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ACUTE Announces Eating Disorder Medicine Fellowship Training Program

We are please to announce that applications are now being accepted for our inaugural fellowship training program. Contact Dennis Gibson, MD, CEDS, ACUTE Medical Director, at Dennis.Gibson@dhha.org or 303-602-5067 for more information or to apply.

About the Fellowship

Fellows on ACUTE will be exposed to patient suffering from severe malnutrition secondary to various eating disorders. Throughout the course of the year, the fellow will develop an in-depth understanding of the pathophysiology of starvation, the litany of medical complications associated with starvation, the various treatment options for the resulting medical complications, and recognition and management of the refeeding syndrome. They will also become facile in the medical complications associated with purging and how to manage their resultant medical complications, electrolyte abnormalities, and fluid management. The fellow will be involved with the day to day medical decisions regarding their patients and will be the primary medical provider for his/her patients under direct supervision of one of the eating disorder attendings. They will be responsible for admission History and Physical, follow up progress notes, discharge summaries and daily communication with the multidisciplinary team. Discussion of pathophysiology, physical exam findings, laboratory findings, radiologic findings, and medical decision making will occur daily with the Attending on service. There will be extensive interaction with psychologists, registered dieticians, physical therapists, occupational therapist, and social workers as ACUTE operates as a multidisciplinary team.

Location

ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health (9 months) and a local residential eating disorder treatment center (3 months)

Length of Fellowship

12 months

PGY Level

PGY 4 and beyond

ACUTE Fellowship Goals and Objectives

  1. Fellow will understand the DSM-V diagnostic criteria for various eating disorders (anorexia nervosa- restricting and binge-purge subtype, avoidant/restrictive food intake disorder, bulimia nervosa, etc.).
  2. Fellow will know the pathophysiologic changes and adaptive mechanisms that occur to the human body during extreme starvation as a result of kcal restriction.
  3. Fellow will be able to recognize and treat the refeeding syndrome and learn modalities to prevent it.
  4. Fellow will understand the medical complications associated with starvation and their medical management.
  5. Fellow will understand the unique pathophysiologic changes associated with purging behaviors and learn how to manage the resulting medical complications.
  6. Fellow will know the overall medical management of patients with severe malnutrition stemming from various eating disorders.
  7. Fellow will know the clinical presentation, work up, and treatment options for patients suffering from superior mesenteric artery syndrome.
  8. Fellow will become familiar with the treatment options and side effects for the various medications used to treat constipation in the restricting as well as the laxative abusing eating disorder population.
  9. Fellow will know the clinical presentation, work up, and treatment options for gastroparesis.
  10. Fellow will know the clinical presentation, prevention strategies, and management options for the refeeding syndrome.
  11. Fellow will gain an understanding of the metabolic changes that occur with weight restoration and manage how to meet patients’ changing metabolic demands via dietary changes.
  12. Fellow will understand the pathophysiology of edema in both refeeding syndrome as well as pseudoBartter’s syndrome and learn management modalities for both.
  13. Fellow will recognize purging behaviors and modalities and learn how to manage their ensuing electrolyte abnormalities.
  14. Fellow will understand the diagnosis and treatment options for osteoporosis in adolescents/young adults.
  15. Fellow will gain knowledge on the rare medical manifestations that are frequently associated with extreme malnutrition.
  16. Fellow will be able to recognize patients admitted to the general medical floors that may be suffering from eating disorders in order to correctly diagnose and treat them.
  17. Fellow will recognize the psychosocial needs of these underserved patients.
  18. Fellow will gain expertise in the various psychological treatment modalities for patients suffering from an eating disorder.
  19. Fellow will know psychiatric treatment of these patients: meds and psychotherapy.

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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