This is accomplished by providing the advanced training and experience needed to acquire the knowledge, skills, and attitudes in all competencies required by a consultant in this field through:
- Broad and intensive clinical exposure and teaching to acquire the knowledge, skills, attitudes, and experience required for all of the competencies needed by a consultant in this field
- Training in and opportunities for teaching and academic presentations
- Post-doctoral level training in basic, translational, or clinical research
The program recognizes that some fellows may evolve into specialists whose activities encompass more than one of the above career paths. The teaching environment and educational experiences for fellows, detailed below, will equip them to become strong clinicians, educators, and investigators.
The first year of fellowship is devoted predominantly to clinical training. Fellows spend 12 months simultaneously participating on the Ambulatory Endocrine and Diabetes Training Experience, which involves mixture of clinics, and the Inpatient Endocrine and Diabetes Training Experience. All clinical training in the first year occurs at both the Hospital of the University of Pennsylvania and its associated clinical practices in the Perelman Center for Advanced Medicine and Penn Medicine at University City and the Philadelphia Corporal Michael J. Crescenz Veterans Affairs Medical Center (VAMC). Fellows also attend divisional conferences, including Journal Club, Endocrine Grand Rounds, Endocrine Case Conference, Diabetes Didactic Conference, Neuroendocrine Sella conference, Summer Didactic Series, the Institute of Diabetes, Obesity and Metabolism research seminar series and Thyroid, Metabolic Bone and VAMC case conferences.
During the late fall/early winter of the first year, fellows choose whether to follow the research or clinical educator pathway for the second year. Both pathways include all the required educational, clinical and research components to train fellows to become an independent Board certified endocrinologists The research pathway is targeted to those fellows who will embark on investigative careers in basic science, translational, or clinical research. For these fellows, the primary emphasis becomes the fellow's individual research project (basic science, or clinical/translational research), supervised by a faculty mentor and they maintain one weekly continuity clinic. In addition, fellows who wish to further pursue clinical/translational research may apply for post-graduate degree programs awarding either a Masters of Science in Clinical Epidemiology, Masters of Translational Research or a Masters in Health Services research. The goal is for the fellow to transition to a research associate position at the conclusion of the two-year fellowship program and then subsequently, to apply for independent mentored research funding as they continue to prepare for research careers in academic medicine.
If the fellow chooses the clinical educator pathway, the second year is structured to develop further the skills of a consultant endocrine specialist, a clinical innovator, and an educator, and to plan and perform a primary clinical research project with a faculty mentor. The clinical educator educational pathway is designed for those who will pursue careers in clinical endocrinology, including those in the academic setting. Therefore, this second year has more clinical exposure to refine clinical, technical, and didactic skills, including additional neck ultrasound, insulin pump and continuous glucose monitoring training. The fellows in the clinical educator pathway maintain continuity clinics in a variety of settings. In addition, fellows conduct a mentored scholarly research project with a goal of abstract presentation and subsequent publication, perform a Quality improvement project, and actively engage in didactic activities targeted at all levels of medical training. After completion of the second year, some fellows in this pathway may transition to a one-year instructor position. As an instructor, they assume independent care for their patients and are consultants for the inpatients at Presbyterian Hospital. In addition, they can complete their clinical research or QI project. The Department of Medicine also offers a one-year fellowship in medical education, the Measey Fellowship, to which clinical educator pathway fellows can apply.
This fellowship program is supervised by Susan J. Mandel, MD MPH, Program Director, who reports directly to the Internal Medicine Program Director, Todd Barton MD. The Fellowship Coordinator is Ms. Helen Poulos. Upon completion of our Program, all fellows are well equipped to provide expert clinical care for individuals with endocrine and metabolic disorders, and/or to pursue investigative careers in clinical, translational or basic research. We provide a supportive environment in which fellows assume graduated levels of independence in caring for patients of all genders, from culturally and economically diverse backgrounds, who present with from a broad range of endocrine disorders, including diabetes, lipid and metabolic disorders, osteoporosis and bone metabolism, thyroid, pituitary, adrenal disease, reproductive disorders, endocrine neoplasia, pediatric endocrinology and clinical nutrition. Fellows acquire the technical and procedural skills necessary to enable them to provide complete, clinical, patient care services, including, thyroid ultrasound and biopsy, interpretation of bone densitometry, and radioiodine scanning and therapy. Throughout the Program, ethical and compassionate behavior and cultural competency are emphasized, as is the impact of socioeconomic factors on health care delivery. Fellows are prepared to negotiate the increasingly challenging practice environment, should they elect to become practicing physicians. Fellows also receive education and mentoring that enable them to become active participants and future leaders in clinical, translational, and/or basic research.
In an article in the NEJM (2004; 351:1163) entitled, “Learner-Centered Medical Education", Dr. Kenneth Ludmerer captured our educational philosophy very well. As Dr. Ludmerer states, our program aims to “create a true learner-centered environment that makes active, self-directed learning under the close tutelage of interested faculty members the core of the experience.” Further, we hope to instill “high professional standards” and help fellows “develop the power of critical reasoning, the capacity to generalize, the ability to acquire and evaluate information, and the intellectual tools to become lifelong learners.” We agree that “accomplishing these goals requires thoughtful and personalized teaching. Instructors must generalize and synthesize, not just provide the view from their particular specialty. Students need seminars, tutorials, and individualized instruction, not lectures alone, for their reasoning powers to be developed fully. Students also need close interactions with experienced, mature physicians in the work of patient care — and the opportunity to talk with them about that work.”
Susan J. Mandel, MD, MPH
Fellowship Program Director
Fellowship Program Coordinator