Introduction to the Multidisciplinary Approaches to Celiac Disease

ME 517M.J Subject & Catalog Number

Description

This is a multidisciplinary, multicenter 4-week rotation about the management of adult and pediatric celiac disease. The course will take place in the ambulatory clinics at Boston Children's Hospital, Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Massachusetts General Hospital for Children. The medical student will evaluate under supervision patients with celiac disease at the time of their diagnosis and on follow-up during adult and pediatric GI clinics.  Students will be assigned patients at the beginning of each care session with the following expectations: 1. Review the chart prior to seeing the patient 2. Obtain history and perform physical exam 3. Develop and prioritize a differential diagnosis and problem list for each patient 4. Provide written and oral presentations of each patient 5. By the end of this rotation, students will place orders for appropriate treatment and evaluative testing (to be reviewed by the preceptor) , discuss assessment and treatment plans with the patient, deliver patient education and practice shared decision-making models (with the guidance of the preceptor). 6. Interpret all testing results both during and after the visit, and communicate with patients about these results. Patients will be seen initially by students alone; once the student has completed an oral presentation including assessment, workup, and treatment plans, the preceptor will see the patient and confirm the findings.

In addition to the clinical sessions, the student will attend individual nutrition counseling and group classes held by a pediatric and adult celiac dietitians. They will also participate to pathology rounds at Boston Children's Hospital and Massachusetts General Hospital for children, where slides of duodenal biopsies for celiac are reviewed. They will attend other clinics related to celiac disease (diabetes clinic). They will meet with the social worker and patient education director at Boston Children Hospital, to better understand the social and financial burden of the disease and  to get an overview of patient's engagement and education initiatives in the celiac community. Time will be spent with basic and clinical research teams in celiac disease.

The rotation will thus include 10 half day sessions per week, unless the student has other curricular activities with the medical school. Each half day session will be 4 hours (8AM-12PM) and 1-5PM). There will be at least one session per site (3) per week at the GI clinic, one session per site (3) per week with the dietitian and one full day per site with the research teams. The remaining sessions will be with other clinical disciplines, patient educators, social worker. The student will stay at the same site for the entire day, but may rotate between the sites during the week.

There will be recommended lectures, attendance to regional conferences in celiac disease (remote) and an oral presentation will be expected at the joint HMS Celiac Research program meeting at the end of the rotation.