubin metabolism; digestive and absorptive genetic defects; the spectrum of GASTROENTEROLOGY 2002;123:3– 4
Gastroenterology News continued
metabolic liver disease, e.g., ␣1-antitrypsin deficiency, etc. These caused adult gastroenterologists to defer to their pediatric colleagues and for pediatricians trained in adult gastroenterology to be more in demand as consultants. In the United States, the 1980s witnessed the establishment of committees to determine guidelines for training in pediatric gastroenterology. This led to development of subspecialty boards, which were given for the first time in 1990 under the aegis of the American Board of Pediatrics and its Pediatric Gastroenterology and Nutrition subspecialty subboard. The boards, given every other year, have since certified more than 600 pediatricians. As a result of subspecialty boards, the Residency Review Committee
4
for Pediatrics has certified 35 training centers in pediatric gastroenterology in the United States. According to Walker, the 3-year formal training program must contain “a clinical or research experience that leads to a publication, a grant, or at least a formal project under a mentor. The director of training has to formally ‘sign off’ before trainees are allowed to sit for the Boards. Only boardcertified pediatricians can take the examination.” Currently, only Canada and the United States hold formal examinations in pediatric gastroenterology, where an estimated 800 to 1000 board-certified or board-eligible practicing physicians currently align their professional identities with the subspecialty. Europe is just now beginning to examine the issue of train-
ing programs in pediatric gastroenterology within the European Union. As with adult gastroenterology, the field has evolved to contain subsubspecialties such as hepatology, inflammatory bowel disease, motility, and nutrition. Research follows these interest areas. For example, as the field of mucosal immunology has expanded over the past decade, studies of the pathogenesis of Crohn’s disease and its management in children have received prominent attention at meetings. “This is an evolving field, and my personal view is that its strength lies in its ability to interdigitate–to move back and forth–with its parent group of adult gastroenterologists,” Walker said. Stories by Leslie Lang
New Executive Vice President at FDHN he AGA’s Foundation for Digestive Health and Nutrition (FDHN) has appointed Carol M. Dreher as Executive Vice President. Dreher, who will spearhead FDHN fund-raising efforts, brings to the foundation more than 18 years of senior-level fund development experience at major health and educational institutions. These include Scripps Clinic and Research Foundation in La Jolla, California; the Neurosciences Institute in San Diego; the University of California at San Diego; and the Johnsson Comprehensive Cancer Center at the University of California, Los Angeles. An alumna of UCLA, Dreher is a veteran of 3 major institutional fundraising campaigns, each having met targets in excess of $150 million. “Given the numerous improvements that research has brought to the practice of gastroenterology, the AGA governing board decided last year to dramatically increase funding for all aspects of digestive health research and public health education. To accomplish this, AGA is supporting a much broader and more aggres-
T
Pediatric Gastroenterology Evolves Rapidly rom its beginnings in the 1960s, pediatric gastroenterology, a subspecialty of pediatrics, emerged largely from internal medicine gastroenterology programs, which explains why many of its “senior” practitioners trained in adult gastroenterology after a pediatric residency, said Dr. W. Allan Walker, Conrad Taff Professor and Chair of Nutrition and Professor of Pediatrics at Harvard Medical School. “Those of us who started in the field, like I did,
F
sive fund-raising strategy though its foundation, FDHN,” Dreher said. The foundation plans to establish regional offices that will coordinate “broad-based funding programs,” she added. “Critical to our success will be working with member physicians throughout the country and grateful patients.” According to Dreher, physicians can play “distinct roles to advance health care philanthropy.” Among these are volunteering on FDHN committees, participa-
Carol M. Dreher
in the late ‘60s or early ‘70s, took the principles learned in adult patients and adapted them to pediatric patients.” Walker noted several factors that underscored the development of a field separate from internal medicine. One particular catalyst was the introduction of new diagnostic techniques that required special skills. Another catalyst was the development of complex new therapies for children with GI disorders that required careful monitoring, particularly for their possible effect on growth and development.
tion in regional or local committees, and helping to identify prospective donors. “Physicians can participate in the fund-raising process without having to ask for money,” Dreher noted. “They can be guest speakers who can present a strong message. Physicians tend to underestimate their status with the donor public and don’t fully realize the opportunity they have to encourage philanthropy.” “Raising funds for research is one of the most important ways we can dramatically change lives for better,” Dreher said. “I look forward to working with AGA physicians and other interested individuals to meet this important goal.” Along with raising funds in support of AGA’s research agenda, FDHN administers grants on behalf of the organization. In digestive disease public education, largely through a variety of print material including fact sheets and monographs, the foundation educates consumers, policymakers, and health care professionals about prevention, early detection, and new treatments for ulcers, colorectal cancer, viral hepatitis, and functional GI disorders. For more details on FDHN, go to www.fdhn.org
“The profound impact that many chronic gastrointestinal diseases have upon growth and the onset of puberty demonstrate that such children should be under the care of subspecialists trained to deal with gastrointestinal disease in children, rather than adult gastroenterologists.” In addition, there were the unique gastrointestinal conditions that specifically affected infants and were not seen in older children and adults: the inborn errors in bilirubin metabolism; digestive and absorptive genetic defects; the spectrum of GASTROENTEROLOGY 2002;123:3– 4
Gastroenterology News continued
metabolic liver disease, e.g., ␣1-antitrypsin deficiency, etc. These caused adult gastroenterologists to defer to their pediatric colleagues and for pediatricians trained in adult gastroenterology to be more in demand as consultants. In the United States, the 1980s witnessed the establishment of committees to determine guidelines for training in pediatric gastroenterology. This led to development of subspecialty boards, which were given for the first time in 1990 under the aegis of the American Board of Pediatrics and its Pediatric Gastroenterology and Nutrition subspecialty subboard. The boards, given every other year, have since certified more than 600 pediatricians. As a result of subspecialty boards, the Residency Review Committee
4
for Pediatrics has certified 35 training centers in pediatric gastroenterology in the United States. According to Walker, the 3-year formal training program must contain “a clinical or research experience that leads to a publication, a grant, or at least a formal project under a mentor. The director of training has to formally ‘sign off’ before trainees are allowed to sit for the Boards. Only boardcertified pediatricians can take the examination.” Currently, only Canada and the United States hold formal examinations in pediatric gastroenterology, where an estimated 800 to 1000 board-certified or board-eligible practicing physicians currently align their professional identities with the subspecialty. Europe is just now beginning to examine the issue of train-
ing programs in pediatric gastroenterology within the European Union. As with adult gastroenterology, the field has evolved to contain subsubspecialties such as hepatology, inflammatory bowel disease, motility, and nutrition. Research follows these interest areas. For example, as the field of mucosal immunology has expanded over the past decade, studies of the pathogenesis of Crohn’s disease and its management in children have received prominent attention at meetings. “This is an evolving field, and my personal view is that its strength lies in its ability to interdigitate–to move back and forth–with its parent group of adult gastroenterologists,” Walker said. Stories by Leslie Lang