Digestive diseases that affect the gastrointestinal (GI) tract and the liver have a major impact on the health of American people. They range from bothersome symptoms that result in primary care visits and outpatient GI consults to severe life threatening illnesses that require hospitalizations and costly medications or procedures. Scientific progress in the recent decades has shed much light on the pathobiology of various digestive diseases, which has led to novel means to prevention and intervention that have saved lives and improved quality of life of our patients. However, the burden of digestive diseases remains high, with incidence and mortality associated with some of the disorders actually increasing. There remains a large need for scholarly physicians to discover novel ways to prevent, diagnose and treat patients with digestive diseases. The singular mission of the Stanford University T32 Training Program in Gastroenterology is to recruit the most talented young physician scientists in basic, translational, clinical and population-based research and develop them into leaders of future academic gastroenterologists. Led by three co-program directors, the Training Program has a functioning governing structure consisting of Oversight, Selection, Mentorship and Evaluation Committees. Additional support is obtained from an Administrative Subcommittee and Advisory Council. The Program includes 38 faculty, consisting of members of the adult and pediatric GI Divisions and other scitentists who have strong track record of mentoring trainees in GI. The mentors cover a wide range of expertise including (1) basic biology of enteric and hepatic viruses and the development of novel therapeutic strategies; (2) host-microbiome interactions; (3) signal transduction in cancer biology; (4) mucosal immunology and the immunology of digestive diseases; (5) stem cell biology, (6) bioengineering and medical device development; (7) population science and epidemiology; and (8) health services and clinical outcomes research. Trainees spend two years working in a laboratory or in translational/patient-oriented research. For trainees in the latter category, a Master's degree program in epidemiology, health policy/services research or biomedical informatics is offered and financially supported. The Training Program is structured to optimize its operations in (1) selecting the best candidates, (2) identifying, selecting, and facilitating mentors to create the most productive research training experience, (3) monitoring trainees' progress and providing necessary support, and (4) critically evaluating the Program for continuous improvement. The trainees are largely drawn from fellows in the adult and pediatric clinical gastroenterology training programs who have already demonstrated a commitment toward pursuing an academic investigative career. Many of the trainees were selected through the Stanford Translational Investigator Program that identifies medicine residency applicants, highly motivated for an investigative career, wish to commit their fellowship training in digestive diseases. The program is enriched by Stanford's strong academic environment and commitment to training physician- scientist leaders of the future. This is exemplified by resources ranging from infrastructure, personnel, and financial support from the adult and pediatric GI Divisions to a diverse array of institutional programs promoting research and research education across campus. Thanks to these, for the past 41 years, the Training Program has been able to achieve its goal of providing the most promising candidates an opportunity to realize their career objectives in discovering new knowledge in digestive diseases and translating the information to reduce their burden in patients and community. Essentially all (89%) of our graduates are in an investigative career, a vast majority of them in academic institutions (73%). We propose to continue the strong tradition of physician-scientist training at Stanford University School of Medicine and seek to enhance it to best prepare our trainees for the future of digestive medicine.

Public Health Relevance

Digestive diseases have a large impact on the health of Americans and their healthcare, highlighting the need for qualified researchers for improving prevention, diagnosis and treatment of those conditions. The Training Grant in Academic Gastroenterology at Stanford University, throughout its existence for the past 41 years, has supported research training at Stanford University to prepare the best-qualified and highly motivated physician- scientists for an investigative career in digestive diseases. In addition to the strong track record and outstanding trainees, the strengths of the Training Program include experienced and engaged faculty, rich and collaborative academic environment and leadership committed to providing the best training possible to prepare our trainees as future academic leaders in digestive medicine.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Institutional National Research Service Award (T32)
Project #
2T32DK007056-42
Application #
9279602
Study Section
Kidney, Urologic and Hematologic Diseases D Subcommittee (DDK)
Program Officer
Densmore, Christine L
Project Start
1975-07-01
Project End
2022-06-30
Budget Start
2017-07-01
Budget End
2018-06-30
Support Year
42
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94304
Barakat, Monique T; Banerjee, Subhas (2018) SpyCatcher: Use of a Novel Cholangioscopic Snare for Capture and Retrieval of a Proximally Migrated Biliary Stent. Dig Dis Sci 63:3224-3227
Barakat, Monique T; Girotra, Mohit; Huang, Robert J et al. (2018) Scoping the scope: endoscopic evaluation of endoscope working channels with a new high-resolution inspection endoscope (with video). Gastrointest Endosc 88:601-611.e1
Barakat, Monique T; Girotra, Mohit; Banerjee, Subhas (2018) (Re)building the Wall: Recurrent Boerhaave Syndrome Managed by Over-the-Scope Clip and Covered Metallic Stent Placement. Dig Dis Sci 63:1139-1142
Barakat, Monique T; Huang, Robert J; Thosani, Nirav C et al. (2018) Liver transplant-related anastomotic biliary strictures: a novel, rapid, safe, radiation-sparing, and cost-effective management approach. Gastrointest Endosc 87:501-508
Barakat, Monique; Kothari, Shivangi; Sethi, Saurabh et al. (2018) Au Naturel: Transpapillary Endoscopic Drainage of an Infected Biloma. Dig Dis Sci 63:597-600
Barakat, Monique T; Kothari, Shivangi; Banerjee, Subhas (2018) Cut and Paste: Endoscopic Management of a Perforating Biliary Stent Utilizing Scissors and Clips. Dig Dis Sci 63:2202-2205
Barakat, Monique T; Thosani, Nirav C; Huang, Robert J et al. (2018) Effects of a Brief Educational Program on Optimization of Fluoroscopy to Minimize Radiation Exposure During Endoscopic Retrograde Cholangiopancreatography. Clin Gastroenterol Hepatol 16:550-557
Kwong, Allison J; Kim, W Ray; Flemming, Jennifer A (2018) De Novo Hepatocellular Carcinoma Among Liver Transplant Registrants in the Direct Acting Antiviral Era. Hepatology 68:1288-1297
Wei, Mike; Ford, Jason; Li, Qihan et al. (2018) Hospital Cirrhosis Volume and Readmission in Patients with Cirrhosis in California. Dig Dis Sci 63:2267-2274
Yu, Jessica X; Oliver, Melissa; Lin, Jody et al. (2018) Patients Prescribed Direct-acting Oral Anticoagulants Have Low Risk of Post-Polypectomy Complications. Clin Gastroenterol Hepatol :

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