All clinical activities of the Division of Metabolism, Endocrinology & Diabetes (MEND) trainees are carried out under direct faculty supervision. Ariel Barkan, M.D., Professor of Internal Medicine and Neurosurgery, is the Director of the Fellowship Training Program and the Principal Investigator on the MEND training grant. Moreover, the clinical activities of trainees are closely monitored on an individual basis by Craig A. Jaffe, M.D., who is Associate Division Chief for Clinical Development.

Trainees work with faculty in 3-month blocks to allow exposure to all clinical Program faculty. Each trainee spends two months per year as the fellow responsible for the Endocrine Consultation Service for the University of Michigan Hospitals. In this capacity, the trainee supervises Internal Medicine house officers, and selects and presents patients for teaching conferences.

Per ACGME regulations, trainees spend 30% of their time in the outpatient setting (3 half-day clinics per week) over the 2 year-long duration of training. This is the minimum clinical exposure leading to eligibility for Endocrinology and Metabolism Board Certification. The structure of clinical training is designed individually, in consultation with the trainee's mentor, to optimize research experience.

One of the clinics is a specific Continuity Clinic in which each trainee follows his/her own patients over the entire fellowship period. Also, trainees rotate through general endocrinology and diabetes clinics as well as specialty clinics (Pituitary Tumor, Endocrine Surgery, Thyroid, Adrenal Tumor, Pediatric Endocrine, High-Risk Pregnancy, Infertility, Lipids).

In all clinics, trainees are supervised by MEND faculty and/or by faculty from other units. Thus, over the period of training, all fellows are exposed to a wide variety of endocrine diseases and learn modern diagnostic and therapeutic approaches.