Our subspecialty training program is designed to provide two to three years or more of advanced clinical and research training in the field of Endocrinology, Diabetes and Metabolism. While our major emphasis is on training academic endocrinologists who have an interest in basic and/or clinical research, our program also fulfills the needs of trainees who wish to become clinician-educators. Our program recognizes that some trainees may evolve into specialists whose activities encompass more than one of the above career paths.
Trainees are given increasing responsibility as they progress through the program and demonstrate their expanding knowledge base and expertise in diagnosis and management of endocrine disease. They serve as leaders of the endocrine team, which consists of the fellow, internal medicine residents and medical students, with attending supervision. Our program emphasizes a scholarly approach to diagnosis and management. Self-instruction; is expected of the trainee along with critical analysis of the patient’s problems and appropriate decision analysis regarding further evaluation and/or management.
There are two fellowship tracks. The first is the traditional track, involving a clinical year with a focus on ambulatory and inpatient training, followed by one to two years of research. During the second fellowship year, the fellow will maintain participation in an ambulatory continuity clinic. The traditional track provides a foundation in academic endocrinology. The second track is a clinical track with an emphasis on clinical training, critical thinking, and teaching to prepare the fellow for a career as a clinical educator. In this track, the fellow will perform two years of ambulatory and inpatient training, with an emphasis in the second year on continuity care in the ambulatory setting, progressive education in endocrine subspecialities, and house officer teaching. In both tracks, there is further emphasis on training in the competencies, including practice based learning and systems based practice, through participation in quality improvement projects and the Stanford Hospital diabetes task force.
The first year is similar between the traditional and clinical tracks and is devoted entirely to a clinical experience. Since most endocrine care is delivered in an ambulatory setting, the ambulatory experience is emphasized throughout the entire duration of the program. A variety of clinics are included in the teaching program to provide a wide diversity of patients. At Stanford there are weekly clinics in general endocrinology, neuroendocrinology, diabetes and metabolism, as well as a diabetes clinic devoted to transplant patients and patients with cystic fibrosis. At the VA Hospital, there is a weekly general endocrine clinic. Two very busy general endocrinology clinics and two diabetes clinics are conducted weekly at SCVMC. First year fellows participate in all of these clinics at Stanford, the VA and SCVMC.
Second year fellows in the traditional track will participate in a continuity care ambulatory clinic in general endocrinology, as well as have the opportunity to participate in several specialty clinics at Stanford which are available for further in-depth training, including pregnancy related endocrine disorders, thyroid cancer, Graves eye disease, pediatric endocrinology, and reproductive endocrinology. Second year fellows in the clinical track will maintain the same clinical experience of the first year, with an emphasis on more specialty training in the clinics described above.
Fellows participate in extensive consultative activities on the general ward. During their clinical training, endocrine fellows spend equal time on the inpatient consultation services at Stanford, the VA and SCVMC. A Stanford/VA fellow leads the Stanford/VA general endocrine consultation team which includes an attending endocrinologist, rotating residents and students. In addition, the Stanford fellow and team provide consultative management to patients with diabetes who are inpatients at Stanford. A second fellow is assigned to lead the inpatient consultative team at SCVMC that includes an attending endocrinologist, a SCVMC internal medicine resident and a medical student. The team is responsible for general endocrine consultations at SCVMC.