Academic year 2007-2008 has been another banner year for the Division of Endocrinology, on the academic, patient care, administrative, teaching, training, and the national and international recognition fronts. With over 30 faculty members, the Division is without question one of the largest, strongest and most stable in the US, and is a leader in academic, didactic and clinical endocrinology.
Clinical Care. The Endocrinology Division now provides endocrinology consultations and care at Presbyterian, Montefiore, Shadyside, Magee Hospitals as well as the Pittsburgh VA. We also have launched community-based practices in Mt. Lebanon and Monroeville. Outpatient visits to the endocrine clinics at the University of Pittsburgh School of Medicine and UPMC continue to increase, surpassing 1200 visits per month, or 14,000 per year, and new patients comprise some 5000 of these visits. Approximately 25% of these visits are for thyroid-related disorders and 25% for diabetes, with the remainder heavily represented by osteoporosis and other disorders of calcium and mineral metabolism, pituitary and adrenal disease, lipid disorders and male and female reproductive disorders. Clinical revenues are increasing in parallel, and clinical operations operate on a balanced budget. In recognition of this, UPMC leadership has expanded nursing and support staff substantially, and has built a new 7000 square-foot Endocrinology outpatient clinic, the Center for Diabetes and Endocrinology, in the Falk Building. UPMC has also supported the further augmentation of the numbers of clinical endocrinologists as well, and in the coming year, we plan to expand the number of designated purely clinical endocrinologists from 13 to 17, complementing the eight additional research-oriented MD faculty, who also perform clinical patient care. This means that the 21 MD faculty, together with the 10 PhD faculty, comprise one of the largest Endocrinology Divisions in the US. Ten of our physicians were ranked among the Best Doctors in the US by Woodward and White.
Over the past five years, we have also developed a flourishing, fully-staffed inpatient diabetes hospitalist service, comprised of two attending endocrinologists, two nurse practitioners and two designated clinical fellows along with residents and students.
In addition to these services at UPMC, five Division endocrinologists provide outpatient and inpatient care at the Pittsburgh VA Medical Center. In regional terms, we have developed and validated a database of 135,000 patients with diabetes cared for in the 19 UPMC hospitals and their associated outpatient facilities and clinics in western Pennsylvania. Remarkably, this is the largest diabetes registry of unselected patients in the US. (Medicare, the VA and Kaiser-Permanente have larger, but demographically selected diabetes registries.) We have also developed the second or third largest ADA-certified diabetes educator network in the US. Working with this University of Pittsburgh Diabetes Institute Registry and ADA-Certified Diabetes Education Network, we have launched quality improvement initiatives on a scale not possible in almost any other hospital system. We have also implemented system-wide computer-based physician order-entry initiatives targeting the inpatient management of hypoglycemia and sliding scale management of hyperglycemia, and also to site-specific and physician-specific reporting of ADA management targets. These have led to marked, large scale improvements in the management and outcomes relating to hypoglycemia, hospital length of stay, and achievement of compliance targets for diabetes management. Compliance measures and outcomes System-wide far exceed national averages and ADA guidelines. Finally, over the past year, Dr. Haruko Kuffner has established a Thyroid Cancer Registry which includes some 3000 patients making it one of the two or three largest in the US. We currently care for approximately 800 patients with thyroid cancer in our outpatient clinic.
Research. Research continues to excel in the Division. In FY '08, faculty within the Division received a total of $11,000,000 in research support from the NIH, the ADA, the JDRF, the AHA the VA, and from pharmaceutical trials, with the large majority coming from the NIH. All 17 of 18 research faculty cover all or most of their salary from NIH grants, and the remainder is covered by the VA, private foundations or Division reserves. Areas of clinical research excellence include clinical diabetes, obesity, calcium metabolism, osteoporosis, and thyroid cancer. Areas of excellence in basic research include obesity, type 2 diabetes, insulin resistance, type 1 diabetes, pancreatic beta cell function, survival and regeneration, osteoblast and osteoclast biology, and arterial smooth muscle in health and disease. Pitt faculty are highly visible at the annual meetings and leadership councils of the American Diabetes Association, the American Society for Bone and Mineral Research, and the Endocrine Society. Research is supported faculty research grants, by an NIH Training Grant (now in its 38th year and which was recently renewed), and by the NIH-funded CTSA Clinical Translational Research Center. Outstanding facilities for microarray gene profiling, DNA and protein synthesis and sequencing, animal care, proteomics, cellular imaging, and bioinformatics and biostatistics are available. From a research perspective, then, the Division clearly ranks among the top ten in the US. This excellence in research within the Division is complemented by the NIH ranking of the overall University of Pittsburgh, which ranked #6 out of 130 US Medical Institutions in NIH support for 2006, the most recent year for which these numbers are available.
In the coming year, we plan to hire additional research faculty. We have been provided with additional research space and have start-up packages for research faculty, and are actively recruiting and hiring outstanding applicants
Teaching and Training. Division faculty rank among the best in the Medical School once again in both the second year medical students course, and also among resident and fellow teaching. In parallel, improvements in the quality and quantity of applicants for the fellowship has increased dramatically over the past five years. For example, for fellowship training slots beginning both in July 2007 and 2008, we received approximately 200 applicants per year, interviewed 15-20, and selected 5 per year. Thus, 200 applicants compete for 5 slots per year. Of twelve positions offered in the past two years, ten applicants accepted this program. For the 2009 year, as for other Endocrinology Training Programs nationally, we have entered the NRMP matching program. Recent and current fellows have trained at Columbia, Duke, Brown, Pitt, Penn, Jefferson, Cornell, Dartmouth, Harvard and other excellent institutions. Because of the unusually large clinical volumes described above, as well as the unusually large number of clinical faculty, training in clinical endocrinology is intense, rich, high-volume, and exceptionally diverse. Teaching and supervision are equally outstanding. Clinical care is also outstanding, and occurs at the University, Magee Women's Hospital, Shadyside Hospital, Children's Hospital of Pittsburgh, and the Oakland VA Medical Center. Training excellence is documented by a 100% passage rate on the Endocrinology Board exams for the past 30 years, by the large proportion of training graduates who enter academic careers, and by the recent excellent score of our NIH Training Grant which will allow another five years of training support. A concrete example of the excellence in teaching is Dr. Rao's winning (again!) the Distinguished Housestaff Teacher Award for the Department of Medicine.
For the enitre annual report, please click the link below labeled "Annual Report 2007".