Scope of Clinical Training:
Training for fellows in pediatric endocrinology involves intensive clinical training in all aspects of clinical pediatric endocrinology, as well as development of clinical and/or basic research skills. The large volume and broad range of endocrine pathology seen by Children’s Hospital endocrinologists ensures an optimal clinical experience for endocrine fellows. To accomplish this, pediatric endocrine fellows will be trained to become proficient in endocrine-focused history and physical exam skills, interpretation of growth charts. They will learn appropriate selection, performance and interpretation of endocrine-related diagnostic tests, and integrate this knowledge base to develop appropriate management plans for patients with endocrine disorders referred for outpatient and inpatient endocrine consultation. During the last two years of the training program they will become highly skilled in the field of pediatric endocrine research, ready to assume leadership roles in the nation’s biomedical and behavioral research efforts in pediatric endocrinology.
The 1st year of the fellowship consists of clinical training and incorporates some preparation for the 2nd year, while the 2nd and 3rd years consist mainly of research with some clinical training (continuity clinics, inpatient consultation). During year one of the clinical track you will identify an area of research interest and a mentor for pursuit during the second year.
To prepare trainees to function as effective endocrinologists upon completion of their fellowship, fellows are encouraged to assume progressive responsibility for patient care over the course of their three years. Late in the first year, and certainly during the second and third years, fellows are expected to direct clinical care during rounds, with the supervision of a faculty attending. Fellows are expected to actively seek the most up-to-date information to guide clinical care whenever possible. Likewise, fellows are expected to take an active role in teaching the pediatric house staff, both through didactic lectures and extemporaneous bedside teaching.
All fellows are directly supervised by faculty members (CHCO, UCH, or BDC) specific to that rotation and by the inpatient consult attending for the inpatient consultation rotation. This attending physician shall be available at all times to the endocrine fellow. It is the responsibility of the fellow to communicate effectively and in a timely fashion with the attending physician as well as other members of the Endocrine Faculty. At each stage of training, the goal is to provide a level of supervision that ensures patient safety and maximizes education while promoting the trainee’s sense of independence and autonomy
All clinical activity during fellowship occurs at Children’s Hospital Colorado, University Colorado Hospital or The Barbara Davis Center. The clinical schedule is broken into discrete 4-week blocks and over the course of the fellowship; each trainee will spend 12 blocks on service. The clinical schedule is intentionally front loaded, with fellows spending 10 blocks on service during their first year of training (rotating between BDC, UH, and CHCO). During each of the last 2 years, a fellow spends 1-2 blocks on service with the rest of the blocks dedicated to research.
Call for pediatric endocrine fellows are at home call. They are required to answer phone calls from parents of patients, outpatient phone consults and inpatient consults. They rarely have to go into the hospital for an urgent consult. First year pediatric endocrine fellows take call up to 10 days per month, including one weekend. Second and third year pediatric endocrine fellows take care up to 7 days per month, including one weekend.
Fellows are expected to attend the following conferences during the fellowship program:
Monday Case conference – Monday 8-9 am.
Conference includes pediatric endocrine fellows and pediatric endocrine faculty. Cases are brought by both fellows and faculty for discussion and review. Inpatients are reviewed. Fellows present a more formal case with a detailed literature search 4-6 times per year during their first year. This is also the forum for discussion of topics related to the laboratory.
Diabetes conference – Tuesday 12-1 pm.
Conference includes pediatric endocrine fellows and pediatric diabetes faculty. Endocrine fellows present in the conference annually. Topics include research in progress, clinical topics related to diabetes care, instruction on effective reading of the literature.
Endocrine grand rounds – Wednesday 8-9 am.
Conference includes pediatric endocrine fellows and pediatric endocrine faculty, endocrine fellows and faculty. Endocrine fellows present once as a first year fellow. Topics include challenging endocrine cases, updates to clinical practice of endocrinology, invited speakers from across the country.
Journal club – Friday 8-9 am
Conference includes pediatric endocrine fellows, pediatric endocrine and diabetes faculty. Second and third year fellows present 2-3 times per year. Journals are reviewed by the presenter to identify articles that are pertinent to pediatric endocrinology and diabetes. Reviewers select 3-5 articles for detailed discussion. Fellows are encouraged to select 2-3 articles for more in depth discussion of study design, statistics and interpretation of results. This facilitates skill in critical reading of the literature, analysis of study design, statistics, extrapolation of research studies to clinical care of children with diabetes and other endocrine problems.
Fellow case conference – First and Third Tuesdays 4-5 pm
Conference includes Drs. Barker, Klingensmith and Zeitler and pediatric endocrine fellows. This informal conference consists of fellows bringing particularly challenging cases for discussion with a focus on understanding the underlying physiology and pathophysiology associated with the cases. Additionally, PREP questions are reviewed. Lastly, this conference is the opportunity to identify issues related to the fellowship that need to be addressed.
Pediatric Endocrine Summer School – Monday, Tuesdays and Friday (July-August)
Conference consists of varied topics pertinent to the clinical care of children with diabetes and other endocrine problems. Presenters are faculty in the division of pediatric endocrinology and the Barbara Davis Center. The purpose is to provide a broad overview of the general topics of pediatric endocrinology and diabetes and provide the fellows with a foundation for the clinical care of children with these disorders.
Endocrine quarterly meeting- Every 3 months Friday afternoons 12:30-4:30
Endocrine and diabetes faculty and fellows attend this conference. Conference includes an hour of didactic lectures from disciplines throughout the University (radiology, urology, genetics, reproductive endocrinology, etc), time for morbidity and mortality. Conference includes an hour for the discussion of disorders of sexual differentiation in a multi-disciplinary team.
Multiple research focused conferences throughout the Medical Campus, including at Children’s Hospital and the Barbara Davis Center – Required as appropriate for mentored research project