DrNB Medical Gastroenterology: Admissions, Medical Colleges, Fees, Eligibility Criteria details

DrNB Medical Gastroenterology or Doctorate of National Board in Medical Gastroenterology also known as DrNB in Medical Gastroenterology is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course. The duration of this super specialty course is 3 years, and it focuses on the study of the human digestive system and the diagnosis and treatment of diseases related to it.

The course is a full-time course pursued at various accredited institutes/hospitals across the country. Some of the top accredited institutes/hospitals offering this course include Amala Institute of Medical Sciences-Kerala, Apollo BGS Hospital- Karnataka, Apollo Hospital (Unit International Hospitals)- Assam, and more.

Admission to this course is done through the NEET-SS Entrance exam conducted by the National Board of Examinations, followed by counseling based on the scores of the exam that is conducted by DGHS/MCC/State Authorities.

The fee for pursuing DrNB (Medical Gastroenterology) varies from accredited institutes/hospital to hospital and may range from Rs. 1,25,000 to Rs. 3,00,000 per year.

After completion of their respective course, doctors can either join the job market or can pursue certificate courses and Fellowship programmes recognized by NMC and NBE. Candidates can take reputed jobs at positions as Senior residents, Consultants etc. with an approximate salary range of Rs. 4 Lakh to Rs. 45 Lakh per year.

DNB is equivalent to MD/MS/DM/MCh degrees awarded respectively in medical and surgical super specialities. The list of recognized qualifications awarded by the Board in various broad and super specialties as approved by the Government of India are included in the first schedule of the Indian Medical Council Act, 1956.

The Diplomate of National Board in broad-speciality qualifications and super speciality qualifications when granted in a medical institution with attached hospital or in a hospital with the strength of five hundred or more beds, by the National Board of Examinations, shall be equivalent in all respects to the corresponding postgraduate qualification and the super-speciality qualification granted under the Act, but in all other cases, senior residency in a medical college for an additional period of one year shall be required for such qualification to be equivalent for the purposes of teaching also.

What is DrNB in Medical Gastroenterology?

Doctorate of National Board in Medical Gastroenterology, also known as DrNB (Medical Gastroenterology) or DrNB in (Medical Gastroenterology) is a three-year super specialty programme that candidates can pursue after completing a postgraduate degree.

Medical Gastroenterology is the branch of medical science dealing with the study of the human digestive system and the diagnosis and treatment of diseases related to it.

The National Board of Examinations (NBE) has released a curriculum for DrNB in Medical Gastroenterology.

The curriculum governs the education and training of DrNB in Medical Gastroenterology.

The postgraduate students must gain ample knowledge and experience in the diagnosis, treatment of patients with acute, serious, and life-threatening medical and surgical diseases.

PG education intends to create specialists who can contribute to high-quality health care and advances in science through research and training.

The required training done by a postgraduate specialist in the field of Medical Gastroenterology would help the specialist to recognize the health needs of the community. The student should be competent to handle medical problems effectively and should be aware of the recent advances in their speciality.

The candidate is also expected to know the principles of research methodology and modes of the consulting library. The candidate should regularly attend conferences, workshops and CMEs to upgrade her/ his knowledge.

Course Highlights

Here are some of the course highlights of DrNB in Medical Gastroenterology

Eligibility Criteria

The eligibility criteria for DrNB in Medical Gastroenterology are defined as the set of rules or minimum prerequisites that aspirants must meet in order to be eligible for admission, which includes:

Note:

• The prior entry qualifications shall be strictly in accordance with Post Graduate Medical Education Regulations, 2000 and its amendments notified by the NMC and any clarification issued from NMC in this regard.
• The candidate must have obtained permanent registration with any State Medical Council to be eligible for admission.
• The medical college's recognition cut-off dates for the Postgraduate Degree courses shall be as prescribed by the Medical Council of India (now NMC).

Admission Process

The admission process contains a few steps to be followed in order by the candidates for admission to DrNB in Medical Gastroenterology. Candidates can view the complete admission process for DrNB in Medical Gastroenterology mentioned below:

• The NEET-SS or National Eligibility Entrance Test for Super specialty courses is a national-level master's level examination conducted by the NBE for admission to DM/MCh/DrNB Courses.
• Qualifying Criteria-Candidates placed at the 50th percentile or above shall be declared as qualified in the NEET-SS in their respective specialty.
• The following Medical institutions are not covered under centralized admissions for DM/MCh courses through NEET-SS:

1. AIIMS, New Delhi and other AIIMS

2. PGIMER, Chandigarh

3. JIPMER, Puducherry

4. NIMHANS, Bengaluru

• Candidates from all eligible feeder specialty subjects shall be required to appear in the question paper of the respective group if they are willing to opt for a superspecialty course in any of the super-specialty courses covered in that group.
• A candidate can opt for appearing in the question papers of as many groups for which his/her Postgraduate specialty qualification is an eligible feeder qualification.
• By appearing in the question paper of a group and on qualifying for the examination, a candidate shall be eligible to exercise his/her choices in the counseling only for those superspecialty subjects covered in the said group for which his/ her broad specialty is an eligible feeder qualification.

Fees Structure

The fee structure for DrNB in Medical Gastroenterology varies from accredited institute/hospital to hospital. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for DrNB in Medical Gastroenterology is around Rs. 1,25,000 to Rs. 3,00,000 per year.

Colleges offering DrNB in Medical Gastroenterology

There are various accredited institutes/hospitals across India that offer courses for pursuing DrNB in Medical Gastroenterology.

As per the National Board of Examinations website, the following accredited institutes/hospitals are offering DrNB (Medical Gastroenterology) courses for the academic year 2022-23.

Syllabus

A DrNB in Medical Gastroenterology is a three years specialization course that provides training in the stream of Medical Gastroenterology.

The course content for DrNB in Medical Gastroenterology is given in the NBE Curriculum released by the National Board of Examinations, which can be assessed through the link mentioned below:

Broad guidelines

1. For a broad sub specialty like Medical Gastroenterology it is difficult to decode limits of syllabus .

2. Science is very progressive and ever advancing so every candidate getting trained is advised to keep following the developments closely

3. The objective of the syllabus is an outline of scope of available theory.

i) Basic Sciences

Anatomy and Physiology

• Immune system of the gastrointestinal tract (GIT) and its importance in various GI disorders

• Molecular biology in relation to GIT

• Genetic diseases of the GIT and the liver

• Gene therapy

• GI tumors and tumor biology

• Gastrointestinal hormones in health and diseases

• Embryology of the gut, liver, pancreas and congenital anomalies

• Enteric microbiota

ii) Symptoms, Syndromes, and Scenarios

• Heartburn and noncardiac chest pain Dysphagia and odynophagia

• Chronic or recurrent abdominal pain,

Dyspepsia: ulcer and non-ulcer/bloating and early satiety/belching and rumination

 Nausea and vomiting

• Disorders of defecation

• Diarrhea

• Fecal incontinence

• Rectal bleeding

• Anorectal pain and pruritus ani

• Functional gastrointestinal disease,

• Anorexia nervosa and bulimia nervosa, Weight loss, Gastrointestinal causes of anemia and occult bleeding,

• Intestinal gas

• Upper and lower gastro-intestinal bleeding

• Gastrointestinal tuberculosis

iii) Esophagus

• Basic anatomy, histology and physiology

• Congenital anomalies

• Motility of the esophagus and motor disorders Mechanism of deglutition and dysphagia

• Approach to a patient with dysphagia

• Gastro-esophageal reflux disease

• Tumors of the esophagus

• Esophageal webs, membranes and diverticulum

• Management of benign and malignant esophageal strictures

• Esophagus and systemic diseases

• Infectious diseases of the esophagus

• Foreign bodies in the esophagus and stomach

• Esophageal perforation

• Drug induced esophagitis

• EUS: Techniques, diagnosis, therapy

iv) Stomac

• Anatomy, histology, functions

• Physiology of acid and bicarbonate secretion in health and diseases

• Defence mechanisms against acid and pepsin

• Gastroduodenal motor function in health and diseases.

• Gastritis (nonspecific and specific)

• Helicobacter pylori infection

• Peptic ulcer

• Dyspepsia

• Stress and stomach

• Gastric hypersecretory states including Zollinger Ellison syndrome

• Ulcer complications and their management

• Surgery for peptic ulcer

• Post gastrectomy complication

• Bezoars

• Tumors of the stomach

• Diverticuli and hernia of the stomach

• UGI Endoscopy: technique, diagnosis, therapy

v) Small Intestine

• Anatomy, blood supply, histology

• Motility of the small intestine

• Congenital anomalies

• Normal absorption of the nutrients

• Intestinal electrolyte absorption and secretion

• Malabsorption syndromes Pathophysiology, manifestations and approach

• Celiac sprue

• Infection related diseases a. Intestinal microflora in health and diseases

b.Tropical sprue

c. Whipple's disease

d. Infectious diarrhoea and food poisoning

e. Parasitic diseases

• Small intestinal ulcers

• Short bowel syndrome and intestinal transplantation.

• Eosinophilic gastroenteritis

• Food allergies

• Intestinal obstruction and pseudo-obstruction

• Short bowel syndrome

• Acute appendicitis

• Malrotation of the gut

• Bezoars

• Management of diarrhea

• GI lymphomas

• Small intestinal tumors

• Small intestinal transplantation

• Enteroscopy: Technique, diagnosis, therapy

vi) Colon

• Basic anatomy blood supply, histology and functions

• Motility of the colon and disorders of motility

• Congenital anomalies

• Megacolon

• Constipation

• Colonic pseudo-obstruction

• Fecal incontinence

• Antibiotic associated diarrhea

• Inflammatory bowel disease a. Ulcerative colitis

b. Crohn's disease

c.Indeterminate colitis

d. Ileostomies and its management

• Diverticular disease of the colon

• Radiation entero-colitis

• Colonic polyps and polyposis syndromes

• Malignant diseases of the colon

• Other inflammatory diseases of colon including a. Solitary rectal ulcer syndrome

b. Diversion colitis

c. Collagenous and microscopic colitis

d. Non specific ulcerations of the colon

e. Malakoplakia

f. Pneumatoses cystoids intestinalis

• Hemorrhoids

• Diseases of the anorectum

• Tubercosis of g.i. tract peritoneum

• Colonoscopy and iloscopy: Technique, Diagnosis, therapy

vii) Pancreas

• Anatomy, physiology, blood supply, developmental anomalies

• Physiology of the pancreatic secretion

• Pancreatic function tests

• Acute pancreatitis

• Recurrent acute pancreatitis

• Chronic pancreatitis

• Malignancies of the pancreas(Exocrine and endocrine)

• Cystic fibrosis and other childhood disorders of the pancreas

• Hereditary pancreatitis

• Pancreatic transplantation

• Pancreatic ERCP: Techniques, Diagnosis, therapy

viii) Biliary Tree

• Anatomy, Physiology

• Physiology of bile formation and excretion

• Enterohepatic circulation

• Bilirubin metabolism.

• Approach to a patients with jaundice

• Gallstones, its complications, and management

• Acute acalculous cholecystitis

• Miscellaneous disorders of the gallbladder

• Acute cholangitis

• Benign biliary structure

• Benign and malignant neoplasms of the biliary system.

• Endoscopic management of biliary obstruction.

• Motility and dysmotility of the biliary system and sphincter of Oddidysfunction

• Congenital diseases of the biliary systems

• Biliary ERCP and cholangioscopy: Diagnosis and therapy

ix) Liver

• Anatomy, physiology, blood supply

• Functions of the liver

• Microcirculation of liver

• Liver function tests

• Portal hypertension i. Extrahepatic portosplenic vein obstruction ii. Non cirrhotic portal fibrosis iii. Cirrhosis

• Acute viral hepatitis

• Chronic hepatitis

• Fulminant hepatic failure

• Subacute hepatic failure

• Cirrhosis of liver

• Ascites

• Hepatorenal syndrome

• Autoimmune liver disease

• Metabolic liver disease

• Sclerosing cholangitis- primary and secondary

• Primary biliary cirrhosis

• Hepatic venous outflow tract obstruction

• Fibrocystic diseases of the liver

• Wilson's disease

• Hemochromatosis

• Liver in porphyria

• Hepatic tumors

• Infections of the liver

• Liver in pregnancy

• Liver in congestive heart failure ,Liver diseases and pregnancy,

• Liver biopsy

• Liver transplantation and artificial liver support Liver transplantation

• Liver transplantation: indications and selection of candidates and immediate complications

x) Peritorium and Retroperitoneum

• Ascites

• Chronic peritonitis

• Budd-Chiari syndrome

• Malignant ascites

• Diseases of the retroperitoneum

xi) Diseases of Multiple Organ Systems

• Oral Disease and Oral-Cutaneous Manifestations of Gastrointestinal and Liver Disease

• Disorders of Mouth and Tongue,

• Mucocutaneous Candidasis, Mucocutaneous Features of HIV Infection,

• Mucocutaneous Ulcerative Disease,

• Eosinophilic disorder

• Vesiculobullous Diseases,

• Cutaneous Manifestations of Intestinal Disease

• Collagen vascular and vasculitic disorders

• AIDS and the gut,

• Graft-versus-host disease,

• Radiation and other physicochemical injury

• Systemic amyloidosis,

• Foreign bodies

• Porphyria

• Cutaneous manifestations of GI diseases

xii) Psychosocial factors

• A Biopsychosocial Understanding of Gastrointestinal Illness and Disease Case Study:

• A Typical Patient in a Gastroenterology Practice,

• The Biomedical Model,

• The Biopsychosocial Model

xiii) Nutrition

• Normal nutritional requirements

• Assessment of nutritional status

• Protein energy malnutrition

• Manifestations and management of nutritional deficiency and excess

• Nutritional support in various GI disorders (malabsorption, acute

and chronic pancreatitis, inflammatory bowel disease) Vascular Diseases of the GI Tract

xiv) Paediatric Gastroenterology

• Congenital disorders of gastrointestinal system, liver, biliary tract and pancreas

• Age related physiological and psychological variables of children

• Unique aspects of disease in paediatric age group as compared to adult

xv) Geriatric Gastroenterology

• General Issues:

o Impact of age on presentation, diagnosis and treatment of importantgastrointestinal conditions.

o Impact of depression and dementia on presentation and treatment.

o Pathophysiology of aging

o Social and ethical issues Geriatric gastroenterology

• Changes of G.I. function with aging, (e.g.) slowing of colonic motility and rectaldysfunction

• Changes in drug metabolism

• Effect of aging on nutrition

• GI problems in institutionalized and bedridden patients (e.g) fecal impaction asrisk factor for urine incontinence.

xvi) Womens Health Issues in Digestive Diseases

1. General women health issues

• Doctor-patient relationships

• Cultural and religious issues

• oPsycho-social issues

• Lab values and diagnostic tests - Gender differences as well as changes during pregnancy in normal lab values

2. Specific women health issues

 Health and disease states – gender difference in demographics,

epidemiology, pathophysiology, clinical presentation.

 Effect of menstrual cycle and menopause on digestive disease

 Pharmacokinetics of medications – differences in absorption, metabolism and therapeutic response.

3. Pregnancy and child bearing

 GI and liver changes / disorders in normal pregnancy

 Effect of pre-existing GI and liver disorders on pregnancy and fertility.

 Impact of pregnancy on gastrointestinal & liver disease

 GI and liver disorders unique to pregnancy

 Maternal-fetal transmission of infections and appropriate management of mother and infant

 Pharmacokinetics and interactions of medications during pregnancy and breast feeding - potential harm to fetus.

 Nutritional requirements Post-partum issues Rectal prolapse, hemorrhoids, urinary / fecal incontinence

xvii) Research

 Basic knowledge of clinical research methods, biostatistics, epidemiology and ethics.

 Basic knowledge of cell biology, molecular biology, molecular genetics and immunology

 Critical analysis of current literature, ability to formulate research questions,make a study design, calculate sample size, data management, ways to avoid bias etc

 Preparation of proposals for funding and evaluation by institutional review boards

 Presentation of work in written/oral form at Conferences 6. Help mentors in peer review of articles submitted for publications.

xviii) Primer of Diagnostic Methods: Endoscopic

 Upper gastrointestinal endoscopy and mucosal biopsy

 Lower gastrointestinal endoscopy and biopsy

 Endoscopic ultrasonography,

 Diagnostic and interventional endoscopic retrogradecholangiopancreatography

 Enteroscopy (single or double-balloon)

 Capsule endoscopy

 Percutaneous ultrasound

 Barium radiology

 Computed tomography

 Magnetic resonance imaging,

 Magnetic resonance cholangiopancreatography,

 Positron emission tomography

 Non-invasive liver assessment

 Functional testing

 Gastrointestinal motility testing

 Measurement of portal pressure

 Liver biopsy

xix) Primer of Treatments

 Medical treatments of various GI diseases

 Drug prescription in liver disease,

 Nutritional assessment and support

 Therapeutic endoscopy

 Non-variceal upper gastrointestinal bleeding control

 Variceal ligation, glue injection for varices and other lesions

 Snare polypectomy and foreign body removal from GI Tract

 Percutaneous endoscopic gastrostomy

 Endoscopic techniques of removing early gastrointestinal neoplams,

 Dilation and stenting of the gastrointestinal tract,

 The transjugular intrahepatic portosystemic shunt (TIPS Interventional radiology) (Observation only)

 Paracentesis

xx) Miscellaneous

 Biostatistics & clinical epidemiology

 Preventive Gastroenterology and Hepatology

 Management of GI emergencies like upper and lower GI bleed, Acute pancreatitis, hepatic encephalopathy and cholangitis

 Psychological factors in GI diseases

 Medicine relevant to Gastroenterology

 Bio ethics, ethical issue in transplantation, including 'Human Organ Transplant Act'

xxi) Laboratory Methods

The candidate is expected to perform routine stool examination and ultrasonography. In addition he/she must familiarize himself/herself with the following investigations:

 Liver function tests

 Auto analyzer functioning

 Gastro and Liver pathology interpretation including immuno-fluoresence andelectron microscopy.

 Electrolyte and acid base analysis

 Digital subtraction angiography.

 Selective Gastrointestinal angiography and interventional angioplasty andstenting

 Doppler studies

 CT imaging

 Magnetic resonance imaging including MRCP

 Percutaneous Trans hepatic Biliary Drainage (PTBD)

 Various gastro-intestinal isotope imaging and functional technique Microbiology:

 Viral, Bacterial and fungal cultures, Serological and PCR techniques andImmunological test:

 ANA, anti SMA, Anti-LKM, AMA and ANCA, TTG, Anti-endomysial antibody

 Research: The candidate will present at least two paper in the national conference and publish at least one paper in a journal. Practical work:

 Radiology: Reading and interpreting the common x-ray films including X- ray films of the abdomen

 Barium studies

 Ultrasound examination, CT scans

 MR scans and angiography and ERCP films

 GI Pathology Reading and interpreting histological slides of commongastrointestinal and liver disease.

xxii) Gastroenterology and Enviroment Impact on Gastroenterology and Liver physiology due to environmental changes including Air, pollution, Climate change and Heat wave such as

 Effect of air quality on g.i. microbiome

 Effect of heat wave on GI infections and Inflammatory Bowel Diseases

 Effect of air pollution in GI Endoscopy unit

 Relationship of air pollution and peptic ulcer bleeding etc.

 Effect of water contamination on GI health

xxiii) Others

 Ethics

 Medico legal aspects relevant to the discipline

 Health Policy issues as may be applicable to the discipline

ROTATION

During the Training Period.

The resident would be required to rotate through clinical gastroenterology, hepatology, diagnostic and therapeutic endoscopy. In addition, he/she will spend some time in rotations through allied specialities (pathology, radiology, laboratory medicine etc.) Extramural rotations (Institutions outside the primary centre) or rotation at affiliated centres for a maximum period of 3 months may be allowed during after the 1st year of training.

Posting in Gastroenterology

1) Clinical Gastroenterology and Hepatology

2) Diagnostic and Therapeutic Endoscopy

3) Radiology / Pathology

4) OPD consultation

5) Critical care and Emergency

The pattern of training in each of the semester would be as follows :

1st year

Clinical ward posting including ICU, Initiating Research process, Human Rights information Awareness about right to information, Development of communication skills both in the vernacular and English language, Ethical training, Defining brain death, Counseling for organ transplantation, Computer orientation.

2nd year

Change of posting to a busier ward with greater responsibility Independent OPD and Oesophagogastro duodenoscopy under supervision, Organising CME,workshops and seminars

3rd year

Change of posting – Independent charge of the wards, Independent Oesophagogastro duodenoscopy and based procedures Teaching (Inter and intradepartmental) Organising CME, workshops and seminars.

Schedule of Posting

The residents should be posted in the gastroenterology ward, emergency (casualty) and gastroenterology intensive care unit during the three year course. They should also undergo rotation in allied specialties. The following should be the training program in the department

1. Gastroenterology Ward - 2 years

2. Endoscopy Lab - 4 months

3. Gastroenterology ICU/ Emergency- 6 months

4. Pathology- 2 weeks.

5. Microbiology- 2 weeks.

6. Radiology - 1 month

Career Options

After completing a DrNB in Medical Gastroenterology, candidates will get employment opportunities in Government as well as in the Private sector.

In the Government sector, candidates have various options to choose from which include Registrar, Senior Resident, Demonstrator, Tutor etc.

While in the Private sector the options include Resident Doctor, Consultant, Visiting Consultant (Medical Gastroenterology), Junior Consultant, Senior Consultant (Medical Gastroenterology), etc.

Courses After DrNB in Medical Gastroenterology Course

DrNB in Medical Gastroenterology is a specialisation course that can be pursued after finishing a Postgraduate medical course. After pursuing specialisation in DrNB in Medical Gastroenterology, a candidate could also pursue certificate courses and Fellowship programmes recognized by NMC and NBE, where DrNB in Medical Gastroenterology is a feeder qualification.

Frequently Asked Questions (FAQs) – DrNB in Medical Gastroenterology Course

Question: What is the full form of DrNB?

Answer: The full form of DrNB is Doctorate of National Board.

Question: What is a DrNB in Medical Gastroenterology?

Answer: DrNB Medical Gastroenterology or Doctorate of National Board in Medical Gastroenterology also known as DrNB in Medical Gastroenterology is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course.

Question: What is the duration of a DrNB in Medical Gastroenterology?

Answer: DrNB in Medical Gastroenterology is a super specialty programme of three years.

Question: What is the eligibility of a DrNB in Medical Gastroenterology?

Answer: Candidates must have a postgraduate medical Degree in MD/DNB (General Medicine) obtained from any college/university recognized by the MCI (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.

Question: What is the scope of a DrNB in Medical Gastroenterology?

Answer: DrNB in Medical Gastroenterology offers candidates various employment opportunities and career prospects.

Question: What is the average salary for a DrNB in Medical Gastroenterology candidate?

Answer: The DrNB in the candidate's average salary is between Rs. 4 Lakh to Rs. 45 Lakh per year depending on the experience.

Question: Can you teach after completing DrNB Course?

Answer: Yes, the candidate can teach in a medical college/hospital after completing DrNB course.

Question: What is the difference between DrNB and DNB?

Answer: As of today, DrNB is a super-specialist qualification imparted by the NBE (SS level). Whereas DNB is a specialist qualification. Earlier DrNB used to be called DNB SS but now it is called DrNB.