The first year of fellowship is devoted to clinical training through time spent on the inpatient consultative service, in general and specialty endocrine clinics, and on rotations with other sections and departments throughout the institution. Fellows spend six months on the consult team which is responsible for consultative service or direct management of patients admitted for the diagnosis or management of endocrine and metabolic diseases.

The fellow sees all patients under the guidance of the attending physician in tandem with medical students (usually 2 or 3) and medical residents (usually 1) who are taking elective rotations in endocrinology and are supervised by the fellow. Outpatient clinics entail three half days per week (two general endocrine clinics and a specialty diabetes clinic).

Fellows follow their own patients throughout their fellowship under guidance of the faculty, and have the opportunity to work with all of the faculty in the inpatient and outpatient settings. An additional one to two half days per week are spent on rotations on reproductive endocrinology, nuclear medicine, radiology, Osteoporosis Center, and Pediatric Endocrinology. In addition, the fellow is responsible for the organization of a weekly clinical conference, and participates in various lectures and seminars for the medical students and Internal Medicine, Family Practice, and Psychiatry residents who rotate through the Endocrinology service.

The second and optional third years are spent largely in the conduct of a research project. A wide spectrum of topics are under investigation by the section using techniques that span from basic research through animal investigation to an active clinical research program within the General Clinical Research Center.

During the course of the first year, fellows identify the area of research they wish to pursue and the faculty member they wish to work with. They work closely with the faculty member to devise the project and prepare a written outline. Fellows are closely supervised during their research years by their faculty mentor, but there also is ample opportunity for guidance and scientific interaction with all of the faculty through participation in lab meetings, divisional research conferences, and institutional seminars.

Clinical activities during the second and third years are one half day per week general endocrinology continuity clinic, and a half day per week diabetes clinic, and from time to time, coverage of the inpatient consultation service. Fellows may also pursue  interests in specialty areas of endocrinology or take additional outpatient or inpatient electives if they wish during the second and third years.

Endocrine Fellowship Didactic Programs

Monday Endocrine Grand Rounds
This one hour CME-accredited conference is held each Monday at noon with a rotating format:  

Research Conference. The first Monday of the month is our research conference, in which current and proposed research projects within the endocrine division are presented and discussed. The goal of this conference is to keep all endocrine faculty and staff abreast of the many research activities within our division, and to provide our fellows and residents a forum for discussion and critique of their research proposals, as well as an introduction to study design and research methods. 

Diabetes Conference. The second Monday of the month is a multi-disciplinary case-based conference devoted to diabetes care. Participants include both clinical and research faculty, fellows, and non-physician providers in the diabetes clinic: registered dieticians, diabetes educators and nurse practitioners.  The goal of this conference is to gather all providers of diabetes care around the table to discuss challenging cases, debate issues in diabetes management, and present new products, devices and drugs. The Diabetes conference director is Meg Costello, NP.

Endocrine Case Conference. The third Monday of the month is a case conference, in which one or more challenging cases from the inpatient service or outpatient clinic are presented by residents and fellows . The goal of this conference is for fellows to learn to perform effective case presentations and to use the medical literature to develop an evidence- based  approach to the evaluation and management of endocrine disorders. Fellows’ case presentations are formally evaluated by faculty, and fellows receive written feedback on each presentation.

Endocrine Journal Club. The fourth Monday of the month is our journal club, in which fellows and faculty review a paper from the current literature that presents a contribution to the field of endocrinology and metabolism, such as new   diagnostic or treatment protocols, therapeutic options or epidemiologic trends. The goal of journal club is to teach fellows to critically evaluate the study design, methodology, statistics, and conclusions of  peer-reviewed papers. Each fellow chooses and presents a paper under the guidance of an endocrine faculty member. Fellows’ journal clubs are formally evaluated by faculty, and fellows receive written feedback on each presentation.

Thyroid Pathology Conference
Each Friday morning at 9am the endocrine faculty, fellows and medical house staff meet  in the FAHC cytopathology department to review the week’s cytopathology (e.g., thyroid FNAs) and endocrine and neuroendocrine surgical pathology (e.g., thyroidectomy, parathyroidectomy, adrenalectomy, pancreatectomy) of our patients under the tutelage of the pathology faculty and fellows. Timely review of the fellow’s FNA results provides timely feedback on their proficiency in thyroid fine needle aspiration. The goal of this conference is for endocrine fellows and faculty to learn to recognize the key features of benign and malignant thyroid lesions, and other surgically–resected endocrine tumors. Conference  director, Muriel H. Nathan, MD

Friday Didactic Conference
Each Friday at noon a one hour didactic conference is held for the endocrine fellows. The first, second and  fourth Fridays of the month this is held in a UHC conference room under the direction of Muriel H. Nathan, MD.  This weekly lecture series is provided by faculty in many medical and surgical disciplines, including but not limited to cardiology, ophthalmology, reproductive endocrine, pediatric endocrine, endocrine surgery, and nephrology. The goal of this conference is to provide a comprehensive year-long review of endocrinology, diabetes and metabolism. Lecturers from outside the endocrine unit widen the fellow’s exposure to diagnostic and treatment options for shared conditions, increase exposure to non-endocrine medical and surgical faculty and promote an inter-disciplinary approach to patient care.

Metabolic Bone Conference
On the third Friday of each month, a one hour CME-accredited bone conference held at noon in the hospital’s Austin Auditorium.  Each month a topic related to bone metabolism and disorders is presented by the Osteoporosis Center faculty, other FAHC-UVM faculty or fellows, or outside speakers. The goal of this conference is to educate fellows and faculty in many disciplines on key issues in the diagnosis and management of bone and mineral disorders. Metabolic Bone Conference director is Rose Christian, MD.

Thyroid Imaging Conference
On the first Friday of the month a one hour conference held in conjunction with faculty in otolaryngology, radiology and nuclear medicine.  The technique and interpretation of thyroid ultrasonography, CT, PET and scintigraphy are addressed and challenging cases presented in a multidisciplinary setting. The goal is to enhance endocrine fellows’ and faculty’s understanding of thyroid imaging options and applications, and to improve fellows’ competence in thyroid ultrasonography.