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Endocrinology and Metabolism Fellowship Program
Phone: (412) 648-9317 |
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Training Program
Educational Goals of the Program
The Endocrine Division has approximately 30 faculty members. The clinical and research interests of this group are summarized in the 2005-2006 Division Annual Report elsewhere on this site. The goals of this program are to provide subspecialty training in the broad range of diseases of endocrinology, diabetes mellitus and metabolism for physicians already trained and board eligible in General Internal Medicine, and to ensure continued development of general competencies as defined by the ACGME. Inpatient and outpatient experiences as well as multiple didactic sessions including conferences, lectures and seminars, which foster the development of the fellow, allow the fellow to become expert in initial evaluation and treatment of the disorders of this discipline. In outpatient clinics, fellows gain experience in the longitudinal care for treatment and health maintenance of patients with endocrine disorders. Humanistic and ethical behavior is stressed as a part of the training program. Graduates of the fellowship training program are expected to:
- be eligible for and have sufficient knowledge to pass the subspecialty examination in endocrinology and metabolism of the American Board of Internal Medicine
- be able to directly care for patients with disorders of endocrinology and metabolism
- be able to function as a specialty consult to other care providers and other specialties regarding patients with disorders of endocrinology and metabolism
- be able to teach other health professionals in endocrinology and metabolism
- be able to understand the literature and to interpret reports describing new findings regarding patients with endocrine disorders, and
- be prepared to enter an academic career as a faculty member in endocrinology and metabolism.
Selection of Fellows
- Step 1: Selection begins with screening of the completed application forms by the Endocrine Curriculum Committee/Fellow Selection Committee.
- Step 2: Candidates with strong applications are invited in for an interview and are interviewed by several faculty members as well as current Endocrine Fellows.
- Step 3: Final selection is determined by the Division Chief who is advised by the Curriculum Committee/Fellow Selection Committee.
Applicants must be board certified or eligible in internal medicine. The latter normally sit for the internal medicine boards during their first year of fellowship training. Fellows are supported by a combination of hospital-based positions and research training grants in endocrinology and metabolism. Only U.S. citizens and permanent residents are eligible for positions on the Divisional NIH Training Grant. Minority applicants are encouraged to apply.
Evaluation of fellows
- Each fellow is evaluated by the faculty attending during each month of their clinical rotation. Strengths and weaknesses of the fellow's performance are discussed with the trainee during each rotation.
- The Chief of the Division meets at least semi-annually in a formal manner and informally more frequently to discuss the evaluation and clinical competence of each of the fellows. Fellow performance is also reviewed at Division meetings with all faculty.
- A permanent record of the evaluations is maintained in the division office.
- The Chief of the Division provides a final evaluation of the fellow at completion of the program and indicates the eligibility of the fellow to sit for the ABIM subspecialty examination in endocrinology and metabolism.
- The teaching function of the fellows is evaluated monthly on each clinical rotation. Fellows also present at a variety of didactic functions where their teaching is also evaluated by the faculty.
Guidance in research
The Division has an extremely strong basic and clinical research program which is supported by approximately $9 million in annual extramural research funds. Before entry into the program, the fellows meet with prospective preceptors of the training faculty to discuss available research opportunities. They select a mentor prior to arrival on July 1. In the summer of the first year, the trainee and the preceptor together define the trainee's project, and decide on a series of questions for literature review. The trainee prepares a written description of his proposed research project which is reviewed by the Curriculum Committee. Throughout the second and third year, the fellow participates in research training under the direct supervision of a research preceptor. Progress in their research is evaluated semi-annually by the Director of the Fellowship Program and the Chief of the Division of Endocrinology and Metabolism.
Faculty Meetings
Meetings of the Curriculum Committee/Fellow Selection Committee take place quarterly. Current fellows are member of the Curriculum Committee.
Quality Assurance
Continuous input, both oral and written, is obtained from the fellows on the faculty, rotations and conferences. This is reviewed by the Division Chief and the Curriculum Committee. Fellow recommendations are considered and implemented when appropriate. Performance of trainees completing the program in the ABIM certifying exam in Endocrinology and Metabolism is also used to assess the quality of training. All graduates of the training program have passed the ABIM certifying exam on the first attempt. Graduates of the program are also surveyed to asses the extent to which their training prepared them for their current careers in practice or research. These responses are used to improve training.
Clinical Rotations
Fellows rotate through a broad range of clinical rotations. These include inpatient endocrinology consultations at UPMC Presbyterian University Hospital, UPMC Montefiore University Hospital, UPMC Shadyside Hospital, the Western Psychiatric Institute and Clinic, and the VA Pittsburgh Healthcare System. In addition, fellows rotate through a wide variety of clinics from the Center for Diabetes and Endocrinology at the University, to Thyroid Clinic, to Pituitary Clinic, to Osteoporosis Clinic, to Pediatric Clinic, to Lipid Clinic, to Reproductive Clinic at Magee Women's Hospital, and the diabetes and general endocrinology clinics at the VA Pittsburgh Healthcare System.
Fellows participate in the following didactic sessions
- Patient Care Conference - Selected clinical cases seen in consultation by the Division of Endocrinology and Metabolism and selected outpatient consultations are presented weekly to a Patient Care Conference which is attended by all clinical faculty of the division, all fellows and residents and medical students doing their rotations on the service. This conference is run by the fellows, and allows a review of clinical findings, presentation, discussion and interpretation of laboratory results, radiologic procedures, pathology slides, surgical results and treatment plans. The conference allows all of the fellows to hear, discussed in detail, all of the inpatient and selected outpatients seen during their entire fellowship training. It also provides input from other faculty members to supplement that provided by their attending of the month, thus greatly expanding the teaching input for every case.
- University-Wide Endocrine Conference (Endocrinology Grand Rounds) - A weekly clinical conference occurs in the Endocrinology Division. Faculty and postdoctoral fellows from Pediatric Endocrinology and Children's Hospital also attend. Approximately 50% of these conferences are presented by outside experts and the remaining 50% by faculty members and senior fellows in the Division of Endocrinology or other academic departments at the School of Medicine. The conference is also attended by endocrinologists from the community, the Department of Pediatrics, the Department of Obstetrics and Gynecology, and the Department of Surgery.
- Multidisciplinary Thyroid Cancer Conference - This conference is held monthly where faculty members and trainees from the Departments of Radiology (Nuclear Medicine, Ultrasound, Nuclear Safety), General Surgery, ENT, Pathology and Division of Endocrinology get together. Each month a topic is chosen within the field of thyroid cancer and the presenter will lead the discussion based on thorough literature review. Any difficult or interesting cases are also presented at the beginning of the conference to assist in patient care.
- Pituitary Conference - Patients with hypothalamic pituitary disease are reviewed by a multidisciplinary group (endocrinologists, neuroradiologists, neurosurgeons, and neuropathologists). Cases are presented by the Endocrinology Fellow; clinical materials are reviewed and discussed in detail by trainees and the faculty present.
- Bone Club - This is a weekly multidisciplinary conference including members of the Division of Endocrinology, Pediatric Endocrinology, Orthopedics, the Graduate School of Public Health, and the Department of Pharmacology. The conference is run by the Endocrinology Division and rotates between clinical case discussions involving difficult of interesting management and diagnosis issues, ongoing research program reviews, outside speakers, and fellow journal clubs.
- Research Conference - This is a weekly conference in which faculty and fellows within the Division present their ongoing research projects. The conference is intended to be a mini-study section, with members within the division constructively criticizing and evaluating the research programs of other members. Approximately 50% of the time, a prominent outside speaker is invited to speak about their research.
- Fellows Journal Club - The purpose of this weekly activity attended by all fellows is to review topics for the Endocrinology boards. Literature reviews are undertaken by one of the fellows and discussed with other fellows and an attending. The emphasis is on practical issues for diagnosis and management.
- Diabetes Journal Club - This journal club is held monthly in which current literature in the field of diabetes is critically reviewed. A broad range of topics relating to diabetes is covered, areas in both science literature and clinical trials are used as articles for discussion. Usually two articles per month are analyzed by both the current Endocrine Fellows and Faculty who specialize in diabetes.
- Thyroid Cytology Conference - This conference is held monthly at the Pathology Department. Interesting or difficult thyroid cytology cases are presented and reviewed with the pathologists.
- Summer Lecture Series - This series occurs weekly for a total of eight weeks during the summer. Relevant principles of basic science, endocrine physiology and biochemistry and the fundamentals of endocrine disorders are reviewed.
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