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 Rocky Mountain Regional Veterans Administration Medical Center (RMR 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. During the first year fellows learn through supervised patient care, didactic conferences and multidisciplinary conferences (details below).
During the fall of the first year, fellows will have the opportunity to meet with faculty members to discuss research training opportunities available to them and determine the best training course for them. Fellows have the option of a 3 year research intensive course of training or a 2 year 'clinical educator' option that can be tailored to the trainee's educational goals. Rather than have applicants decide up front what the best track is, we work with our fellows during the first year of training to decide what 2nd year training experiences will best serve their needs.
Endocrine Consult 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. Each of the first year fellows is assigned to the inpatient endocrine consult service at one of the three teaching hospitals (UCH, RMR VAMC or DH) at any given time and move between these clinical sites on a rotating basis. Attending rounds are held daily at the 3 hospitals and there is a dedicated teaching session with the UCH consult attending for all of the fellows at least two times per week. The inpatient endocrine consult service as a whole 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 manages several outpatient clinics in the Anschutz Outpatient Pavilion at UCH including: 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 colleagues), Multidisciplinary NAFLD Clinic, Integrated Transgender Clinic (another joint multidisciplinary clinic), and Lipid Clinic. We also have very active General Endocrine Clinics at the Rocky Mountain Regional VAMC and Denver Health Medical Center, as well as a dedicated VA Medical Weight Management Clinic. First year fellows attend four to five half days of clinics per week at the three teaching hospitals. Second-year fellows typically attend a little less than two to up to three half day clinics per week (depending on whether they choose a research or clinical educator focused 2nd year), and third-year research fellows typically attend one half day of clinic per week. In the second year, all fellows attend Metabolic Bone, Lipid, and Gestational Diabetes/Reproductive Endocrine Clinics. Fellows may also attend the other Subspecialty Endocrine clinics, as well as Pediatric Endocrine clinics at Children’s Hospital Colorado, depending on their interests.
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, and usually include newer developments in the basic sciences that are of increasing importance to a clinician. Several times each year, Endocrine fellows present case discussions based on patients they have seen in the inpatient or outpatient setting, and often stimulate lively discussions among attendees. At the end of the year, second year fellows present the findings from the quality improvement projects they have been working on during their training.
Journal club follows Endocrine Grand Rounds every Wednesday. Fellows gather to discuss 1-2 recent or landmark articles of their choice. In this forum, first year fellows learn from senior fellows and faculty. Often, this conference allows the opportunity to gain a more in-depth understanding of clinical research and clinical trials, and to compare published 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 as well as reviewing recent guidelines and 'classic articles.'
Fellows attend and present patients at the monthly Thyroid/Parathyroid and Pituitary interdisciplinary conferences. Pathology slides and imaging studies are reviewed and discussed in the context of the clinical case. Fellows participate in lively diagnosis and management discussions with specialists in Endocrinology, Surgery, Pathology and Radiology. Fellows also attend monthly Metabolic Bone and Diabetes Clinical Conferences, and participate actively in case presentations and discussions of difficult/challenging clinical questions.