Fran Calvache Meyer, PhD

Based within the Yale Gastroenterology Functional and Motility program, the Digestive Health rotation is an immersive six-month experience in an integrated specialty GI clinic located in North Haven, CT. Fellows deliver care for adults with disorders of gut–brain interaction (DGBI) and GI motility disorders. Referrals most often involve: (1) targeted brain–gut behavioral therapy to reduce GI symptoms and strengthen coping; (2) brief psychotherapy to support adjustment to chronic GI conditions and quality-of-life challenges; (3) skills-based preparation for pre-procedural anxiety that can interfere with endoscopy or motility testing; and (4) assistance addressing adherence and health-behavior barriers around medication routines, bowel prep, therapeutic diets, or home pelvic-floor programs. Fellows see a broad range of upper and lower GI presentations – IBS, functional dyspepsia, chronic nausea, belching disorders and rumination syndrome, esophageal motility disorders, and pelvic-floor dysfunction – and learn to develop rich biopsychosocial conceptualizations and communicate clear, actionable recommendations to medical teams.

Training emphasizes practical, in-demand skills aligned with core clinical health psychology competencies. Fellows conduct focused GI consultations; deliver health-behavior interventions that remove psychological barriers to medical care; and provide brief, evidence-based brain–gut therapies to reduce physical GI symptoms. Interventions include GI-focused cognitive behavioral therapy, acceptance-based strategies, and relaxation/skills training, as well as gut-directed hypnotherapy. Gut-directed hypnotherapy is available through observation and co-therapy for all trainees; direct provision and supervision are reserved for fellows who complete a Level 1/introductory hypnotherapy course through ASCH or SCEH.

The rotation is deliberately interprofessional and rooted in real GI spaces. Fellows are invited to observe endoscopy and motility procedures, shadow GI physicians and advanced practice providers in clinic, and spend time with dietitians and pelvic-floor therapists to see how dietary and pelvic-floor interventions interface with brain–gut treatment. These opportunities help fellows learn more about GI conditions, the role of different team members, and how patients may experience different points of contact with their care system. As interests and schedules allow, fellows are also invited to functional/motility case conferences and selected GI didactics to build fluency in the language and flow of specialty medical care.

Interested fellows can also able design a mentored “footprint” project that outlives the rotation – for example, launching a brief skills group, creating a protocol for pre-procedure anxiety or nonadherence, or developing a patient-education toolkit. Those drawn to health-system design can learn Epic Clinical Building skills (questionnaires, note templates, dashboards) and contribute to a system-wide innovation with guidance from a certified Epic Physician Builder. Trainees also may learn strategies for neurodivergent-affirming care – particularly for autistic adults and adults with ADHD – using sensory-aware, concrete, and structured approaches. Spanish-speaking fellows may provide care in Spanish with bilingual supervision, and language access is supported through interpreters when appropriate.

The GI Motility Continuity Clinic Rotation provides Yale GI fellows with immersive, multidisciplinary training in the diagnosis and management of gastrointestinal motility and foregut disorders. Fellows gain hands-on experience with a broad range of motility evaluations, including high‑resolution esophageal manometry, pH impedance testing, EndoFLIP, and motility‑focused endoscopic procedures. Clinical experiences take place primarily at the North Haven Digestive Health Center, with additional integrated pelvic floor physical therapy exposure.

A defining feature of the rotation is its strong multidisciplinary, gut–brain–body focus. Fellows participate in two dedicated clinic sessions with GI Psychology, during which they receive direct training in core GI psychology concepts and have structured opportunities to observe and receive precepting on brain–gut behavioral therapy, focused GI psychology assessment, and interdisciplinary case formulation. Additional required activities include sessions with the GI dietician, shadowing motility diagnostic studies, and attending monthly multidisciplinary swallow meetings.

Fellows also complete a curated set of guideline‑based readings covering achalasia, GERD, functional gastrointestinal disorders, gastroparesis, IBS, and disorders of gut–brain interaction, helping to integrate clinical exposure with evidence‑based practice.