Endocrinology, Metabolism, and Molecular Medicine Clinical Fellowship Overview
Applications for our 2014 first-year fellowship class will only be accepted via the Electronic Residency Application Service (ERAS)
The Division of Endocrinology, Metabolism and Molecular Medicine at Northwestern University has a long tradition of excellence in training fellows in both clinical and basic endocrinology. The endocrinology fellowship prepares individuals for careers in academic or clinical endocrinology, and the program meets the requirements for board eligibility in endocrinology. The program consists of compulsory two-year training, followed by a research year which is contingent upon performance and funding. Several of our former fellows have achieved prominence in endocrinology, and we make every effort to continue this tradition. Our faculty is enthusiastic about its teaching mission and strives to make the success of the Fellowship Program a priority. Input and feedback from fellows is encouraged, and their suggestions are continuously integrated into the program in an effort to maximize the learning experience. Fellows are expected to be active participants and partners in fostering a climate of academic excellence and outstanding patient care.
Endocrinology fellowships are offered to MDs who have completed at least two years of post-graduate training in internal medicine in an ACGME-accredited program. All applicants are expected to be board eligible in internal medicine when beginning the fellowship. This implies that a physician must have completed the requisite pre-doctoral medical education, met the postdoctoral training requirements, and demonstrated clinical competence in the care of patients. It is expected that all Endocrinology Fellows will have passed USMLE I, II and III as requirements of training. In addition, applicants must be eligible for an unrestricted Illinois Medical License and have US citizenship or permanent resident status. Unfortunately, due to funding constraints, applicants on J-1 or H-1B visas currently will not be considered.
This track requires eligibility for medical licensure. With some exceptions, successful applicants have been trained in U.S. medical schools. Eligibility for the NIH training grant that supports most fellows during the research years requires U.S. citizenship or permanent residency status.
The program meets and exceeds the requirements for board eligibility in endocrinology, diabetes and metabolism. After two years of clinical training, a third year dedicated to clinical or basic research is offered to qualified trainees.
The clinical training program is based at Northwestern Memorial Hospital (NMH), Northwestern Medical Faculty Foundation, the Jesse Brown VA Medical Center (JBVAMC), the Rehabilitation Institute of Chicago, and Ann & Robert H. Lurie Children's Hospital of Chicago. Collectively, they form the McGaw Medical Center of Northwestern University. The program is completely integrated among these related institutions. Northwestern Memorial Hospital, a 868-bed hospital, offers a broad range of medical and surgical programs including specialized endocrine surgery, islet cell and pancreas transplantation, bone marrow and solid organ transplantation, cardiac surgery, trauma care, nuclear medicine, and an NIH-supported Clinical and Translational Science Institute (NUCATS). The JBVAMC is an outpatient clinic; the Rehabilitation Institute of Chicago is a nationally renowned, 182-bed rehabilitation facility, and the Lurie Children's Hospital, with 288 all-private rooms, serves as a major referral center for pediatric patients.
The research laboratories of the Division of Endocrinology, Metabolism and Molecular Medicine are located in research buildings that also house several of the basic science departments. The fellowship can be divided into clinical and research components, although these experiences overlap. The following describes a typical fellowship, but the program is flexible and may be modified to meet individual needs.
The first year of the fellowship focuses primarily on clinical training. Northwestern's endocrinology faculty includes some of the most sought after clinicians and lecturers in the country. These mentors in the field provide fellows with a thorough introduction to endocrinology and help lay the foundation for lifelong approaches to problems in the subspecialty. All fellows are assigned a personal faculty mentor.
During this year, the fellow is "on-service" for in-patient endocrinology consultations for approximately six months. In conjunction with a faculty attending physician, the on-service fellow assumes primary responsibility for all consultations, in addition to teaching medical residents and students and participating in selected protocols in the Center for Clinical Research. In addition, the fellow attends two half-days of general endocrinology outpatient clinics per week, one at the Northwestern Medical Faculty Foundation and another at the VA. These clinics are continuity clinics, to which fellows remain assigned throughout their fellowship. This arrangement provides important longitudinal experience in endocrine disease, which is typically of chronic nature. Fellows also attend specialty outpatient clinics on a six-month rotation, such as those devoted to pediatric endocrinology, reproductive endocrinology, diabetes in pregnancy, osteoporosis, lipid disorders, and thyroid nodules/fine needle aspiration. The fellows are introduced to thyroid ultrasound with formal lectures, hands-on exercises, and they perform ultrasound evaluations and fine-needle biopsies under supervision in the outpatient clinic. The remainder of the time during the first year is devoted to the development and initiation of research projects.
A typical weekly schedule includes two half days of general endocrinology/diabetes outpatient clinics, one half day each of outpatient clinics in pediatric endocrinology, reproductive endocrinology/polycystic ovarian disease, lipid disorders, diabetes in pregnancy, osteoporosis and thyroid nodule clinic.
Consultation rounds take place on a daily basis with a consultation team consisting of a faculty preceptor, the fellow, 2-3 medical residents, and 1-2 senior medical students.
Weekly educational activities include a Fellow Core Curriculum Lecture, a Journal Club, a Clinical Conference, an Endocrine Tumor Board (Endocrinology, Surgery, Nuclear Medicine, Pathology), Endocrine Grand Rounds (a conference focusing on aspects of clinical or basic research), and Medical Grand Rounds.
Second and Third Year
During the second year, nine to ten months are committed to either clinical or laboratory research projects. The two continuity outpatient clinics (two half-days per week) continue during the second year. The fellow continues to rotate through various specialty clinics and typically covers the consultation service during two months.
The third year is contingent upon performance and available funding. It is primarily devoted to research. Consultation time is reduced to one month, and outpatient activity to one clinic per week. While the third year is not required for board eligibility, most fellows interested in academic careers are expected to complete at least a third year of training to prepare themselves as independent physician-scientists.
Inpatient consults take place at Northwestern Memorial Hospital and the Rehabilitation Institute of Chicago. Most consults are directed to the general endocrinology service. However, fellows also are involved routinely in consults directed to specific full-time or contributed service faculty members. This activity provides a broad exposure to clinical endocrinology, but allows ample time for careful follow-up, reading, teaching, and continuing involvement in research projects. A wide array of disorders ranging from diabetes to rare genetic endocrine syndromes provides broad-based and in-depth exposure to clinical endocrinology. Rotations on the consultation service in pediatric endocrinology at Children's Memorial Hospital are available for interested fellows.
Northwestern Memorial Hospital has been among the first academic institutions to implement an inpatient glucose management service (GMS). It is staffed by four full-time Nurse Practitioners, but the fellows participate actively in the GMS particularly during weekends.
Experience in the outpatient setting is critical to training endocrinologists as the majority of endocrine contacts occur in the ambulatory setting. Fellows participate in clinics during each year of the program, with the number and composition of the clinics as described above, but additionally tailored to the needs of each trainee. Fellows are encouraged to assume a primary role in patient management and to follow individual patients during the course of their fellowships. All training in clinics occurs under the direct guidance and supervision of an attending physician. In addition to the general endocrinology and diabetes continuity clinics, fellows receive training in specialty clinics that focus on pediatric endocrinology, reproductive endocrinology, diabetes in pregnancy, osteoporosis, and lipid disorders. Fellows receive training in thyroid fine needle aspiration under ultrasound-guidance with a pathology faculty member specialized in this area.
Clinical Laboratory Experience
As the proper interpretation of clinical laboratory results is crucial to a successful endocrinology practice, fundamental training in assay methodology and its pitfalls is part of the training program. Fellows rotate through the NIH-supported Clinical Research Center core laboratory to familiarize themselves with the principles of hormone assays and their interpretation. During this rotation, they will be exposed to assay quality control, quality assurance issues, and the fundamental elements of assay methodology.
For information on the Endocrine Fellowship Program, please contact:
Peter Kopp, MD
Fellowship Program Director
Division of Endocrinology, Metabolism, and Molecular Medicine
Northwestern University, Feinberg School of Medicine
303 E. Chicago Ave., Tarry 15-709
Chicago, IL 60611
Phone: (312) 503-1394
Fax: (312) 908-9032
Fellowship Program Coordinator
Phone: (312) 503-4370
Fax: (312) 908-9032