Fellows usually enter the Research Training Period after having completed their clinical training. Fellows who enter the Research Track are selected during the application and interviewing process and prior to matriculation. It is anticipated that the Fellow will spend more than the 18 months remaining in the fellowship acquiring the necessary skills towards to become an independent investigator. The initial 24-36 months of research training is supported by National Institutes of Health (NIH) Institutional Research Training Grants. The Section of Digestive Diseases presently has two Institutional Research Training Grants, one in Investigative Gastroenterology and the other in Investigative Hepatology and has been extremely successful in obtaining funding from appropriate granting agencies for subsequent training. However, it is essential that the Fellow begin the application process to obtain funding early in his or her training period under the direction of his or her mentor and/or the program director.
Three major investigative directions are emphasized: gastroenterology, hepatology, and clinical investigation. The investigative training that the Fellow receives, whether it is basic science or clinical science research, includes both a core curriculum and supervised research under the direction of one or more preceptors. Preceptors will usually be members of the Digestive Diseases faculty, but use of preceptors outside of the Section of Digestive Diseases is also possible. Research preceptors may be identified before beginning the Fellowship or selected after a trainee has entered the program and becomes familiar with the work of the faculty. Each trainee has a research advisory committee that includes the preceptor and other members of the faculty. The purpose of the advisory committee is to provide guidance and support and monitor the trainee's progress toward becoming an independent investigator.
The Investigational Training Program in Gastroenterology supports trainees interested in acquiring research training in the physiology and pathophysiology of gastrointestinal tract function. The training program's faculty include investigators that study cell and molecular biology and physiology and pathophysiology of intestinal epithelium and the pancreatic acinar cell with particular emphasis on the mechanisms of intestinal ion transport as related to diarrheal disorders and cellular events related to the initiation of pancreatitis. Dr. Fred Gorelick is the Program Director for the Investigational Training Program in Gastroenterology.
The Investigational Training Program in Hepatology includes faculty who study cell and molecular biology of hepatocytes and bile duct cells, and the pathobiology of portal hypertension. The Klatskin Library is a resource that includes the records and slides from over 10,000 patients with liver disease. The Yale Liver Center provides both clinical and investigative resources for the study of liver diseases. It also fosters interactions between the faculty in the Section of Digestive Diseases and other faculty that perform research relevant to liver physiology and disease. Dr. Michael Nathanson is the Program Director for the Investigational Training Program in Hepatology. Dr. James Boyer is Director of the Yale Liver Center.
The Department of Internal Medicine maintains a Training Program in Investigative Medicine that leads to a Ph.D. degree. This program is designed to provide physicians with a period of advanced study following their clinical training. Trainees in Digestive Diseases are eligible to apply to the Investigative Medicine Program. This program emphasizes both disease-oriented and patient-oriented research training and consists of participating in courses that have been specifically designed for this program as well as preceptor-directed, hypothesis-driven research training. The usual time course for completion of all requirements for the Ph.D. is 4-5 years of fellowship training.
In addition to the above established training programs research training under the preceptorship of faculty outside of the Section of Digestive Diseases may be initiated on an individual basis. For example, past Fellows in Digestive Diseases have also trained with mentors in the Departments of Cellular and Molecular Physiology, Cell Biology, Biology, Pathology, and Genetics. Research activities at the School of Medicine are comprehensive and run a spectrum from the study of very basic biological processes to clinical and community-based research. Numerous interdepartmental and interdisciplinary programs are ongoing that promote cooperative research activities. Relevant activities centered within the Department of Internal Medicine are the Comprehensive Cancer Center, the General Clinical Research Center, Digestive Diseases (Liver) Center, and the Diabetes Center.
The resources of the School of Medicine are available to enrich the research training experience of Fellows in the Section of Digestive Diseases. The proximity of Yale University's clinical and basic science departments with Yale-New Haven Hospital creates a collegial environment where trainees can find direction in all aspects of their activities. This can range from advice on the details of new research techniques to formal lectures by the faculty and daily seminars of visiting clinicians and scientists from around the world.