The Clinical Program, composed of the outpatient and inpatient experience, provides opportunities for the Fellow to develop clinical competence in the field of endocrinology, diabetes and metabolism. Clinical experience includes opportunities to evaluate, diagnose and manage adult patients in the outpatient and inpatient settings, representing the full spectrum of endocrine and metabolic diseases and variable acuity.
The Fellows assume responsibility for patients and follow them throughout the training period in both outpatient and inpatient settings and observe the evolution and natural history of these disorders, as well as the effectiveness of therapeutic interventions. To accomplish these goals, the program devotes more than 70 percent of the clinical training in outpatient care settings.
Outpatient Endocrine Clinics
The Division offers complete diagnostic and therapeutic services for patients with endocrine and metabolic disorders. Attending physicians work closely with referring primary care physicians as well as other subspecialty services including General Surgery, Cardiothoracic Surgery, Neurosurgery, Ophthalmology, Radiology, Nuclear Medicine, Nutrition and Podiatry to coordinate the diagnosis and management of complex endocrine diseases.
The Subspecialty Endocrine Clinics are supervised by attending physicians who have an interest and expertise in the field. This arrangement provides for a unique educational experience for the Fellows. For a brief description of the Subspecialty Clinics, please view our Outpatient Endocrine Clinics.
Our outpatient volume is over 10,000 visits a year. About 40% of patient visits are conducted with the Fellows. For the specific clinics that first- and second-year fellows attend, please see First-Year Responsibilities and Second-Year Responsibilities.
Inpatient Endocrinology Consultation Service
Training in the inpatient setting broadens the exposure to endocrine disorders and enriches the educational experience. The Consultation Service is composed of the General Endocrinology Consultation Service (covered by the fellows and an endocrinology Attending) and the Glycemic Consultation Service. The latter provides consultative and continuing management care for many inpatients with diabetes mellitus and is covered by advanced practice practitioners (e.g., NP) during the week.
Fellows obtain a comprehensive understanding of indications, contraindications, limitations, techniques, complications and interpretations of procedures that are required for diagnosis and management of patients with endocrine disorders. For the thyroid FNA, a minimum of 10 aspirations must be done before a trainee can be proficient. During the program, fellows rotate in the Thyroid US and FNA Clinic and perform 30-40 thyroid FNAs, most of them during the first year.
Thyroid US is also taught during the Training Program. The Fellows are encouraged to attend the AACE Certification on Thyroid Ultrasound and Ultrasound Guided FNA at some point during their fellowship to obtain their Endocrine Certification in Neck Ultrasound (ECNU) under the mentorship and supervision of our ECNU-certified faculty.