Physicians in the Pediatric Endocrinology and Diabetology Fellowship program spend twelve months in clinical training and 24 months conducting either basic laboratory and/or clinical research. Eight months of the first year and two months in each of the subsequent two years are devoted to clinical training. A standard curriculum of pediatric endocrinology topics is covered each year during weekly section conferences.
Combined medicine-pediatrics fellows spend a total of 12 months on clinical Pediatric Endocrinology, another 12 months on clinical Internal Medicine Endocrinology, and 24 months conducting clinical or basic research. The overlap in research training between the fellowships allows combined fellows to become board-eligible for both the American Board of Pediatrics and American Board of Internal Medicine in four years.
Clinical Training with High Patient Volume
The pediatric endocrinology clinical service is busy and staffs more than 30 half-day endocrine and diabetes clinics that see 300 patients weekly. Most outpatient visits are at Riley Hospital for Children (Indianapolis) with others at satellite clinics in Indianapolis, Bloomington, South Bend and Evansville, Indiana.
While on the clinical service, fellows are responsible for managing the care of inpatients and providing consults to other clinical teams. The inpatient team typically covers 3-10 endocrinology service patients and 5-10 consult patients.
On-call duty is every other night from home and every other weekend. Fellows cover a limited number of weekends when on research months. Three endocrine continuity clinics and one diabetes continuity clinic per month allow fellows to manage their own group of patients through the duration of the fellowship. Fellows also rotate through the sub-specialty endocrine clinics, allowing them to gain expertise in specific areas.
Pediatric endocrinology and diabetology fellows are encouraged to participate in the training of residents and medical students. On the inpatient service, there are two pediatric residents and at least one medical student. The fellow develops supervisory experience in directing the trainees’ activities. Fellows present informal teaching sessions to these trainees at least weekly and formal conferences to the entire pediatric endocrinology team monthly. In addition, fellows deliver lectures to the pediatric residents, conferences at the campus-wide Endocrinology Grand Rounds, and journal club presentations.
The American Board of Pediatrics requires fellows to engage in scholarly activity during their fellowship and this is one of the most important aspects of post-residency training. Participating in clinical or basic research gives the fellow a deeper understanding of the questions that must be asked to advance the field and methods used to answer these questions.
The research training program differs for each fellow depending on his or her individual needs and previous research experience. During their first months, fellows meet with program directors to explore research interests. By the end of six months, each fellow will have chosen a research project and mentor and begun research activities that continue throughout their training. The senior investigator on every project closely mentors the fellow with the fellow participating actively in the scientific design, execution, and interpretation of results from each experiment or project.
Structured mentorship and didactic courses in statistics, research ethics and clinical research methods or molecular biologic techniques prepare graduates for a career as a physician scientist. Fellows typically present their work at national meetings such as the Pediatric Academic Societies (PAS), the American Diabetes Association, and the Endocrine Society. These presentations are carefully coordinated and the entire division participates in preparing the fellow for these public presentations. Fellows have numerous opportunities for authoring case reports, review articles and book chapters.