Clinical Training

Inpatient Consultation Service

Our fellowship training program includes 6 months of inpatient consultations: 16 weeks during the first year and 10 weeks during the second year.  Fellows work on the inpatient consult service for one week at a time, and call is taken from home.  There is a dedicated inpatient consult attending who rotates simultaneously with the fellow, and the inpatient consult team may also include a Diabetes Fellow, Internal Medicine residents, and a 3rd or 4th year Medical Student.  Fellows may schedule hospital follow-up visits for patients they have managed on the inpatient service, providing continuity of care during the patients’ transition to the outpatient setting.  Fellows do not have outpatient clinics during inpatient consult weeks.

Outpatient Clinic Services

Most our program’s training occurs in the outpatient setting, and fellows gain experience in a variety of clinic types.  Most clinic sessions take place in our General Endocrinology Clinic, located in the Brody Outpatient Center, which is directly connected to ECUHMC.    Our clinic team members include physicians, a nurse practitioner, a physician assistant, a registered dietician/certified diabetes educator, nurses, medical assistants, and patient access representatives.

Continuity Clinic

Continuity Clinic occurs on four half-days per week for both first year and second year fellows.  Patients are scheduled directly with the fellows, and each fellow follows their patients longitudinally over the course of training.   All of our faculty members serve as preceptors, giving our fellows exposure to varying styles of patient management.

Diabetes-in-Pregnancy Clinic

First year fellows spend one half-day per week seeing patients in our dedicated Diabetes-in-Pregnancy clinic during either the first 6 months or second 6 months of the year.  This clinic utilizes a team-care model, and rotating fellows are encouraged to follow individual patients over the course of pregnancy as much as possible.  After the conclusion of pregnancy, the patient may then be managed by the fellow in their continuity clinic.   For patients delivering at ECUHMC, our inpatient team provides consultative assistance with glycemic control in the immediate peripartum period, providing an additional layer of continuity and supporting patient transitions between the inpatient and outpatient settings.

Greenville VA Endocrinology Clinic

First year fellows spend one half-day per week seeing patients in at the Greenville VA Endocrinology clinic during either the first 6 months or second 6 months of the year, opposite from the Diabetes-in-Pregnancy clinic.  The Greenville VA Outpatient Center is located less than a mile away from the Brody Outpatient Center and houses the Greenville VA Endocrinology clinic.  This rotation exposes fellows to a unique system of healthcare delivery and grants experience with a different patient population from that seen in continuity clinic.

Second-Year Electives

Second-year fellows spend one half-day per week in elective rotations during the first six months of the year.  Elective experiences include Pediatric Endocrinology clinic and intensive self-guided study in either obesity medicine or lipidology.

Thyroid Procedure Clinic

Fellows perform thyroid ultrasonography and fine needle aspiration (FNA) biopsies using our dedicated procedure room in the General Endocrinology Clinic.  Each first-year fellow has thyroid procedure clinic one half-day per week.  Second-year fellows have thyroid procedure clinic on one half-day every 3 weeks.  All FNA biopsies are performed with the immediate on-site support of a Cytopathology technician.

Bone Densitometry Service

Our Bone Densitometry Center is located just down the hallway from the general endocrinology clinic.  Patients are referred for bone densitometry and/or clinical consultation for the prevention and treatment of metabolic bone disease.  Patients referred for clinical consultation are seen in the fellows’ continuity clinics.  Fellows review and generate an interpretive report for one DXA scan per week when they are not assigned to the inpatient service.  Fellows are preferentially assigned DXA scans for their own patients seen in continuity clinic.

Educational Conferences

Educational opportunities are offered through our robust didactic curriculum, with morning conferences occurring 4 times per week.  Divisional Grand Rounds, Endocrine Core Curriculum, and Diabetes Conference each occur on a weekly basis.  Journal Club, Scholarly Activity Conference, and Radiology Conference are each held monthly.  Pathology Conference and Professional Development Conference are each held every-another month.  Additional workshops and in-services (such as hands-on insulin pump and CGM training) are held sporadically on Friday afternoons.

Scholarly Activity

Our division offers ample opportunities to participate in clinical and translational research, quality improvement initiatives, and patient safety projects.

Each fellow is required to engage in a research project and/or quality improvement project during their training.  First-year fellows explore potential project ideas and formulate a participation plan that is presented at the end of the year, while second-year fellows engage in their project(s) and present a summative project report near the end of training.

Our fellows often encounter patients with rare conditions and/or unique presentations, and they are strongly encouraged to compose case reports for submission to conferences and/or scholarly publication.

Each fellow is required to submit at least one abstract for presentation at a regional or national conference during each year of training.  Our fellows often choose to submit and present their work at our institution’s annual GME Research Day, but they have also presented their work at national meetings of the Endocrine Society, AACE, ATA, and ASBMR.