How to apply for Lahey’s Endocrinology Fellowship
Endocrine fellows see patients in both the outpatient Endocrine
Clinic and on the inpatient hospital consult service. This allows the fellows
to assume responsibility for and follow patients to observe the evolution and
natural history of various endocrine disorders as well as the effectiveness of
Endocrine fellows attend a variety of conferences on a regular
basis throughout their two-year fellowship training program. There is
opportunity to teach the Lahey Hospital & Medical Center internal medicine
residents and third- and fourth-year medical students from Tufts University
School of Medicine.
Endocrine Continuity Clinic.
Fellows see patients at this clinic to develop a basic understanding of
the presentation, evaluation and management of a wide variety of disorders
encountered in a general endocrine practice. The learning experience evolves
from review of history, physical examination and laboratory results with the
precepting faculty member, taking direction from the faculty and being provided
with references or other learning materials that can be used for self-instruction
and subsequent review with the faculty.
Endocrine Clinic. Fellows
develop a comprehensive understanding of how to evaluate and manage
reproductive endocrine disorders including primary and secondary male and
female hypogonadism, gynecomastia, erectile dysfunction, polycystic ovary
syndrome and fertility disorders. They learn how to evaluate and manage female
sexual dysfunction and female androgen deficiency, how to understand the
effects of age on the reproductive axis in men and women, and how to counsel
postmenopausal women regarding hormone replacement therapy.
Weight Loss Clinic. The goal of this
rotation is for fellows to become competent in the management of obesity, both
through dietary means and through the use of various medications used to
promote weight loss. In addition, fellows learn about the indications for
bariatric surgery and how to prepare such patients for surgery as well as
manage them postoperatively, especially as it pertains to management of
diabetes in this setting.
Endocrine Clinic. Fellows develop an
understanding of a wide variety of pediatric endocrine disorders, but special
emphasis is placed on those disorders that an adult endocrinologist needs to
gain a working knowledge of. These include diabetes mellitus, growth
retardation and delayed puberty, precocious puberty and thyroid disorders.
- Inpatient Hospital Consult Service. To learn about a variety of diseases of endocrinology
and metabolism as they occur in hospitalized patients, fellows see patients on
the Inpatient Hospital Consult Service daily for one week, every other week,
throughout the two-year endocrine fellowship. Fellows also learn, under
supervision, how to interact not only with the patient and family, but also
with other physicians caring for the patient.
- Research. Fellows
are expected to conduct their own clinical research and are encouraged to
present the results at regional and national specialty meetings. They work with
a mentor on research methodology, IRB submission, and data analysis and
interpretation, to ultimately write a manuscript to be submitted for
publication in a peer-reviewed journal.
- Procedures. Procedures
that fellows must learn to perform include fine needle aspiration biopsy of
thyroid nodules, thyroid ultrasounds, interpretation of continuous glucose
monitoring system (CGMS) and insulin pump downloads, interpretation of bone
densitometry studies, and tests such as insulin hypoglycemia, clonidine
suppression, water deprivation, saline infusion, and Dex/CRH.
- Quality Improvement. Fellows are required to develop a Quality Improvement
project to identify a potential area of performance improvement based upon
their observations and experiences on either the hospital inpatient service or
the ambulatory clinics, and to draft a plan to address this. Fellows are
expected to eventually present their findings at a hospital-wide symposium.
- Didactic Conferences. Fellows are responsible for presenting at weekly
conferences to discuss diseases of endocrinology and metabolism in greater
depth. Conferences include the Endocrine Clinical, Endocrine Journal Club,
Pituitary Tumor, Thyroid/Parathyroid, Endocrine Morbidity and Mortality,
Endocrine Research, Endocrine Core Curriculum, Cytology/Pathology, Medical
Ground Rounds, Medical Ethics, the Lahey Hospital & Medical Center Resident/Fellow
Core Competency Lecture Series, and the Internal Medicine Residency Noon-Time