Overview of Clinical Training

Trainees holding the MD degree will typically have completed 3 years of residency training, usually in Internal Medicine before entering the Program. Advanced clinical training in Endocrinology and Metabolism provides the trainee with familiarity with the spectrum of endocrine and metabolic disorders and defines the areas in clinical endocrinology where diagnosis and therapy are presently lacking. This training is implemented through the Endocrinology and Metabolism inpatient consultation service and the Endocrinology and Metabolism outpatient clinics at University Hospital and the Ann Arbor VA Medical Center. Approximately 7000 patients are referred to the Metabolism, Endocrinology and Diabetes Division each year for the management of a wide variety of endocrine diseases, including those involving the hypothalamus, pituitary, thyroid, pancreas, adrenals, gonads, calcium metabolism, and diabetes mellitus. Clinical training in the management of diabetes in pregnancy is also available to trainees in the High-Risk Pregnancy Clinic run jointly by the Metabolism, Endocrinology and Diabetes Division and the Department of Obstetrics and Gynecology. Trainees also have access to elective rotations in pediatric endocrinology, endocrine surgery, infertility, lipids and neurosurgery.

Outpatient training occurs during 2 to 3 sessions each week in the various Metabolism, Endocrinology and Diabetes Clinics. Trainees will attend a weekly General Endocrinology Continuity Clinic, and will rotate through a series of required outpatient clinics, including the General Endocrinology Clinic at the Ann Arbor Veterans Affairs Medical Center (AA VAMC), Thyroid Clinic, High Risk Pregnancy Clinic, and each of three diabetes clinics. Fellows will also be strongly encouraged to participate in a variety of elective clinics.

Inpatient training occurs on the Endocrinology Consultation Service, which provides adult endocrine consultative services at the University of Michigan Hospitals and the AA VAMC. In addition to providing and coordinating clinical care, the fellows, in conjunction with an attending physician, will also be responsible for teaching students and house officers rotating on the Endocrinology Consultation Service. Fellows will spend between 1 and 3 months each year on the consult service. Clinical training will be supplemented by formal training in endocrine testing, and weekly conferences covering major areas of endocrinology and the evaluation of patients with endocrine disorders.

After completing the fellowship program, trainees will have a detailed understanding of the pathogenesis, clinical presentation, diagnostic approach, and therapeutic management of endocrine disorders. They will also have been trained in the interpretation of laboratory tests, immunoassay techniques, endocrine imaging studies (e.g., radiologic, radionuclide and ultrasound), fine needle aspiration of the thyroid, and effective communication with referring health care providers.