FNB in Paediatric Gastroenterology: Admissions, Medical Colleges, Fees, eligibility criteria details

FNB Paediatric Gastroenterology or Fellow of National Board in Paediatric Gastroenterology also known as FNB in Paediatric Gastroenterology is a doctoral fellowship program for doctors in India that is done by them after completion of their postgraduate medical degree course. The duration of the FNB course is for 2 years.

FNB Paediatric Gastroenterology deals with the care of pediatric patients with gastrointestinal problems. It is a branch of Pediatrics concerned with the prevention, investigation, and therapy of and research into diseases involving gastrointestinal disorders.

The course is a full-time course pursued at various accredited institutes/hospitals across the country, the top hospitals include Bai Jerbai Wadia Hospital for Children Institute of Child Health and Research Centre, Mumbai, Indraprastha Apollo Hospital, New Delhi, and more.

Candidates can get admission to 2 years FNB course after successfully qualifying for the FET (Fellowship Entrance Test) examination which is conducted by NBEMS.FET is conducted annually as per the prescribed schedule. The merit-based counselling for admissions to the FNB Programme after the conduct of FET is administered by NBEMS.

The fee for pursuing FNB Paediatric Gastroenterology varies from accredited institutes/hospital to hospital is around Rs.1,25,000 per year.

After completion of their respective course, doctors can join the job market. Candidates can take reputed jobs at positions as research fellows, Senior residents, Consultants, etc. with an approximate salary range of Rs. 24 lakhs to Rs. 31 lakhs per year which varies according to experience.

The Nomenclature of the FNB qualification awarded by the National Board of Examinations in Medical Sciences is “Fellow of National Board”. The FNB qualifications are recognized qualifications in terms of the Gazette notification dated 10th August 2016.

What is FNB in Paediatric Gastroenterology?

FNB in Paediatric Gastroenterology is a two-year doctoral fellowship program that candidates can pursue after completing a postgraduate degree.

FNB in Paediatric Gastroenterology deals with the care of pediatric patients with gastrointestinal problems. It is a branch of Pediatrics concerned with the prevention, investigation, and therapy of and research into diseases involving gastrointestinal disorders.

The National Board of Examinations (NBE) has released a curriculum for FNB Paediatric Gastroenterology.

The curriculum governs the education and training of FNB Paediatric Gastroenterology.

Course Highlights

Here are some of the course highlights of FNB Paediatric Gastroenterology

Eligibility Criteria

Note:

The admission process contains a few steps to be followed for the candidates for admission to FNB. Candidates can view the complete admission process for FNB Paediatric Gastroenterology mentioned below:

• FET is a qualifying-cum-ranking examination for admission to Fellow of National Board (FNB)/Fellow of National Board - Post Doctoral (FNB-PD) courses.
• The selection of a student will be through an MCQ-based examination namely Fellowship Entrance Test.
• A student can apply for the fellowship courses for which his/her broad or super speciality qualification/ equivalent qualification is eligible, at the time of online submission of the application form.
• The total duration of the question paper will be 105 minutes (Part A - 45 minutes and Part B - 60 minutes).
• QUALIFYING CRITERIA: Students who obtain a minimum of 50th Percentile in their respective question paper/speciality shall be declared as “Qualified”.
• NBEMS shall declare a speciality-wise merit list i.e., there will be a separate merit list for each fellowship course. There shall not be any equating/scaling and normalization. The merit shall be generated strictly based on marks obtained by the student and application of the prescribed tie-breaking criteria.
• The admission to Fellowship courses in the accredited hospitals shall be undertaken solely based on merit-based counseling conducted by NBEMS.
• Documents required to be produced at the time of counselling: MBBS Degree Certificate and MD/MS/DNB/DM/MCh/DrNB Degree Certificate/Provisional Pass Certificate of eligible Post Graduate Medical Qualification issued.

Fees Structure

The fee structure for FNB Paediatric 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 FNB Paediatric Gastroenterology is Rs.1,25,000 per year.

Colleges offering FNB Paediatric Gastroenterology 

Various accredited institutes/hospitals across India offer courses for pursuing FNB Paediatric Gastroenterology.

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

Syllabus

FNB in Paediatric Gastroenterology is a two years specialization course that provides training in the stream of Paediatric Gastroenterology.

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

OVERVIEW

The training is designed to develop both the generic and speciality-specific attributes necessary to practice independently as a consultant pediatric gastroenterologist. The aim is

to train individuals to provide the highest standard of service to patients with gastrointestinal disorders. This includes the development of positive attributes toward

lifelong learning and the ability to adapt to future technological advances and the changing expectations of society.

The educational process in pediatric gastroenterology aims to provide basic knowledge, and intellectual, clinical,l and transferable skills to produce competent gastroenterology specialists. These specialists will be capable of providing specialized care of the highest order to pediatric patients with gastrointestinal disorders in the community as well as clinical tertiary centres. They shall recognize the health needs of the community and carry out professional obligations ethically and keep their standards by engaging in continuing medical education.

The scientific basis of Pediatric Gastroenterology

• Basic principles in Gastroenterology

• Explain the anatomy and physiology of the alimentary system.

• Explain gastrointestinal biochemistry

• Apply clinical skills to diagnose and manage gastrointestinal and hepatobiliary disorders.

Diseases and presentations

Acute and chronic diarrhoea

• Know the causes and symptoms of acute and chronic diarrhoea

• Be familiar with local isolation policies

• Know about oral and intravenous fluid therapy

• Understand the scientific principles for oral and intravenous fluid therapy

• Recognize features in the presentation which suggest serious pathology, e.g.hemolyticc uraemic syndrome, pelvic appendicitis, intestinal obstruction

• Know work-up and management of acute diarrhoea

• Know the causes of chronic diarrhoea and relevant work-up/ management of both enteral and total parenteral nutrition

• Know to recognize and manage CMPA/ IBD/ celiac disease and intestinal lymphangiectasia

• Be able to evaluate the complex case of malabsorption

Approach to vomiting

• Know causes of vomiting/ appropriate evaluation and management

• Recognize features in the presentation which suggest serious pathology,

• e.g. appendicitis, intestinal obstruction, malrotation, ICSOL,

Congenital abnormalities and the newborn

• Know the presenting features of congenital abnormalities including tracheoesophageal fistula. Malrotation, bowel atresias, Hirschsprung’s disease, abdominal wall defects, diaphragmatic hernia

• Be familiar with potentially associated abnormalities.

• Know when the antenatal transfer to a neonatal Surgical centre should be considered

• Institute appropriate emergency treatment

• Recognize the need to liaise with surgeons

• Institute appropriate emergency treatment and be able to assess the fitness of the baby and the need to transfer to a specialist centre.

• Recognize when the bowel might be compromised

• Recognize the need to liaise with surgeons and when this urgent

• Know the full range of presenting features of congenital abnormalities of the intestinal tract.

• Be able to diagnose and manage care for the child with shorter bowel syndrome. Inflammatory bowel disease

• Be familiar with uncommon and unusual manifestations of inflammatory bowel disease

• Know and recognize the macroscopic and microscopic features of Crohn’s disease, ulcerative colitis, and intermediate colitis

• Be able to recognize the common extra-intestinal manifestations of IBD

• Be able to manage all forms of IBD but especially severe cases including fistulas

• Anticipate and manage the complications of IBD, including malnutrition, osteoporosis, and dysplasia/ cancer.

• Know the indications of surgery in IBD

• Be familiar with anti-inflammatory drugs and immune suppression used to manage IBD

• Be familiar with novel agents for treating IBD and possess an open attitude to their use in research protocols

Celiac disease

• Know and recognize the histopathological changes in celiac disease.

• Know the precise level of risk and short and long-term complications of celiac disease.

• Be able to conduct a gluten challenge safely and measure adherence to a gluten-free diet by endoscopy if necessary.

Upper and lower Gastrointestinal bleeding

• Know the cause of upper and lower gastrointestinal bleeding

• Understand the potentially life-threatening nature of this condition

• Assess the severity of this condition

• Institute appropriate emergency treatment

• Recognize features in the presentation which suggest serious pathology

• Be able to investigate and manage upper and lower GI bleeding

• Recognize and be able to resuscitate a child with a significant GI bleeding

Motility problems including gastro-oesophageal reflux and oesophagitis

• Know the range of presentations of gastro-oesophageal reflux and oesophagitis

in otherwise well-infant children and also in disabled children.

• Recognize the range of signs and symptoms associated with gastro-oesophageal reflux and oesophagitis

• Manage mild and moderate gastro-oesophageal reflux and recognize when to refer.

• Be able to manage severe gastro-oesophageal reflux disease

Be able to manage severe dysphagia

• Be able to diagnose and treat H. Pylori infection in young children and recurrent episodes in adolescents.

• Be able to perform and interpret intestinal transit studies

• Know the indications for the surgical treatment of gastro-oesophageal reflux disease and how to manage complications of surgery

• Pseudo Obstruction

Chronic or recurrent abdominal pain

• Know the possible biological, psychological, and social contributing factors in chronic or recurrent abdominal pain.

• Know which features suggest that reassurance rather than investigation is needed.

• Recognize features in the presentation that suggest the importance of different etiologies

• Be able to refer appropriately to psychology when required

• Consider when there might be child protection issues

• Be aware of different management strategies for irritable bowel syndrome (IBS)

• Be able to manage patients with IBS

Pancreatic diseases

• Know about exocrine pancreatic dysfunction including cystic fibrosis and Shwachman-Diamond syndrome

• Know the cause of acute and chronic pancreatitis

• Know the management of chronic pancreatitis and its complications

• Indications for ERCP/ surgery/ celiac plexus block

• Be able to prescribe Enzyme supplements for Infantile Cholestasis

• Know the cause of intra and extra-hepatic cholestasis

• Understand the clinical manifestations of cholestasis

• Know the potential diagnosis and jaundice, particularly the differential between biliary atresia and other forms of infantile cholestasis.

• Understand the various genetic basis of cholestatic syndromes

•  Know the reasons behind nutritional deficiencies in cholestasis and chronic liver disease

• Understand the clinical manifestations of nutritional deficiencies

•  Understand the clinical manifestations of nutritional deficiencies particularly found in liver disease

• Know the special nutritional formulae and supplements and the indications for their use.

• Be able to identify infantile cholestasis and initiate appropriate medical treatment and investigations

• Be able to interpret blood, ultrasound, and biopsy results and understand their importance and limitations in reaching a diagnosis.

• Be able to interpret blood, ultrasound, and biopsy results and understand their importance and limitations in reaching a diagnosis

• Be able to identify treatable causes of infantile cholestasis such as metabolic and infectious conditions

• Be able to counsel parents about the cause of cholestasis and give a realistic prognosis

• Be able to recognize and assess nutritional deficiencies and manage appropriate medical treatment and investigations

Hepatosplenomegaly

• Know the causes of cirrhosis

• Understand the pathophysiology of portal hypertension

• Know other causes of ascites

• Know the causes of hepatic and extra-hepatic masses

• Know about storage disorders

• Know about haematological malignancies

• Know about peripheral stigmata of liver cell failure

• Be able to identify hepatosplenomegaly and other abdominal masses and manage appropriate treatment investigation

• Be able to make a diagnosis of cirrhosis, hepatic malignancies, and metabolic conditions presenting in older children

• Be able to manage appropriately ascites and SBP

• Be able to manage refractory ascites and SBP

• Be able to recognize stigmata of liver cell failure Viral hepatitis and immune disorders

• Understand the serology, molecular diagnostics, and their prognostic value in hepatotropic viruses

• Understand the screening tests used to detect hepatotropic viruses

• Understand the immune basis of some liver disorders

• Be able to identify viral and immune liver disorders and initiate appropriate medical treatment and investigations

• Be able to interpret immunological profiles related to auto-immune liver disorders

• Be able to interpret immunological profiles related to auto-immune liver disorders especially atypical patterns

Metabolic liver disease

• Know the pathophysiology of metabolic conditions

• Know the pathophysiology of metabolic conditions affecting the liver and recent advances in treatment

• Understand the management of these conditions

• Be able to discuss metabolic problems with consultants in metabolic medicine

Acute liver failure

• Be familiar with the causes of acute liver failure

• Be familiar with the complications of acute liver failure

• Know the management of paracetamol poisoning

• Know the causes of acute liver failure

• Recognize the need to discuss the case with the liver unit early

• Be able to assess the severity and complications of this condition

• Be able to initiate appropriate resuscitation and liaise early with the pediatric liver unit

• Be able to identify acute liver failure and manage appropriate medical treatment and investigations

• Be able to identify acute liver failure and initiate first-line treatment whilst arranging referral to a Pediatric liver transplant unit

• Be able to recognize the progression of acute liver failure and the need for transplantation

• Be able to recognize the progression of acute liver failure and when liver transplantation is indicated and contra-indicated

• Know the causes of acute hepatic failure

• Understand the clinical manifestations of acute hepatic failure

• Know the pathophysiology of complications including cerebral oedema and heap-to-renal syndrome

• Understand the indications for liver transplantation

•  Understand the indications for liver transplantation and know the importance of timely involvement of the transplant team

• Know about liver assist devices, dialysis, and intracranial pressure monitoring

Hepatic Tumor

• Know about benign and malignant liver tumours

• Understand the investigations in liver tumour

• Be able to assess a child with a hepatic tumour

• Be able to initiate specialist investigations and interpret their results

Nutrition

• Be able to take a detailed dietary history

• Know the physiology of nutrient digestion, absorption, metabolism, and elimination

• Know about the nutrition of the newborn, infancy, childhood, and adolescent

• Know about child growth and development

• Be able to assess anthropometry

• Be able to assess WHO growth standard

• Know about the nutritional status of children: Global and National

• Know about Breastfeeding: Anatomy, Physiology & Biochemistry

• Know about Breastfeeding problems & their management

• Know about Breastfeeding: Recent advances

• Know about Breastfeeding management, counselling, and lactation management centre

• Know about the importance of breastfeeding

• Know about IYCF: Complimentary feeding

• Know about Nutritional disorders: Chronic energy deficiency disorders, micronutrient deficiency disorders & different kinds of nutrients

• Know about PEM

• Be able to manage SAM

• Be able to assess FTT

• Know about food-based dietary guidelines: Food classification, food groups demonstration, including prepared home-based menus

• Know about healthy food habits

• Know the epidemiology, aetiology, and clinical features of childhood obesity

• Know how to recognize, investigate and manage a case of short stature

• Know the indications and contraindications for commencing enteral and parenteral nutritional supports

• Know the composition of different enteral feeds and parenteral nutritional supports

• Understand the role of different members of the nutritional support team in the establishment and maintenance of patients receiving enteral and parenteral nutritional supports

• Know the causes and effects of specific nutrient deficiencies including iron, zinc, copper, selenium, folate, vitamins, and essential fatty acids

Abdominal distension

• Know the causes of abdominal distension

• Initiate investigation and seek surgical opinion when required Constipation with or without soiling

• Be familiar with local and national guidelines for the management

• Know about the predisposing conditions, e.g. hypothyroidism, neuro disability, psychosocial problems

• Understand the relevance of predisposing conditions, e.g. hypothyroidism, neuro disability, psychosocial problems

• Manage simple constipation with and without soiling

• Recognize when to liaise with more senior paediatricians or with specialist nurses,

psychologist or psychiatrists

Dysphagia

• Know the causes of dysphagia

• Be able to distinguish between organic and functional dysphagia

• Be able to evaluate dysphagia – recognize achalasia cardia/ stricture oesophagus/

oesophagal stenosis and eosinophilic esophagitis

Malabsorption

• Know the causes of malabsorption including celiac disease

• Understand the principles of treatment of different types of malabsorption

• Recognize the role of the dietician and liaise appropriately

• Be able to explain and initiate investigations, nutritional assessment, and dietary principles and liaise appropriately with the dietician

Malnutrition

• Know the causes of malnutrition including organic and inorganic causes

• Be familiar with the consequences of malnutrition

• Know the principles of enteral and parenteral nutrition support

• Be able to assess nutritional status

• Be able to initiate investigations to establish the diagnosis and detect

nutritional deficiencies

Iron deficiency anaemia

• Know the causes of iron deficiency anaemia including poor diet, bleeding, and malabsorption

• Understand factors that predispose to dietary iron deficiency anaemia

• Be aware of the consequences of this condition

• Be able to manage iron deficiency anaemia

• Be able to counsel parents about dietary iron deficiency

Other areas in which knowledge is to be acquired:

• Biostatistics, Research Methodology and Clinical Epidemiology

• Ethics

• Medico-legal aspects relevant to the discipline

• Health Policy issues as may apply to the discipline

Career Options

After completing FNB Paediatric Gastroenterology, candidates will get employment opportunities in Government and the Private sector.

In the Government sector, candidates have various options to choose from which include Junior research fellow, Teaching at academic medical centres, and Consultants.

While in the Private sector, the options are Fellow (Paediatric Gastroenterology), Junior research fellow, Senior Research fellow (Paediatric Gastroenterology), and Consultants.

Frequently Asked Questions (FAQs) –FNB Paediatric Gastroenterology Course/ FNB in Paediatric Gastroenterology

•  Question: What is the full form of FNB?

Answer: The full form of FNB is Fellow of National board.

• Question: What is an FNB Paediatric Gastroenterology?

Answer: FNB in Paediatric Gastroenterology or Fellow of National Board in Paediatric Gastroenterology is a doctoral fellowship program for doctors in India that they do after completion of their postgraduate medical degree course.

•  Question: What is the duration of an FNB in Paediatric Gastroenterology?

Answer: FNB in Paediatric Gastroenterology is a doctoral fellowship program of two years.

• Question: What is the eligibility of  FNB in Paediatric Gastroenterology?

Answer: The candidate must have a postgraduate medical Degree in DNB/MD Paediatrics obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE. The 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 FNB Paediatric Gastroenterology?

Answer: FNB Paediatric Gastroenterology offers candidates various employment opportunities and career prospects.

• Question: What is the average salary for an FNB Paediatric Gastroenterology candidate?

Answer: The FNB Paediatric Gastroenterology candidate’s average salary is between Rs.24 lakhs to Rs. 31 lakhs per annum depending on the experience.

• Question: Can you teach after completing FNB Paediatric Gastroenterology Course?

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