The Fellowship Program is an ACGME accredited fellowship training program for pediatric endocrinologists. It is a young, vibrant, and thriving fellowship experience that offers extensive clinical training as well as outstanding clinical research and basic research training for future pediatric endocrinologists.
Faculty and Section Expertise
The faculty is nationally recognized in their respective areas of clinical or basic research and they are also accomplished clinicians. Their areas of expertise are complementary to one another so that there is excellence in most clinical areas of pediatric endocrinology including general endocrinology, growth and pubertal development, bone disease, diabetes, and metabolic disorders. As teachers, the faculty has been recognized by medical students, graduate students and residents as being outstanding. They are extremely popular with students and residents and are highly sought after to serve as mentors and advisors. Each faculty member has made a sincere commitment to teaching, and they have received special recognition for these teaching efforts.
The comprehensive fellowship is a three-year program. Twelve months are spent in clinical training and 24 months are dedicated to either basic laboratory and/or clinical research. Eight months of the first year and two months in each of the subsequent two years are devoted to clinical training.
Building on the close relationship with our adult endocrine colleagues, the Section has a strong track record in training combined Medicine/Pediatric Endocrinology fellows. Since 1998, we have trained more combined fellows than any other group in the country. Combined fellows spend a total of 12 months on clinical Pediatric Endocrinology, another 12 months on clinical Internal Medicine Endocrinology, and 24 months conducting clinical or basic research. The overlap in research training between the fellowships allows combine fellows to become board-eligible for both the ABP and ABIM in four years.
The Pediatric Endocrinology clinical service is busy. Currently, there are over 30 half-day endocrine or diabetes clinics per week and the outpatient service averages 300 patients per week. The inpatient service typically averages between three and ten patients. Because the program is based in the largest children's hospital in the state (population of 6.5 million), there is a wealth of clinical activity. Fellows are also welcome to attend the section's satellite clinics in South Bend, Evansville, Carmel, and St. Francis Hospital South Campus.
While on the clinical service, the fellow is responsible for managing the care of patients on the Endocrine service and consults. During the week, the fellow is expected to be available between 7:30 am and 5:30 pm daily. During the clinical rotations, the fellow takes call from home every other night and every other weekend on average. This schedule is designed so that the trainee has at least two nights off each week and has no program duties every other weekend.
Throughout their training, each fellow attends a bimonthly endocrine continuity clinic and a monthly diabetes continuity clinic. In these clinics, the fellow acquires a group of patients that are followed for the duration of the fellowship. Fellows remain actively involved in ongoing outpatient care of these clinic patients via telephone calls and communication with referring physicians. The staff coverage for this clinic includes all faculty members, so that the fellow is exposed to different styles.
The fellow is expected to participate in the education of housestaff and medical students when performing clinical service time. On the inpatient service, there are two pediatric residents and at least one medical student. The fellow is expected to develop supervisory experience in directing the activities of the other trainees. The fellow will present informal teaching sessions to these trainees at least weekly and formal conferences to the entire Pediatric Endocrinology team monthly. In addition, annually the fellow is required to deliver lectures to the pediatric residents, conferences at the campus-wide Endocrinology Grand Rounds, and journal club presentations.
The fellow has great flexibility in selecting a research project. During the first six months of the clinical program, the fellow is exposed to the research activities of the Section's faculty and may elect to work with anyone within the Section or other divisions or departments. The trainee is closely mentored by the senior investigator on every project; however, the fellow is expected to participate actively in the scientific design, execution and interpretation of results from each experiment or project. Regardless of whether the project is clinical or basic research, the trainee is expected to meet twice a week with the research mentor and to present a weekly update of progress to the rest of the specific research team. In addition, the fellow is expected to present an annual review of his or her research to the other members of the Section. At this meeting, progress is critically reviewed and constructive suggestions are made to ensure future productivity. Fellows are encouraged to present the results of their work at national meetings such as the Pediatric Academic Societies (PAS), the American Diabetes Association, and the Endocrine Society. These presentations are carefully coordinated and the entire Section participates in preparing the fellow for these public presentations. Those fellows interested in a career with a major emphasis on clinical or basic science research have the opportunity to apply for additional grant funding to extend their research training, either as a senior fellow or a junior faculty member. Fellows interested in obtaining additional training in clinical research have the option of participating in the CITE program (Clinical Investigator Training Enhancement), a course of study leading to a Master’s Degree in clinical research.
There is a standard curriculum of Pediatric Endocrinology topics that is covered each year during weekly section conferences. In addition, each fellow is encouraged to attend several courses that are offered on the Indiana University campus. These courses include a three week-long workshop on Molecular Biology, a semester-long course in Clinical Research techniques, a Summer Endocrine Didactic course, and courses in Statistics and Epidemiology. Additionally, the CITE Program offers the opportunity to earn a Master’s Degree in clinical research through the School of Medicine.
The fellows meet monthly with the staff physician on the inpatient service to evaluate their clinical skills. Trainees are formally evaluated twice per year by a Clinical Competency Committee. The inputs for this evaluation consist of monthly ward evaluations, evaluations by the research mentor, 360 degree evaluations, and the results of the American Board of Pediatrics Subspecialty In-Training Exam. Written records are kept by the Director of the training program, who reviews the evaluation with the fellow. Constructive comments are always expected and progress in any areas of weakness is reviewed most carefully at subsequent evaluations.
The residents, students and fellows also regularly evaluate the faculty. These evaluations are forwarded to the Section Director, who subsequently shares them with the faculty. Evaluation of the overall training program is also actively sought from the fellows. Twice yearly, the fellows are asked to evaluate the program, and their comments are utilized in the continuing reassessment of the program structure and content.
Past History and Accomplishments
The program graduated its first fellow in 1991, and former fellows now have faculty positions at major university medical centers. During their fellowships, trainees have been awarded NIH National Research Service Awards and have consistently received competitive grant funding. Many fellows have received travel awards to national and international scientific meetings. Each fellow has been invited to present his or her research findings at national meetings, and each fellow has publications in peer-reviewed scientific journals.