Outpatient Endocrine Clinics
Much of the patient care at UVa is directed by housestaff/fellows and staffed by UVa faculty. There are no private patients at the University Hospital, and our fellows do not rotate to other hospitals/clinics for training. Our clinical faculty have active clinical practices, and our division sees over 12,000 outpatients a year. Fellows rotate through these faculty clinics, engaging faculty members in their specific areas of expertise, which include diabetes mellitus (including diabetes-related cardiovascular disease); obesity; thyroid disease; hypertension/adrenal disease; metabolic bone disease/calcium disorders; neuroendocrinology/pituitary disease; reproductive endocrinology/infertility; endocrine disease (e.g., diabetes) in pregnancy; benign breast disease/breast cancer prevention.
Throughout their fellowship training, fellows maintain a weekly, half-day longitudinal care (continuity) clinic in which they provide endocrine care to their own roster of patients while learning from faculty preceptors dedicated to teaching and mentorship.
Inpatient Consultation Service
The fellows have primary responsibility for the inpatient general endocrinology/diabetes consultation service, which renders over 600 initial consultations annually and involves a wide variety of endocrine pathology. Fellow activities include initial evaluation, daily follow-up, and being a liaison between the primary and consulting teams. Fellows complete at least 6 months on the consult service during their first two years (in most cases, 5 months during the first year and at least one month in the second year). Currently, two fellows are on the consult service at all times, allowing them to alternate overnight and weekend call. The typical census includes 12-20 patients per day and 3-5 new consultations per day.
Of interest, the division is in the process of expanding our consult services. The general endocrinology/diabetes service (described above) is staffed by two fellows and faculty member. A second diabetes-specific service was started in late 2013 and is currently staffed by a faculty member and nurse practitioner. For the time being, this diabetes-specific service is focusing on postoperative glycemic management of cardiac surgery patients, although we plan to expand this service to other surgical services soon. Given the educational opportunities inherent to the postoperative diabetes service, our plan is that fellows will spend some time rotating with the postoperative diabetes service.
Coordinated Care Programs
Our division is an integral part of the Neuroendocrine Service (a combined endocrine and neurosurgery service), which performs 150-250 transphenoidal pituitary operations and over 50 gamma knife radiosurgery procedures each year. This service has an international reputation, routinely drawing patients from all parts of the globe. Our division also works very closely with the Endocrine Surgery Service (a division of General Surgery) and the Department of Otolaryngology-Head and Neck Surgery to ensure excellent care of patients requiring thyroid, parathyroid, and adrenal surgery.
- Research in Progress
- Endocrinology Clinical Case Conference
- Fellows’ Didactic (Clinical Lecture) Series
- Fellows’ Journal Club
- Thyroid Cancer Case Conference
- Pituitary Case Conference
Our three-year clinical/research training program involves an in-depth research experience. While we recognize that not all fellows will pursue research as a long-term career, we strongly believe such research experiences are beneficial for all clinicians. For example, meaningful participation in research fosters important critical thinking skills; and it provides a deeper understanding of the nature of scientific evidence, which is the foundation of medical practice. For details regarding research activities during fellowship, please see the Research Curriculum page.
Two-year clinical fellows are required to pursue an academic project (along with a faculty mentor) during her/his second year of fellowship.
Training for Medical Education
While not a formal part of the fellowship curriculum, we are currently bolstering opportunities for fellows who are specifically interested in medical education. In addition to encouraging informal teaching in the clinics and on the wards, we intentionally identify opportunities for fellows to teach in more formalized settings (e.g., resident conferences, graduate student lectures). Specific training in educational methodology is also available through the Teaching Resource Center at the University of Virginia.