Endocrinology Fellowship Clinical Training

Inpatient services include both the Vanderbilt University Medical Center (VUMC) and the Nashville Veterans Affairs (VA) Medical Center, which are adjacent to one another.  Outpatient services feature the Vanderbilt Eskind Diabetes Clinic, a state-of-the-art facility housing both adult and pediatric endocrinology and diabetes clinics at Vanderbilt.  At this full-service clinic, the fellow benefits from a coordinated team approach to diabetes care, as well as full service thyroid and pituitary clinics.

There are also facilities for conducting clinical research.  The Nashville Veterans Affairs (VA) Medical Center outpatient clinic offers excellent training opportunities - staffed by members of the Division of Endocrinology-Metabolism and nurse practitioners.  It is a key component in the Endocrinology Clinical Training Program.

Year 1

The first year of training involves a significant proportion of inpatient and outpatient endocrinology experience (60% of the year). Fellows manage the inpatient consult service 2 weeks at a time. This is a consult service; there is night phone call, but no direct inpatient care responsibilities. Consults are made at both the Vanderbilt University Medical Center (VUMC) and the Nashville Veterans Affairs (VA) Medical Center. In the first month or two of the first year, fellows select their clinical mentor after rotating through organized clinics with several different clinical mentors on our faculty. The continuity clinic experience involves half a day clinic, which is continued for at least 2, if not all 3 years of the fellowship. The fellows are also given an opportunity to rotate through Thyroid ultrasound and biopsy clinics. The remainder of the time is spent in establishing a research mentor and initiating research endeavors.

Year 2 and Year 3

The second and third years of the fellowship are focused on research, but with ongoing exposure to outpatient endocrinology in several elective clinics geared to different aspects of endocrinology. Inpatient consult time during these years is minimal. Fellows rotate through several subspecialty clinics such as pituitary, pediatric endocrinology, metabolic bone disease, thyroid cancer, gestational diabetes, maternal-fetal medicine, reproductive endocrinology, endocrine surgery, and lipids.. Fellows can also rotate through nuclear medicine, if desired. The fellows rotate through the thyroid biopsy and ultrasound clinics on a regular basis throughout the fellowship.

Didactics

Endocrinology Fellows have very well-organized didactics sessions lasting an hour twice weekly. These encompass the complete breadth of endocrine education, in addition to incorporating quality improvement.

Endocrinology Fellowship Research Training

The Vanderbilt Department of Medicine: Division of Diabetes, Endocrinology, and Metabolism has a long track record of training academic endocrinologists. The fellowship program offers an intense research opportunity for fellows to develop their academic careers and thus the program is 3 years in duration. Fellows participate in research approximately 40% of time in the first year, and 80% of time in the second and third years.

Vanderbilt Medical Center has a rich history of collaborative and multi-disciplinary research. This is reflected in the research programs of the faculty and fellows within the Division and the Diabetes Center as a whole. Although many fellows select projects under the guidance of Division faculty, fellows can choose research mentors from any of the Vanderbilt faculty working in the area of diabetes, hormonal and metabolic disorders, obesity, and endocrinology at Vanderbilt. This is a large and diverse group of potential mentors. For example, there are over 100 faculty members of the Diabetes Research and Training Center. Specific areas of research related to diabetes that have been chosen by recent fellows are:

  • hormone action in animals and humans as it relates to diabetes and obesity
  • intermediary metabolism
  • pancreatic islet biology
  • micronutrient effects on metabolic disease
  • metabolic regulation
  • molecular genetics of metabolic disease
  • causes and treatments of obesity
  • translation of diabetes care delivery
  • type-1 diabetes mechanisms and prevention.

After choosing a research mentor, the fellow works in his/her mentor’s research area. The Vanderbilt laboratory and clinical research facilities are extremely strong.  Ones that are especially relevant for fellows in this program are the research laboratories of the Division of Diabetes, Endocrinology, & Metabolism, which occupy approximately 1 the 7th and 8th floors of Medical Research Building IV. This space includes the individual research laboratories, a fully equipped conference room, tissue culture facilities, animal preparation rooms, and shared facilities such as central offices, a break room, instrument rooms and cold rooms. There is additional research space at the VA ACRE building, adjacent to Vanderbilt.  Vanderbilt and the Vanderbilt Diabetes Center offer a variety of core facilities (histology, microscopy, molecular biology, mouse metabolic phenotyping, mouse neurobehavior, islet analysis and preparation, mass spectroscopy, and hormone assay) that are very useful for individual research projects.  Key to training in clinical research is the Vanderbilt Institute for Clinical and Translational Research, funded by the NIH through a Clinical and Translational Service Award.  This facility includes inpatient beds, an outpatient center, as well as a metabolic balance core. It also provides funding and support for individual research projects by the trainees of this program.