Endocrinology Fellowship Curriculum

Our overall educational goal is to provide excellent training in clinical endocrinology and diabetes; to motivate and inspire innovative clinical research in endocrinology and diabetes; and to prepare our trainees to become clinical endocrinologists.

Clinical rotations

Fellows will provide care for patients in the hospitals’ general medical and intensive care units (including medical, cardiac, surgical, cardiothoracic, neurosurgical, and trauma units), as well as in a variety of outpatient settings where fellows will provide continuity care to ambulatory patients. Fellows will have the opportunity to participate in various subspecialty clinics, including wound care, reproductive endocrinology, women’s health clinics. A rotation in pediatric endocrinology is available through an affiliation with Children’s Hospital of Pittsburgh. Procedural experience in thyroid ultrasound, FNA thyroid, insulin pump/CGMS management, and DXA interpretation is provided.

Fellows will be assigned each year to rotations at Allegheny General Hospital (AGH) or West Penn Hospital (WPH). Below is a typical rotation schedule. Individual programs will vary according to the fellows' interests.

Year 1

AGH Inpatient Consults (4 months)

AGH Neuroendocrine (2 months)

Diabetes (2 months)

Wound Care/ Podiatry (1 month)

Thyroid Outpatient Office (1 month)

Research (1 month)

Elective (1 month)

Year 2

AGH Inpatient Consults (2 months)

Block Selective (Diabetes or Neuroendocrine) (4 months)

Pediatric Endocrinology (1 month)

Reproductive Endocrinology (½ month)

Nutrition (1 month)

Thyroid Outpatient Office (1 month)

Research (1 month)

Electives (1 ½ months)

Electives

Electives are offered in 2- or 4-week blocks in the following rotations:

• General endocrine outpatient office rotations (4 sites available, each with a different clinical model and emphasis)
  
• Pharmaceutical clinical trials
  
• Research
  
• Bone disease – in conjunction with rheumatology and orthopedics
  
• Women’s endocrine health
  
• Obesity

Clinical facilities

We offer interdisciplinary collaboration in a comprehensive neuroendocrine institute, a Diabetes Center, a thyroid FNA clinic, and a bone health program. A full complement of support services, including diabetes education, anesthesiology, pathology, diagnostic and interventional radiology, surgery, and oncology are available.

AGH inpatient consult floor

All inpatient or emergency room consults received are evaluated and consultative opinion rendered. Daily attending teaching rounds are made.

AGH neuroendocrine service

Inpatient and outpatient consults to the neuroendocrine service are evaluated and consultative opinion rendered. Daily attending teaching rounds are made.

WPH Diabetes Center outpatient facility

The Diabetes Center outpatient facility is 2 blocks from West Penn Hospital and houses outpatient offices, diabetes education, and dietary counseling services. Inpatient consults to the Diabetes Center at WPH with an emphasis on diabetes and pregnancy are evaluated and an opinion rendered. Daily attending rounds are made. Outpatient experience focuses on diabetes management and multidisciplinary approach to diabetes care.

McCandless Endocrine continuity clinic

Fellows attend the AGH Continuity Clinic at McCandless Neighborhood
Hospital 1 day per week. McCandless is located 9.5 miles north of AGH, and
offers free parking and brand new clinic facilities. Preceptor assignment
changes periodically to provide exposure to different styles of practice during
the continuity clinic.

Didactic experiences

The curriculum is designed to afford fellows the opportunity to attend lectures, conferences, participate in teaching rounds, conduct research and also have sufficient time for review and study of current literature.

Didactic instruction is clustered in an academic half-day (12 to 5 p.m. on Wednesdays) to allow focus on this activity. Fellows participate in conferences and will have the opportunity to improve presentation skills. Didactic activities include:

• Medical Grand Rounds - Medical Grand Rounds are held weekly to provide continued updates in topics within general internal medicine.
• Core Curriculum Lecture Series - This is series of lecture topics intended to introduce the fellows to the literature of endocrinology and provide an understanding of the pathophysiologic basis for endocrine diseases and a broad range of affiliated topics including research, ethics, and genetics. Topics cover all areas required by the Endocrine Core Curriculum. These didactic sessions are presented by endocrine faculty. Periodically, the fellows present landmark articles from the endocrine literature at these sessions.
• Journal Club - On a rotating basis, one fellow and one attending physician per month present an article chosen from the recent literature. Fellows critically discuss the article, key concepts, and clinical relevance, with special attention to applicability to clinical practice.
• Clinical Case Discussions - This weekly fellow-led conference provides an opportunity to present and discuss interesting or challenging cases seen as inpatient consults or in the office. Cases with diagnostic, therapeutic or co-management issues form the basis for lively discussion and lead to thoughtful clinical reasoning and informed patient care decisions.
• Multidisciplinary Endocrine Tumor Conference (METC) - Six times per year, fellows and faculty participate and present at Tumor Board. Physicians from many disciplines, including pathologists, radiologists, and surgeons, participate in this conference, which is approved for patient safety CME credits.
• MM & I (Morbidity, Mortality and Improvement) Conference - At this conference, held quarterly, fellows offer brief case presentations that highlight opportunities for discussion of management decisions and outcomes as well as improvements in patient safety. Representatives from other departments, pertinent to the case under discussion, will frequently be invited to participate to facilitate discussion. Emphasis will be placed on identification, prevention, and correction of medical errors, so as to promote quality assurance, and a culture of blame-free error reporting.
• Research Conference - At this conference, held six times per year, all fellows and faculty review the status of any ongoing research projects or review articles, help prepare for presentations at national level meetings, and discuss initiation of new research interests and help develop and assist the progress of ongoing projects. A didactic curriculum covering topics pertinent to clinical research, including study design, statistical analysis, IRB submission protocol, and paper writing, are covered.
• Board Review - This monthly series assists fellows in preparing for the ABIM Subspecialty Examination for Endocrinology.
• Patient Safety Series - This semiannual series supports the Endocrine Division and GMEC endorsement of instituting a culture of patient safety, and include modules promoting system thinking, error analysis and prevention, and systems-level improvement.
• Endocrine Grand Rounds - During the second fellowship year, each endocrine fellow presents at Endocrine Grand Rounds. These conferences present a formal in-depth exploration of an area of endocrinology that educates attendees in the cutting-edge developments in an area of endocrinology. Outside speakers are also invited to present at these sessions.