The Endocrine Fellowship Training Program at the University of Colorado, School of Medicine (UC) is designed to provide each of our trainees with outstanding clinical and research training in endocrinology, metabolism, and diabetes. Our goal is to provide fellows with a level of training, experience and expertise that will put them on a path to become leaders in endocrinology and to have successful careers in academic medicine. We have designed our program to provide our fellows with the opportunity to work with experienced investigators on either basic or clinical research projects that will provide a foundation of experience that will allow the fellow the opportunity to pursue an independent research career if they so choose. We want to help our fellows tailor an educational experience from a rich environment at UC that will help them reach their personal professional goals. Established in 1982, the Endocrinology Training Program at UC is the only NIH funded endocrine training program between the west coast states of California, Oregon and Washington, and the Midwestern states of Minnesota, Illinois, Missouri and Texas. We have a 20 year history of training outstanding academic and clinical endocrinologists and our faculty are committed to providing (and believe that we provide) one of the best endocrine training experiences in the country.
The First Year:
The focus of the first year of fellowship training is clinical endocrinology. First year fellows see outpatients and inpatients with a broad spectrum of disorders of the endocrine glands, lipid and bone metabolism, reproductive and neuroendocrinology, diabetes mellitus, and obesity. Fellows gain clinical experience on the inpatient Endocrine Consult services of the University of Colorado Hospital (UCH), the Denver Veterans Administration Medical Center (VAMC), and Denver Health Medical Center (DH), and in outpatient endocrine clinics at these three hospitals. We believe that this focus on clinical training during the first year of the fellowship allows each new fellow to make a smooth transition from the role of a well-trained general internist to a skilled clinical endocrinologist. In addition, this period of clinical training provides a foundation on which subsequent research training is built. During the first year fellows learn through supervised patient care, in didactic conferences and multidisciplinary conferences. Details of these activities are listed below.
While some incoming fellows may already have an interest area that they wish to focus on for their research years, many do not. During the fall of the first year fellows will have the opportunity to meet with faculty members to discuss the research training opportunities available to them. We are fortunate to have faculty working in almost all sub-disciplines of endocrinology. By the spring of the first year, fellows will select a primary research mentor and with their mentor will select a “mentorship committee” and begin to plan the research projects that they will work on during the second year. This allows each fellow to “hit the ground running” when they start their period of focused research years at the start of the second year of training.
The Second Year:
The second year for most fellows is primarily focused on research with some continued clinical training. A majority of the trainee’s time is spent in a mentored research experience. One half day per week is spent in his/her continuity clinic, and two half days per month are devoted to specialized training in lipid disorders, pediatric endocrinology, high risk obstetrics, reproductive endocrine and osteoporosis/metabolic bone clinics. Two weeks are spent on the inpatient Glucose Management Team at the UCH to obtain experience managing complex glucose-lowering regimens for patients with cystic fibrosis, solid organ transplantation and other conditions. Fellows are offered the opportunity to teach medical students by facilitating small group discussions of endocrine pathophysiology cases. Realizing that not all applicants are looking for an intensive research experience during their fellowship training, in 2012 we will be considering applicants who are looking for 2 years of training with a greater emphasis on clinical training. For these individuals, the second year will include a scholarly project conducted under the mentorship of an experienced investigator, but will include substantially more experience in inpatient and outpatient treatment of diabetes including experiences at the Barbara Davis Center for Childhood Diabetes, an internationally-known institution in research and the clinical care of type 1 diabetes.
The Third Year:
For fellows interested in pursuing a more research-focused experience and who are supported by the Division’s NIH funded training grant, the third year continues a focus on research. As the ACGME-defined clinical training program ends after 2 years, our goal is to individualize the third year experience to the specific professional goal of the fellow. The bulk of the fellow’s time is devoted to research, preparation of data for publication, and grant writing. Most fellows continue in their weekly half-day continuity clinic. Many spend some time in a focused sub-subspecialty clinic that is related to the research question that they are studying. Fellows also have the opportunity to develop unique skills in specific areas of clinical endocrinology by rotating through optional endocrine subspecialty clinics such as HIV Endocrinology or Obesity clinic. In this year, fellows who would like to further hone teaching skills are given the option to facilitate small group discussions of endocrine pathophysiology cases for medical students.
Training, Clinical and Research Facilities
We believe that one of the strengths of our training program is the diversity of the sites for both clinical and research training. Facilities for clinical and research training in Endocrinology, Metabolism and Diabetes are located at the new Outpatient Pavilion, Inpatient Pavilion and Children’s Hospital at the Anschutz Medical Center in Aurora, at the VA Medical Center in east Denver and at the Denver Health Medical Center (DHMC) in central Denver. Each site serves a unique population and therefore provides unique clinical experiences and research opportunities
The Department of Medicine at the University of Colorado has over 600 full-time faculty members and more than 300 housestaff and fellows. Strong and supportive departmental leadership comes from the Department Chairman, Dr. David Schwartz. Clinical teaching activities utilize three Core teaching hospitals: University of Colorado Hospital (Anschutz Inpatient Pavilion, AIP) is a 373-bed, tertiary care hospital that serves as the major teaching hospital of UC. It is located on the Anschutz Medical Campus in Aurora, CO. The 400-bed Denver Veterans Administration Medical Center is located on the 9th Ave campus in east Denver. The endocrinology service at the VAMC is closely integrated with the service at the University of Colorado Hospital. Denver Health is a modern 300-bed acute care city and county hospital. DH has been a leader in the National Association of Public Hospitals and is one of the healthiest “City and County” hospitals in the country. Endocrine activities at DH are also completely integrated into the clinical and educational activities of the Division at UCH. Each of these clinical facilities has inpatient endocrine consult services and outpatient clinics for clinical training of our Endocrine fellows.
The Division of Endocrinology, Metabolism and Diabetes, occupies 16,000 sq. ft. of laboratory space located in the state-of-the-art Research One South complex on the Anschutz Medical Campus and 2,000 sq. ft. of both laboratory and office space at the VAMC. Additionally, there is an NIH-supported Clinical Translational Research Center (CTRC) located on the 12th floor of Anschutz Inpatient Pavilion which is part of the Colorado Clinical & Translational Science Institute (CCTSI). Many inpatient clinical research studies are performed by fellows and
Division members on the CTRC, which has a rich 42-year tradition and includes both an outpatient and an inpatient facility. Endocrinology Training faculty involved in the CCTSI are Robert H. Eckel, M.D., Director of Participant and Clinical Interactions Resources, Bryan R. Haugen, M.D., Director of the CTRC Core Laboratory, and Jane Reusch, M.D., Associate Director of the Education, Training and Career Development Program. The Barbara Davis Center for Childhood Diabetes led by Dr. George Eisenbarth is a world leader in studies on the pathogenesis of type 1 diabetes and conducts ground breaking trials in the prevention and treatment of this condition in both children and adults. The newest addition to the research facilities available to fellows in the endocrine training program is the Anschutz Center for Health and Wellness (Anschutzwellness.com) which contains state of the art infrastructure for clinical studies in nutrition, obesity and fitness. Finally, the Division has designated office space on the 7th floor of RC1 to be used by the endocrinology fellows. This space is equipped with desks and computers, and is adjacent to the research laboratories.
Core Facilities: A number of Core Facilities are available to researchers including Core labs in Genetics, Clinical Investigation, Biostatistics, Flow and Confocal Cytometry, Laboratory and Transgenic Animal Core, Tissue Culture and Monoclonal Antibody Core, DNA and Sequencing Core, Pathology and Tissue Procurement Core, Fermentation Core, and Immunology Core.
Fellow’s Office within the Division, 350 sq. ft of office space has been architecturally designed to be used by the endocrinology fellows. This space is equipped with desks and computer facilities, and is adjacent to the research laboratories.
Clinical Service, Conferences and Seminars
Endocrine Consulting Service:
The three first year fellows have primary responsibility for the management and organization of the inpatient endocrine consult service. This service includes the management of the endocrine consult team which includes the 3 first-year fellows, residents and medical students, seeing patients in initial consultations, presenting to the Endocrine team on rounds, acting as a liaison between housestaff and attending physicians, and daily follow-up of patients on the consult service. Attending rounds are held four to five times per week; more frequently if the need arises. The service is an active one, seeing an average of 30-50 new consults per month and following 10-15 patients combined at any one time at the three teaching hospitals.
The Division of Endocrinology, Metabolism and Diabetes assumes full responsibility for the management of several outpatient clinics. These include a General Endocrine Clinic, Metabolic Bone Clinic, Diabetes Clinic, Thyroid Neoplasms Clinic (in parallel with our Endocrine surgeons), Pituitary Tumor Clinic (held jointly with our neurosurgeon) and Lipid Clinic at Anschutz Outpatient Pavilion. We also have very active General Endocrine Clinics at the VA Medical Center and Denver Health Medical Center. First year fellows attend four to five half days of clinics per week. Second-year fellows attend a little less than two half day clinics per week, and third-year fellows typically attend one half day of clinic per week. In the second year, all fellows attend Metabolic Bone, Lipid, Pediatric Endocrine, and Reproductive Endocrine Clinics. The third year fellows attend their continuity clinic and may also attend a clinic which focuses on an area that complements his or her research focus.
Weekly Endocrine Grand Rounds:
The Wednesday Endocrine Grand Rounds is attended by faculty from the Division and throughout the University, practicing endocrinologists from the community, housestaff, and students. The topics discussed at this conference are clinically relevant, but may include newer developments in the basic sciences which are of increasing importance to a clinician. Several times each year, Endocrine fellows are scheduled to present interesting cases they have seen and discuss a related area of diagnosis or therapy.
Journal club follows Endocrine Grand Rounds every Wednesday. Fellows gather to discuss a group of recent articles of their choice. In this forum, first year fellows learn from senior fellows and faculty. Often, this conference allows the opportunity to compare the content of the literature with “what we really do.” The focus is very clinical and the goal is to stay up-to-date on a broad range of topics. Fellows often cover 1-3 articles in depth.
Multidisciplinary Clinical Conferences:
Fellows attend monthly interdisciplinary conferences focused on management issues for patients with Thyroid Neoplasms and Pituitary tumors. Pathology slides and imaging studies are reviewed and discussed in the context of the clinical case. Fellows often present patients at these conferences and participate in lively and interesting management discussions with specialists in Endocrinology, Surgery, Pathology and Radiology.
Endocrine Training Faculty
Fellows undergo intensive first-hand participation in basic or clinical research under the direct supervision of a primary faculty mentor with assistance and input from the Mentorship Committee and the Program Director. The endocrinology training faculty are involved in diverse research areas and provide a wide spectrum of research opportunities. Each member of the faculty is actively engaged in either clinical or basic research in various areas of clinical endocrinology, molecular endocrinology, reproductive endocrinology, hormones and cancer, childhood growth disorders, childhood diabetes, nutrition, metabolic bone disease, adult diabetes, obesity and lipid metabolism. From this wide range of research options each fellow’s research training experience can be tailored to his or her specific goals and integrated into the faculty mentor’s ongoing program of research. Please see below for a list of training faculty and their research interests.