In this article, current Ohio State University second year GI fellow and incoming IBD fellow Dr. Judy Daboul and second year Clinical Assistant Professor Dr. Antoinette Pusateri discuss their interest in Inflammatory Bowel Disease (IBD), their inspirations, and offer advice for trainees who are on the fence about subspecializing.
How did you first get interested in IBD? Did you come in wanting to subspecialize and when did you know that you wanted to pursue an additional fellowship?
JD: My start in gastroenterology fellowship was much like I suspected most trainees feel as they begin this next chapter of their lives: uncertain, undifferentiated, a little nervous and yet excited, nonetheless. It felt like a culmination of effort and focus had finally resulted in matching into a lifelong dream, but now what? Most of my inpatient experience was in hepatology, my research in motility, and outpatient experience a mix of hepatology and inflammatory bowel disease. With this varied background it felt best to come in with an open mind.
Moving along into my second year of fellowship, I began to feel pressure to decide if I wanted to subspecialize. This was an important time to seek mentorship and self-reflect. The things that drew me the most to medicine as a field were the ability to teach, not just my peers, but also patients and being able to participate in shared decision making. I also, as a woman in medicine of Syrian background, was hoping to be able to give back to underserved communities. I found that throughout all the years of training, these core concepts remained consistent. Inflammatory bowel disease as a field fit my interests so well. The rapidly evolving therapeutic landscape, the multidisciplinary nature of IBD management, and the opportunity to serve people of all walks of life including women of childbearing age and to provide care as they progress through pregnancy compelled me to pursue an IBD focused fellowship in my 3rd year.
AP: I was diagnosed with Crohn’s disease when I was 12 years old, and so from a young age I knew I wanted to become a gastroenterologist to give back to my community for the compassionate, lifesaving care that restored me to remission. Even with this passion and conviction, I had a similar feeling to Dr. Daboul when I got into fellowship: I was excited and a little overwhelmed by the breadth and depth of sub-specializations the field of Gastroenterology, Hepatology, and Nutrition had to offer. Working with sub-specialists in everything from IBD to advanced endoscopy, motility, transplant hepatology, pancreatology, colon cancer genetics and polyposis syndromes, I was inspired by their work, enthusiasm, mentorship and most of all, by the patients we were serving.
Do you have any special interests within IBD? How do you nurture and grow those interests?
AP: throughout medical school and residency, I always enjoyed point of care ultrasound, yet I was told that we could not see the intestines transabdominally because of bowel gas. I became intensely curious about challenging that paradigm. Upon review of the literature, I found that gastroenterologists from Europe to Australia had been performing intestinal ultrasound for the assessment of IBD for decades. My second year of fellowship I learned through social media about the International Bowel Ultrasound (IBUS) program, through which American gastroenterologists could be trained by international colleagues and earn certification in this technique. With the support of my division, I was accepted into the IBUS program during 3rd year IBD fellowship, completed my training in Milan, Italy, with that training and started the intestinal ultrasound program at The Ohio State University Wexner Medical Center.
JD: After I matched, the idea of becoming clinically competent in all the nuances of IBD in just one year initially seemed daunting enough that I initially did not even consider subspecializing further. But I credit Dr. Pusateri’s mentorship and infectious energy to be instrumental in inspiring an interest in intestinal ultrasound. With her support I was able to successfully apply to the Intestinal Ultrasound Group of the United States and Canada (IUSCAN) fellows training program and hope to further cultivate and grow this interest.
For trainees considering subspecialty paths within Gastroenterology, what advice do you have?
JD: My advice is to pay attention to what consistently captures your curiosity. What began as curiosity in IBD during fellowship evolved into a deep appreciation for the complexity of the disease, the resilience of the patients living with it, and the collaborative effort required to provide optimal care. I am grateful for the mentors who helped guide me and I look forward to the challenges and opportunities ahead.
AP: Ultimately the advice that I received, and that I would give trainees reading this today, was to follow your gut (we are gastroenterologists after all!) and be creative in the cultivation of my niche. My “why” was and remains to help all people living with IBD achieve remission and their wildest dreams. At the same time, I seized every opportunity to connect with faculty and find opportunities for mentorship. Now, I am paying forward for the opportunities I received to train Dr Daboul in intestinal ultrasound. All because I followed my gut and creatively cultivated my niche. And you can do the same: start today!
Authors
Judy Daboul, MD is a current second year Gastroenterology fellow at the Ohio State University Medical Center. She is excited to begin her third year of training as an inflammatory bowel disease fellow and to learn intestinal ultrasound to best serve her future patients.
Antoinette Pusateri, MD is an Assistant Professor in Gastroenterology, Hepatology and Nutrition at The Ohio State University Wexner Medical Center. She was born and raised in the Buckeye State and proud to serve her hometown community, specializing in the care of patients with inflammatory bowel disease with expertise in intestinal ultrasound, a non-invasive tool to assess disease activity and help patients achieve remission.