The Endocrinology, Diabetes and Metabolism Training Program at the GW School of Medicine and Health Sciences (SMHS) provides fellowship training in endocrinology and metabolism to physicians who have completed their internal medicine residency. The two-year training program enables trainees to develop the clinical competence and procedural skills necessary in order to practice endocrinology independently. In addition, fellowship provides an opportunity for trainees to develop their teaching skills, clinical and laboratory research skills, and personal educational skills that will prepare them for continuing professional growth after formal training has been completed.
The goals, content, and evaluation processes of the program are governed by the requirements of the American Board of Internal Medicine (ABIM) and the Accreditation Council for Graduate Medical Education (ACGME). Satisfactory completion of the training program fulfills the requirements for entrance to the certifying exam in Endocrinology, Diabetes and Metabolism administered by the ABIM.
- To develop an understanding of basic endocrine physiology. The trainee should understand normal endocrine molecular biology, biochemistry and physiology, and be able to apply those concepts to understand endocrine disease mechanisms.
- To develop a thorough knowledge of the approach to the evaluation and diagnosis of patients presenting with endocrine disorders and complaints.
- To develop an understanding of treatment and management strategies for endocrine disorders.
- To develop technical skills to perform thyroid ultrasound and fine needle aspiration (FNA) biopsy, dynamic testing, insulin pump therapy, continuous glucose monitoring, DXA interpretation and other skills needed for endocrine practice.
- To develop the ability to interpret diagnostic studies, including hormonal testing and imaging studies.
- To develop skill in the planning, performance and presentation of clinical, translational and laboratory research in Endocrinology and Metabolism.
- To develop skills to design, initiate and perform Quality Improvement projects related to clinical endocrinology.
- To develop skills in educating physicians, other health care professionals, patients, and lay persons about endocrine disease.
The fellowship program is structured such that medical knowledge and skills pertaining to endocrine and metabolic diseases are acquired through supervised clinical experiences and formal education.
Clinical competence is developed through a structured system of learning from patients with endocrine diseases and from formal and informal didactic sessions. The clinical education program is based upon several concepts:
- Trainees are primarily in the program to learn.
- Gradually progressive responsibility for patient care is an important part of learning.
- Staff physicians are responsible for the quality of patient care and the teaching process.
- Patient contacts must be numerous and varied. They include inpatients, and outpatients, with as much variety as the institution can provide.
- Continuity of care is a valuable learning tool.
- Teaching conducted by trainees is a valuable learning tool.
The first year of the endocrine fellowship emphasizes the pathophysiology of endocrine disorders, structured overview of endocrine and metabolic diseases, and progressive improvement of clinical skills including history, physical examination, the diagnostic evaluation, and the therapy of these disorders. During this year, fellows are introduced to endocrine procedures including sonography of the neck, fine needle aspiration of thyroid lesions, stimulation and suppression testing, insulin pump therapy and using continuous glucose monitoring devices.
Fellows are expected to become familiar with the major endocrine literature, to become skilled in searching the published medical literature and to become proficient in analyzing articles in order to extract and summarize methods and results, and critique the major findings and conclusions.
During their first year, fellows are expected to choose a faculty mentor and initiate their research and quality improvement projects. One month of the first year is devoted to initiation of research as well an elective.
The major clinical goal of the second year is to prepare fellows to be independent practitioners. To that end, senior fellows are given increasing responsibilities. They are expected to master the clinical skills that were introduced during their first year of fellowship. They are expected to progress in their teaching skills and improve their own lecture skills. They are expected to teach the junior fellows, as well as the residents and students who rotate through the endocrinology service.
Senior fellows are also expected to complete their research and quality improvement projects, present their findings at conferences and meetings and prepare manuscripts for publication. Two months are given to research and electives. Additionally, each second year fellow will rotate for one month at Children’s National Medical Center, and one month will be spent at National Institutes of Health.
By the completion of their second year, it is expected that fellows will have acquired the knowledge, the humanistic qualities, and the skills needed to become highly capable and independent endocrinologists who can provide outstanding patient care. Additionally, fellows will be equipped to develop their future careers (clinical, academic, research, administrative) with confidence.