The First Year
In the first year, fellows divide their time between inpatient and outpatient rotations that alternate every 2-4 weeks:
- Inpatient Endocrinology Service: 4 months
- Inpatient Diabetes Service: 2 months
- Outpatient Endocrinology & Diabetes Service: 6 months
On the inpatient Endocrinology and Diabetes Services, the fellows work closely with Endocrinology Division faculty to evaluate and manage all endocrine and diabetes consultations within Boston Children’s Hospital, as well as in the newborn nurseries and neonatal intensive care units at the adjacent Brigham and Women’s Hospital (BWH) and Beth Israel Deaconess Medical Center (BIDMC). Fellows directly supervise the care of all endocrine and diabetes patients admitted to the Boston Children’s Hospital Endocrine Service. While on inpatient rotations, fellows maintain one half-day continuity clinic session per week.
On the outpatient service, each fellow conducts 2 half-day continuity clinics per week. The fellow also sees new patients in need of urgent consultations, interacts with primary care physicians about possible referrals, and attends 1-2 endocrine subspecialty clinics per week, including clinics in Differences of Sex Development (BEING-U), Gender Multispecialty Service (GeMS), Type 2 Diabetes/Weight Management (Optimal Wellness for Life), Thyroid Nodules/Cancer, Bone Health, Neuroendocrinology/Cancer Survivorship, and Endocrine Oncology. Remaining time is available for scholarly activities, and fellows may choose to carry out an independent clinical research project during this time based on their interests.
In continuity clinic, each fellow maintains their own panel of patients whom they follow longitudinally, working closely with Endocrine Division faculty. This structure allows the fellow to observe the natural history, treatment, and outcomes of endocrine disorders. Continuity clinics expose fellows to a wide range of pediatric endocrine disorders including type 1 and type 2 diabetes, disorders of puberty and growth, obesity, metabolic bone disease, reproductive endocrinology, thyroid disorders, differences of sex development, transgender medicine and neuroendocrine dysfunction. For patients with diabetes mellitus, the fellow works within a collaborative multidisciplinary team that includes diabetes nurse educators, nutritionists, social workers, and psychologists. The end of each continuity clinic session is highlighted by a lively post-clinic conference at which all fellows, house staff, students, and faculty review the cases of instructive patients seen in clinic that day.
Each first year fellow takes call from home for the inpatient Endocrinology and Diabetes services one weeknight per week (Mon-Thu). Weekend call is divided equally among fellows of all three years. Weekend inpatient call occurs every 9th weekend (on average) and includes daytime rounding in the hospital and overnight call from home (Fri-Sun). In addition, each fellow takes outpatient call from home (Sat/Sun mornings 8a-12p) every 9th weekend to allow the inpatient team to round more efficiently.
Education and Conferences
Participating in education as both a teacher and a learner is an essential component of a career in academic medicine. Each of our fellows receives an appointment as a Clinical Fellow at Harvard Medical School (HMS), and has the opportunity to teach at many levels, including supervision of the medical students and residents who frequently rotate on our service. We are proud that our Endocrinology fellows consistently are highly regarded for their teaching by medical students and residents at Boston Children’s Hospital, both on the wards and in more formal settings at the hospital and medical school.
During the first year, each fellow prepares and presents approximately 9 clinical conferences attended by endocrinologists at Boston Children’s Hospital, Joslin Diabetes Center (JDC), BWH, BIDMC, and the other Harvard-affiliated teaching hospitals in the Harvard Medical School (HMS) area. These conferences give the fellow the opportunity to investigate clinical topics in depth and to engage a group of senior endocrinologists in discussion. Fellows also attend a variety of educational conferences including Fundamentals of Endocrinology, Fellows’ Journal Club, Endocrinology Case Conferences and Division Seminars, and a variety of endocrine subspecialty and multidisciplinary conferences.