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Gastroenterology is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometimes referred to as the GI tract, which includes the esophagus, stomach, small intestine and large intestine as well as the accessory organs of digestion which include the pancreas, gallbladder, and liver. The digestive system functions to move material through the GI tract via peristalsis, break down that material via digestion, absorb nutrients for use throughout the body, and remove waste from the body via defecation. Physicians who specialize in the medical specialty of gastroenterology are called gastroenterologists or sometimes GI doctors. Some of the most common conditions managed by gastroenterologists include gastroesophageal reflux disease, gastrointestinal bleeding, irritable bowel syndrome, inflammatory bowel disease (IBD) which includes Crohn's disease and ulcerative colitis, peptic ulcer disease, gallbladder and biliary tract disease, hepatitis, pancreatitis, colitis, colon polyps and cancer, nutritional problems, and many more.
Internal medicine, also known as general internal medicine in Commonwealth nations, is a medical specialty for medical doctors focused on the prevention, diagnosis, and treatment of internal diseases. Medical practitioners of internal medicine are referred to as internists, or physicians in Commonwealth nations. Internists possess specialized skills in managing patients with undifferentiated or multi-system disease processes. They provide care to both hospitalized (inpatient) and ambulatory (outpatient) patients and often contribute significantly to teaching and research. Internists are qualified physicians who have undergone postgraduate training in internal medicine, and should not be confused with "interns”, a term commonly used for a medical doctor who has obtained a medical degree but does not yet have a license to practice medicine unsupervised.
Residency or postgraduate training is a stage of graduate medical education. It refers to a qualified physician, veterinarian, dentist, podiatrist (DPM) or pharmacist (PharmD) who practices medicine, veterinary medicine, dentistry, podiatry, or clinical pharmacy, respectively, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant. In many jurisdictions, successful completion of such training is a requirement in order to obtain an unrestricted license to practice medicine, and in particular a license to practice a chosen specialty. In the meantime they practice "on" the license of their supervising physician. An individual engaged in such training may be referred to as a resident, registrar or trainee depending on the jurisdiction. Residency training may be followed by fellowship or sub-specialty training.
A fellowship is the period of medical training, in the United States and Canada, that a physician, dentist, or veterinarian may undertake after completing a specialty training program (residency). During this time, the physician is known as a fellow. Fellows are capable of acting as an attending physician or a consultant physician in the specialist field in which they were trained, such as internal medicine or pediatrics. After completing a fellowship in the relevant sub-specialty, the physician is permitted to practice without direct supervision by other physicians in that sub-specialty, such as cardiology or oncology.
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Pediatric gastroenterology developed as a sub-specialty of pediatrics and gastroenterology. It is concerned with treating the gastrointestinal tract, liver and pancreas of children from infancy until age eighteen. The principal diseases it is concerned with are acute diarrhea, persistent vomiting, gastritis, and problems with the development of the gastric tract.
Obesity medicine is a field of medicine dedicated to the comprehensive treatment of patients with obesity. Obesity medicine takes into account the multi-factorial etiology of obesity in which behavior, development, environment, epigenetic, genetic, nutrition, physiology, and psychosocial contributors all play a role. As time progresses, we become more knowledgeable about the complexity of obesity, and we have ascertained that there is a certain skill set and knowledge base that is required to treat this patient population. Clinicians in the field should understand how a myriad of factors contribute to obesity including: gut microbiota diversity, regulation of food intake and energy balance through enteroendocrine and neuroregulation, and adipokine physiology. Obesity medicine physicians should be skilled in identifying factors which have contributed to obesity and know how to employ methods to treat obesity. No two people with obesity are alike, and it is important to approach each patient as an individual to determine which factors contributed to their obesity in order to effectively treat each patient. Physicians specializing in obesity medicine may choose to obtain board certification by the American Board of Obesity Medicine.
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References
- 1 2 "Board of Directors". National Board of Physician Nutrition Specialists.
- ↑ Van Horn, L; Lenders, CM; Pratt, CA; Beech, B; Carney, PA; Dietz, W; DiMaria-Ghalili, R; Harlan, T; Hash, R; Kohlmeier, M; Kolasa, K; Krebs, NF; Kushner, RF; Lieh-Lai, M; Lindsley, J; Meacham, S; Nicastro, H; Nowson, C; Palmer, C; Paniagua, M; Philips, E; Ray, S; Rose, S; Salive, M; Schofield, M; Thompson, K; Trilk, JL; Twillman, G; White, JD; Zappalà, G; Vargas, A; Lynch, C (1 November 2019). "Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination". Advances in Nutrition. 10 (6): 1181–1200. doi: 10.1093/advances/nmz083 . PMC 6855992 . PMID 31728505.
- ↑ "Affiliated Organizations". American Society for Nutrition.
- ↑ Heimburger, Douglas C (1 June 2006). "Training and certifying Physician Nutrition Specialists: the American Board of Physician Nutrition Specialists (ABPNS)". The American Journal of Clinical Nutrition. 83 (4): 985S–987S. doi: 10.1093/ajcn/83.4.985S . PMID 16600961.
- ↑ "About Us". National Board of Physician Nutrition Specialists.
- ↑ Micic, D; McDonald, EK; Stein, AC; Semrad, CE (February 2018). "How to Obtain Training in Nutrition During the Gastroenterology Fellowship". Gastroenterology. 154 (3): 467–470. doi: 10.1053/j.gastro.2018.01.006 . PMID 29337152.
- ↑ Micic, Dejan (December 20, 2019). "Developing a career in nutrition support and small-bowel disorders". GI & Hepatology News.
- ↑ "NUTRITION FELLOWSHIP PROGRAMS". National Board of Physician Nutrition Specialists.
- ↑ "Obesity Medicine and Nutrition Fellowship Training Program". Boston University Medical Campus. Boston University.
- ↑ "Nutrition Support Service Fellowship". Brigham and Women’s Hospital.
- ↑ "Advanced Nutrition Fellowship". Children’s Hospital of Philadelphia. August 2019.
- ↑ "Clinical Nutrition Fellowship". Cleveland Clinic.
- ↑ "FELLOWSHIP IN NUTRITION FOR PHYSICIAN". Columbia University Medical Center.
- ↑ "Subspecialty Fellowship in Obesity Medicine and Nutrition". Massachusetts General Hospital.
- ↑ "Nutrition Fellowship Training Program". Memorial Sloan Kettering Cancer Center.
- ↑ "Gastroenterology, Hepatology & Nutrition". University of Chicago Section of Gastroenterology, Hepatology and Nutrition. University of Chicago.
- ↑ "Section of Nutrition Fellowships for Physicians". University of Colorado.