The overall program goals and objectives are to develop skilled and competent endocrinologists who demonstrate excellence in each of the six general competencies that have been identified by ACGME, placed in the context of providing optimal care for patients with endocrine and metabolic disorders.
Education and Curriculum Overview
Overall Curriculum Requirements
The educational purpose of the elective blocks is to provide additional training and expertise from specialists outside of Adult Endocrinology to enhance the development of clinical competence in Diabetes, Endocrinology and Metabolism.
- Endocrine Continuity Clinic: 1st year - 2 clinics per week; 2nd year - 2 clinics per week
- VA (Kernersville) Outpatient Clinic: ~ 19 weeks per year
- Endocrine Consults: ~ 14 weeks per year
- Elective/Selective Months: ~ 19 weeks per year
Continuity Clinic Experience
The outpatient activities of the fellowship reflect the fact that 90% of the practice of endocrinology occurs in the ambulatory setting. Thus, an extensive and thorough experience in the outpatient setting is critical to the fellowship training experience in endocrinology. The outpatient experience is an important facet of the training program, permitting the trainee to fully explore study and have personal experience with the greatest number of endocrine disorders. Fellows will develop their own patient panel over the 24-month training period. Fellows do not have continuity clinic while on call.Consult Experience
The educational purpose of the fellow's inpatient consultative duties relates to a critical responsibility of the endocrinologist - the role of serving as consultant for other physicians in the management of sick hospitalized patients with endocrine disorders. Clearly, the endocrine problems seen in the inpatient setting are more acute, more severe, and at times more enigmatic than the typically more chronic diseases seen in the outpatient arena. Time considerations and severity of disease call for more speed in decision-making than the typical outpatient consultation; and the complexity of patients with multisystem disease can make the sorting out of endocrine problems a particular challenge.
Elective Experience
The educational purpose of the elective blocks is to provide additional training and expertise from specialists outside of Adult Endocrinology to enhance the development of clinical competence in Diabetes, Endocrinology and Metabolism. Below is a sample schedule for a fellow. Each fellow takes 2 weeks of call, and then has a 6-week block that is split between an elective and a VA rotation. This pattern repeats every 8 weeks. Additionally, each fellow will rotate in the DEC Hospital follow-up/urgent clinic for four weeks, every eight weeks.
Mandatory electives done over 24 months are listed below, but an additional four rotations can be created/repeated to fit fellow needs:
- DXA/Foot pathology
- Endocrine Neoplasm/Nuclear Medicine
- Pediatric Endocrinology and Diabetes
- Reproductive Endocrinology
- Weight Management
- Diabetes Education/ Diabetes Technology
- Private Practice/North Elm
- Inpatient Nutrition/TPN
- Wound care
- Lipid Management
- Research
Weekly Core Curriculum Conference
Collectively, the fellows meet with faculty members on a weekly basis. The goal of this conference is to review topics, which are commonly encountered in the clinical area, and to review uncommon clinical issues, which he/she may not personally encounter during a fellowship, but should be familiar with in order to be a well-rounded endocrinologist (e.g., insulinoma, glucagonoma).
Weekly, On-Call Fellow Presentation
During this conference the on call fellow will do a 30 minute presentation based on an interesting or challenging in-patient consult or clinic patient. During the presentation, each fellow outlines the relevant questions, appropriate literature searched and recommendations for practice management.
Case-based conferences
This conference focuses on clinical topics, either in a formal didactic method or by group discussion of interesting or problematic cases seen in the ambulatory clinic or by the Endocrine consult service.
Mechanisms of Endocrine Disease, or "Research conference"
This conference focuses on the biochemistry and pathophysiology of diabetes and endocrine diseases, with particular attention to cellular and molecular biology and active, ongoing research activities pertinent to endocrinology.
Journal Club
This is a formalized review of current endocrine and diabetes literature. Pertinent journals in endocrinology and diabetes (e.g., JCEM, Diabetes Care, and Molecular Endocrinology) are covered. Specific papers are selected in advance for discussion by faculty and fellows.
Thyroid/Endocrine neoplasia Tumor Board
This is a monthly interdisciplinary conference designed to discuss interesting or complicated patient cases of thyroid cancer or other endocrine neoplasms. Relevant invitees include nuclear medicine, pathology, radiology, endocrine surgery and ENT surgery.
Pituitary Tumor Board
This is a quarterly interdisciplinary conference designed to discuss interesting or complicated patient cases related to pituitary disease. Relevant invitees include pathology, radiology and neurosurgery.
Diabetes Case Conference
This is a quarterly conference held at the Diabetes and Endocrinology Center. This interdisciplinary conference is designed to explore relevant topics in the diagnosis and management of patients with diabetes. Relevant invitees include all faculty, advanced practice providers, nursing, nutrition and CDEs.
Research and QI Opportunities
The purpose of the research training associated with the Fellowship in Endocrinology and Metabolism at the Wake Forest School of Medicine is to provide a broad-based research opportunity even if their ultimate goal is not a career in research and academic medicine. We realize that each fellow will have variable research, and we wish to be able to provide a program that will accommodate all forms of such interest from basic science to QI projects. Each fellow will be expected to complete at least one research/QI project prior to graduation. At a minimum, an aggregate of at least 4 months is available to the fellow to accomplish the research goals.
Endocrinology Fellowship Program Research
The research time will be longitudinal during the 2-year training period with additional research blocks available. Each fellow will have a research mentor and have access to IHI Open School which is a growing catalog of online courses that teaches the foundations of improvement, safety, system design, and leadership. Completion of the basic certification program will provide you the knowledge and skills to perform a QI project.