The Pediatric Endocrinology Fellowship Program is a three-year program designed to prepare pediatricians for careers in academic pediatric diabetes and endocrinology. The first year of this program is dedicated to clinical training in pediatric endocrinology. The second and third years are focused upon research training - in either patient-oriented or basic laboratory research.
Bassil Kublaoui, MD, PhD
Division of Endocrinology/Diabetes
The Children's Hospital of Philadelphia
34th Street and Civic Center Boulevard
Philadelphia, PA 19104-4399
Michael A. Levine, MD, FAAP, FACP, FACE
Division of Endocrinology/Diabetes
The first year of training is an intensive clinical training focused on both outpatient and inpatient endocrine disorders, supervised by an attending physician from the division. The fellow is expected to become proficient in diagnosis and management of common endocrine disorders, as well as become familiar with the social and ethical aspects of care for these patients. The first year fellow rotates among 4 blocks: Inpatient Diabetes & Endocrine Service, Hospital Consult Service, Outpatient Endocrine & Diabetes Clinics and an Outpatient Rotation which includes exposure to adult endocrinology and gynecology as well as academic time. In addition, the first year fellow will collaborate with an attending on a research project (usually clinical) with a goal that there will be a presentation at one of the national meetings.
The inpatient service consists of patients admitted with primary endocrine disorders. A large percentage will have either diabetes mellitus or hypoglycemia due to hyperinsulinism, but other endocrine abnormalities are also seen. The fellow will work closely with both the attending physician and the other members of the Diabetes and Hyperinsulinism Teams (Nurse Educators, Nurse Practitioners, Social Workers, Dieticians). During the first year of clinical training, the fellow also gains experience in patient-oriented research projects carried out in the Clinical and Translational Research Center (CTRC). In addition, the inpatient fellow is directly involved in teaching, at the bedside, by leading daily rounds, and in formal sessions, to residents and other trainees about the management of common endocrine conditions.
The hospital consult service cares for children with a vast variety of endocrine disorders. With the attending physician's supervision, the fellow will work with other services on the wards, NICU, PICU, ER, and other hospital locations to work-up and manage possible endocrine problems. CHOP's role as a tertiary referral center ensures that fellows will be exposed to a high volume of common conditions as well as frequent encounters of rare and complex cases. The fellow often arranges for and manages post-discharge care of these patients, as well, to gain understanding of long-term care of endocrine disease.
On the outpatient clinic rotations, the fellow will rotate through various clinics to see patients with attending physicians in the division. This allows exposure to a broad range of diagnoses, and management styles. For example, the fellow will participate in a specialized Thyroid Cancer Clinic, as well as the monthly Interdisciplinary Cancer Survivorship Clinic. The fellow sees patients with Diabetes Nurse Practitioners and Dieticians and gets exposures to technology used in diabetes management such as pumps and sensors. Clinic sessions are arranged at the (adult) Hospital of the University of Pennsylvania where the fellow has exposure to fine needle aspirations of the thyroid, lipid disorders, as well as management of adult PCOS. There is opportunity to arrange other clinics that are unique to the interest of the fellow.
The second and third years are devoted to clinical or basic research with a mentor chosen by the fellow, based on area of interest. During this time, the fellow is expected to gain experience in designing and conducting hypothesis-driven research. The fellowship research project is expected to culminate in the submission of at least one manuscript to a peer-reviewed journal. The fellow has a wide choice of possible mentors at The Children's Hospital of Philadelphia and The University of Pennsylvania and will have access to the generous resources available at both CHOP and Penn as they conduct their research.
The fellow is required to attend and present his or her research at institutional, local and national meetings. The research experience allows fellows to learn laboratory techniques, protocol development, data analysis, and other skills related to the research area of interest.
In addition, the fellow will have the experience of preparing applications for grant funding. For more formal education, fellows are also able to enroll in degree or non-degree programs (Patient Oriented Research Certificate Programs, MSCE, and MTR programs) in the Center for Clinical Epidemiology and Biostatistics (CCEB) and the Institute for Translational Medicine (ITMAT) at the University of Pennsylvania. The senior fellows are expected to attend several weekly institutional conferences.
The senior fellows continue to participate in weekly continuity clinics, the weekend and weekday call schedule, and 2 weeks of inpatient experience per year, in order to further build on their clinical skills.
During the first year, the fellow establishes a continuity clinic with patients assigned from inpatient admissions as well as referrals from the community. This includes children with diabetes and other endocrine disorders. The fellow provides both consultative care as well as long-term management of endocrine disorders. All patients are seen in conjunction with a faculty member with direct supervisory care.
In the second and third years, the fellow participates in a weekly Academic Clinic. The fellow sees new and follow-up patients with various endocrine disorders with supervision by an attending physician. This clinic provides an opportunity for the senior fellows to work together and to learn from each others' clinical experiences. Once a month, the academic clinic focuses on diabetes, with supervision by attendings from the Diabetes Center.
The program requires that the senior fellows organize and administer the logistics of the other fellows. This includes the on-call schedule, time-off, time-away for conferences and emergency coverage. The fellow also organizes the teaching conferences. Fellows are required to serve on a hospital-wide committee, in an area of interest, including quality improvement and technological changes.
The fellow's teaching experience includes frequent bedside teaching to the pediatric residents and conferences that include basic biomedical information about clinical problems. In addition the fellow presents at the following conferences:
Additional conferences include opportunities for senior fellows to present at lectures for other divisions, CHOP morning report, and outside hospitals.
Additional Division Education: Every Friday EXCEPT the first Friday of the month, there will be a Division-wide clinical conference after journal club from 1-2 pm. This is an informal opportunity for any provider to present a challenging clinical case (inpatient, outpatient, or consults) to the group to get everyone’s input. Cases are organized by Dr. Sheela N. Magge, and this conference is not fellow driven.
In addition to the conferences listed above, there are many educational opportunities at CHOP and Penn that fellows are encouraged and/or required to attend. This includes the Institute of Diabetes, Endocrinology, and Metabolism (IDOM) weekly seminar featuring cutting-edge basic and clinical research. There are various conferences, retreats, and symposia where fellows can attend or present posters and talks.
Fellows have the opportunity to enroll in degree or non-degree coursework at the University of Pennsylvania.
A Certificate Program in Clinical Research offered by the CCEB, involving research design, biostatistics, and ethics is available. Masters programs in Clinical Epidemiology and Translational Research are offered through the Perelman School of Medicine, University of Pennsylvania.
Fellows are expected to attend the national meetings of either LWPES and Pediatric Academic Societies, the Endocrine Society, or the American Diabetes Association. Other conferences, if approved by the program director, can also be attended.
Fellows will also receive training and feedback on how to give successful presentations both from the faculty and Dr. Craig Alter, who has a focus in this area.