ENDO Program At a Glance

Curriculum Overview
The Endocrinology, Diabetes and Metabolism Fellowship Training Program at UC Davis Health System is two years with an emphasis on clinical endocrinology and research. The educational objectives of the training program are to develop clinical competence in endocrinology, diabetes, and metabolism in order to diagnose and manage patients in the inpatient and outpatient settings. The fellowship program has 2 training sites at the UC Davis Medical Center and at the nearby VA Mather Medical Center. During their training, fellows are expected to:

• Learn appropriate and cost-effective means to diagnose and treat patients with endocrine, diabetes, metabolism and clinical nutrition disorders.
• Learn how to be a consultant in endocrinology, diabetes and metabolism in inpatient and outpatient settings.
• Learn biochemical and physiological aspects of endocrinology, diabetes and metabolic disorders.
• Develop experience in the performance and interpretation of clinical laboratory tests including immunoassays.
• Gain experience in conducting ultrasonography and ultrasound guided fine needle aspirations of the thyroid gland.
• Participate in and learn from a multidisciplinary diabetes education and treatment program.
• Learn how to read, analyze and critique journal articles relevant to endocrinology, diabetes, and metabolism including statistical analysis, study design, power statistics, and writing clinical research protocols.
• Participate in research under the mentorship of an experienced scientist in order to learn the principles and practice of scientific inquiry. 

During their training, fellows will be provided opportunity to achieve cognitive knowledge, psychomotor skills, interpersonal skills, professional attitudes, and practical experience required of an endocrinologist.  The training program emphasizes scholarship, professionalism, self-instruction, development of critical analysis of clinical problems and the ability to make appropriate decisions.  Fellows will be encouraged to participate in professional organizations, community programs, and institutional committees.  
 
At the end of the training program, fellows will develop expertise in the evaluation and management of endocrine disorders including disorders of the parathyroid, pituitary, thyroid, adrenal, and gonads, and endocrine function of the kidney, brain, and other "non-endocrine" tissues, lipid disorders and basic principals of nutrition.

Clinical Training
The fellows' principal clinical duties are related to the consultative and clinical activities of the endocrine division in both outpatient and inpatient settings. These involve on average 10 to 15 consultations per week in the inpatient settings (UC Davis Health or Mather VA Medical Center) and outpatient clinics. Rotating medical residents and fourth-year medical students participate in these functions under the supervision of the endocrine fellow and members of the endocrine division faculty. While on the inpatient services, consultative rounds with faculty members are held three or more times per week and at least one teaching conference in endocrinology is scheduled weekly. The program provides clinical exposure to a wide variety of acute as well as chronic endocrine conditions and offers an opportunity for fellows to participate actively in diagnosis and management.

Research Opportunities
The endocrine fellows in our program are guaranteed to be scheduled for dedicated research time, during which it is anticipated that the fellow will participate in quality improvement, basic or clinical research in the general field of endocrinology or metabolism. 

Research opportunities are available within the division as well as with other investigators within the School of Medicine and at the UC Davis campus. All fellows are encouraged to seek grant support and we anticipate that the results of these research activities will be published.

UC Davis is one of twelve institutions that received the Clinical and Translational Science Center award from the National Institute of Health. Our program provides both theoretical and practical research training to the endocrine fellows.

GME Salary Scales are as follows:

Per academic year fellows have a total of 20 Vacation Days & 12 Sick Days total.

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UC Davis Consults

**During the day, you will round with the Endocrine Consult team:**

Endocrine team rounds will generally be in the afternoon or late morning

·       Monday:

o AM: See Consults

o PM: See Consults and round with Endocrine Team

·       Tuesday:

o AM: See Consults

o PM: See Consults and round with Endocrine Team

o If you are on a busy consult service, you are not expected to attend the ENT/Endo Tumor Board

§  2^nd Tuesday of month: Pituitary/Skull Base Tumor Board. Held from 12-1PM via WebEx

§  4^th Tuesday of month: ENT/Endo Tumor Board. Held from 12-1 PM via WebEx

§  E-mails will be sent from the respective conference coordinators and you can submit cases or just come to hear the discussion.

·       Wednesday (Attending switch day on week 1 of rotation):

o AM: See Consults

o PM: See Consults and round with Endocrine Team

·       Thursday:

o AM: See Consults

o   Attend Lunch Conferences:

o   1^st, 2^nd & 5^th Thursdays IM Grand Rounds 12-1 PM

§  Encouraged, but optional attendance for fellows

§  Lunch is provided (when in person) but get there early as is popular

§  Should attend if Endocrine speaker / topic.

o   If you are on a busy consult service, you are not expected to attend the Adrenal Case Conference:

§  3^rd Thursday of month: Adrenal Case Conference. Held from 12:30 to 1:30 via WebEx

§  E-mails will be sent from the respective conference coordinators and you can submit cases or just come to hear the discussion.

o  PM: See Consults and round with Endocrine Team

o   1^st, 2^nd, 4^th & 5^th Thursdays : 4‐5:30 PM case presentations, journal clubs and lecture series; topics vary weekly. 2 lectures: 4-4:45 and 4:45-5:30 PM (January – June) July – January: Clinical Practice Course Lectures 2-5PM.

o   3PM board review January - June

o   3^rd Thursday of the month: Division meeting 4‐5:30 PM. Fellows should plan to attend unless otherwise excused by Fellowship staff or if on consult service with active patient concerns to address.

o   3^rd Thursday of the month: Fellows meeting with Drs. Phatak and Sheely

o   Individual meetings will be scheduled to review Milestones (January & June), rotation performance evaluations, ITE-ESAP testing results (March/April) and on an as needed basis as topics for discussion arise.

·       Fridays:

o   Friday:

o   AM: Fellows Continuity Clinic

§  Attended regularly by Dr. Phatak

§  Rotating Volunteer Clinical Faculty (VCF) include: Drs. Peter Ross, Michael Okimura, Barbara Livermore, Craig Smith, Kent Ishihara, and Manish Upadhyay 

§  Dr. Lado and Dr. Teng also attend 1-2x/month

o   PM: See Consults and round with Endocrine Team

o   12:15-1 PM: Clinical Case Conference: this is an opportunity to informally present complicated/unusual or interesting cases to get the thoughts and opinions of the faculty and your colleagues. This will be virtual with hopes of transitioning to hybrid in the near future. The 1^st Friday of the month will be dedicated to diabetes cases.

§  Consult fellow is expected to attend but may be excused if the service is busy or there are many new consults

o   Preparation for weekend:

§  Sign out to VA fellow if they are covering the weekend

• Inpatient Glycemic Team (IGT) will determine which patients need to be seen by the fellow over the weekend (or on holidays) and will type up a brief summary on the patient in chart sticky note on Friday for the weekend fellow to be able to easily identify the patient's glycemic needs

o   4^th Friday of the month: fellows attend 1-2PM research meeting with Dr. Surampudi and/or Dr. Yoon

§  Consult fellow should attend if service is not busy.

Inpatient Glycemic Team (IGT)/Diabetes

·       Monday:

o AM: Round with IGT, see new consults

o PM: See Consults

·       Tuesday:

o AM: Round with IGT, see new consults

o PM: VA Diabetes Clinic (Template: ***)

o If you are on a busy consult service, you are not expected to attend the ENT/Endo Tumor Board

§  2^nd Tuesday of month: Pituitary/Skull Base Tumor Board. Held from 12-1PM via WebEx

§  4^th Tuesday of month: ENT/Endo Tumor Board. Held from 12-1 PM via WebEx

§  E-mails will be sent from the respective conference coordinators and you can submit cases or just come to hear the discussion.

·       Wednesday:

o AM: Round with IGT and see Consults

o PM: See Consults

·       Thursday:

o AM: Round with IGT

o   After staffing your patients with the IGT attending, you will attend Gestational Diabetes Clinic with Dr. Field (2^nd floor ACC) Please work with the IGT attending to be at clinic by 9AM

§  For gestational DM clinic all notes are typed by the attending

o   Attend Lunch Conferences:

o   1^st, 2^nd & 5^th Thursdays IM Grand Rounds 12-1 PM

§  Encouraged, but optional attendance for fellows

§  Lunch is provided (when in person) but get there early as is popular

§  Should attend if Endocrine speaker / topic.

o   If you are on a busy service, you are not expected to attend the Adrenal Case Conference:

§  3^rd Thursday of month: Adrenal Case Conference. Held from 12:30 to 1:30 via WebEx

§  E-mails will be sent from the respective conference coordinators and you can submit cases or just come to hear the discussion.

o  PM: See Consults

o   1^st, 2^nd, 4^th & 5^th Thursdays : 4‐5:30 PM case presentations, journal clubs and lecture series; topics vary weekly. 2 lectures: 4-4:45 and 4:45-5:30 PM (January – June) July – January: Clinical Practice Course Lectures 2-5PM.

o   3PM board review January - June

o   3^rd Thursday of the month: Division meeting 4‐5:30 PM. Fellows should plan to attend unless otherwise excused by Fellowship staff or if on consult service with active patient concerns to address.

o   3^rd Thursday of the month: Fellows meeting with Drs. Phatak and Sheely

o   Individual meetings will be scheduled to review Milestones (January & June), rotation performance evaluations, ITE-ESAP testing results (March/April) and on an as needed basis as topics for discussion arise.

·       Fridays:

o   AM: Round with IGT and see Consults

o   PM: See Consults

o   12:15-1 PM: Clinical Case Conference: this is an opportunity to informally present complicated/unusual or interesting cases to get the thoughts and opinions of the faculty and your colleagues. This will be virtual with hopes of transitioning to in person in the near future. The 1^st Friday of the month will be dedicated to diabetes cases.

§  Consult fellow is expected to attend but may be excused if the service is busy or there are many new consults

o   Preparation for weekend and/or holidays:

§  Sign out to the weekend or UCD Consult fellow for any non-weekend holidays

• Inpatient Glycemic Team (IGT) will determine which patients need to be seen by the fellow over the weekend (or on holidays) and will type up a brief summary on the patient in chart sticky note on Friday for the weekend fellow to be able to easily identify the patient's glycemic needs. Please work with the IGT attending to determine if any patients need to be reassigned or followed peripherally on weekends and holidays.

o   4^th Friday of the month: fellows attend 1-2PM research meeting with Dr. Surampudi and/or Dr. Yoon

VA Consults/Clinic:  10535 Hospital Way, Mather, CA
(The VA Fellow will cover any additional clinics or activities at the VA.)

Sacramento VA Medical Center- VA Northern California Health Care System.

10535 Hospital Way, Mather, CA 95655.  Endocrine Section in T8 building

Clinic Rotation

·       Fellow’s General Responsibilities:

o   Attendance in clinic is expected even if the attending you are usually assigned to work with is gone that day. This applies to all UCDMC and VA outpatient clinic rotations on all rotation blocks.

§  All AM clinics start at 0800 until ~1200.

§  All PM clinics start at 1300 until ~1700.

§  Please be courteous to those you are rotating with.

§  Be on time and complete your notes in a timely fashion.

o   Monday:

§  Many attendings will have templates they would prefer you use, so please ask and please use them.

§  AM: Fellow works with Dr. Basheer (Template: Sac Endocrine Basheer)

§  Begins at 8:30am (check schedule beforehand)

§  Check schedule beforehand for starting time (or to see if she is away on vacation)

§  Is available to staff inpatient consults and see the patient with you if the on-call Endocrine attending is not on-site or available to do so.

§  12-1PM: VA Endocrine Tumor Board

§  PM: Admin or Research

§  If your research project is completed or paused for some reason or any other free time during clinic or elective/research (due to clinic cancellation or other) rotation, the following opportunities are highly recommended:

§  Watch a Thyroidectomy or Parathyroidectomy. Dr. Arnaud Bewley, Dr. Marianne Abouyared, Dr. Michael Campbell or Dr. Claire Graves after checking schedule to watch a surgery. You will scrub in.

§  Contact Dr. Kiarash Shahlaie to watch a pituitary surgery

§  Shadow CDE’s in ACC clinic to see how they counsel new diabetics/start insulin pumps/review pump downloads

Electives

·       Fellow’s General Responsibilities:

o   This time is dedicated to expanding your clinical skills through elective rotations

o   Clinical duties are meant to provide more specialized focus into specific areas of Endocrinology

o   Discuss with Dr. Campbell at the start of the rotation about setting up a few days when you can observe endocrine surgeries (adrenal, parathyroid, thyroid). You are expected to observe with Dr. Campbell at least once per year

o   Monday:

§  AM: Osteoporosis clinic at ACC with Dr. Teng

§  PM: Andrology clinic at ACC with Dr. Surampudi.

o   Tuesday:

§  AM: ACC Dr. Phatak

§  PM: Pediatric Endocrine Clinic

§  Located in Glassrock Building, 3rd Floor.

§  Attendings: Drs. Styne, Albrecht-Loomba, Fruzza or Glaser.

§  Notes are usually dictated by the attendings or written by scribe, but they appreciate it if you write the notes on patients that you see.

§  Please let Dr. Styne know if you will be on vacation and not in clinic

§  Unless you are away, you are expected to attend the ENT/Endo Tumor Board

§  4^th Tuesday of month: ENT/Endo Tumor Board. Held via WebEx

§  Cases can be submitted to the conference ahead of time

o   Wednesday:

§  AM:  You will alternate between Wednesday AM PCOS/Diabetes clinic with Dr. Plante (1^st and 3^rd weeks of the month) and AM and PM Endocrine Surgery clinic with Dr. Campbell (2^nd and 4^th weeks of the month)

§  PCOS Clinic (Endocrinology ACC)

§  You should work primarily with Dr. Plante to see new PCOS patients

§  Endocrine Surgery clinic with Dr. Campbell is located on the 2^nd floor of the Cancer Center at 4501 X Street  - schedule in EMR is named “cancer center surgical oncology”

§  PM: Pituitary Clinic at Midtown Clinic with Dr. Sheely

§  Midtown Ambulatory Care Center: 3160 Folsom Blvd Suite 3900

§  Code to enter clinic: 44357#

§  Please give the office staff your license plate number to validate parking

o   Thursday:

§  AM:  Diabetes Clinic Dr. Yoon

§  Lunch Conferences

§  1^st, 2^nd & 5^th Thursdays IM Grand Rounds 12-1 PM

§  Encouraged, but optional attendance for fellows

§  Lunch is provided but get there early as is popular

§  Should attend if Endocrine speaker / topic.

§  Unless you are away, you are expected to attend these two conferences the 3^rd and 4^th Thursdays:

§  3^rd week of month: Adrenal Case Conference. Held from 12:30 to 1:30 PM via WebEx

§  E-mails will be sent from the respective conference coordinators and you can submit cases or just come to hear the discussion.

§  PM: 1-4 PM: Admin / Research / Meeting time

§  1^st, 2^nd, 4^th & 5^th Thursdays : 4‐5:30 PM case presentations, journal clubs and lecture series; topics vary weekly. 2 lectures: 4-4:45 and 4:45-5:30 PM (January – June) July – January: Clinical Practice Course Lectures 2-5PM.

§  3PM board review January - June

§  3^rd Thursday of the month: Division meeting 4‐5:30 PM. Fellows should plan to attend unless otherwise excused by Fellowship staff or if on consult service with active patient concerns to address.

§  3^rd Thursday of the month: Fellows meeting with Drs. Phatak and Sheely

§  Individual meetings will be scheduled to review Milestones (January & June), rotation performance evaluations, ITE-ESAP testing results (March/April) and on an as needed basis as topics for discussion arise.

o   Friday:

§  AM: Fellows Continuity Clinic

§  Attended regularly by Dr. Phatak

§  Rotating Volunteer Clinical Faculty (VCF) include: Drs. Peter Ross, Michael Okimura, Barbara Livermore, Craig Smith, Kent Ishihara, and Manish Upadhyay 

§  Dr. Lado and Dr. Teng also attend 1-2x/month

§  12:15-1 PM: Clinical Case Conference: this is an opportunity to informally present complicated/unusual or interesting cases to get the thoughts and opinions of the faculty and your colleagues. This will be virtual with hopes of transitioning to in person in the near future. The 1^st Friday of the month will be dedicated to board review.

§  PM: Administration time to perform clinic duties or work on research project

§  4^th Friday  of the month: fellows attend 1-2PM research meeting w Drs. Surampudi and/or Yoon

Endocrine Case Conference
Fellows decide on cases to be presented, with faculty guidance. During the conference, a case is introduced with supporting laboratory and radiographic studies, and the fellows provide their opinions regarding differential diagnosis and appropriate work-up. The presenting fellow provides a literature review of the topic discussed. 

Clinical Practice Course 
The core curriculum conference consists of lectures covering core topics in the field of Endocrinology. Clinical faculty provides lectures on their areas of subspecialty expertise and guest lectures provide talks on key topics in the field of Endocrinology. This lecture series is linked to board review sessions. During these sessions, In-Training Exam questions and answers are also reviewed, and Board Review topics are covered.  

Fellows Training Series
All fellows are registered for and have access to all modules offered in the Fellow Training Series created by the Endocrine Society. Modules can be covered independently and reviewed with core faculty at teaching sessions throughout the year. Prior In-Training Exam questions are also provided through this resource. 

Research Conference 
During the fall of their first year, the fellows complete a formal research design course. It is expected that the fellows will begin a research project at this time, and continue the research project throughout the two years of fellowship. Bi-annually, each fellow provides a review and status of their research and quality improvement projects. This conference is designed to provide an interactive forum for the fellows to update the division regarding their projects and to receive feedback. 

Journal Club 
Endocrine Journal Club occurs monthly. The objective of the journal club conference is for fellows to acquire skills in evaluation of scientific publications, review and discuss the article with the clinical faculty, and present and critique the article. 

Adrenal Clinic Conference and Tumor Board 
This multidisciplinary conference is scheduled every third Thursday. Attending physicians from Endocrinology, Endocrine surgery, and Radiology as well as fellows and residents review adrenal cases. Cases presented are those of patients undergoing evaluation of an adrenal concern with Endocrinology and/or Endocrine surgery.  The conference is an interactive forum for real-time case discussion, adrenal imaging and lab review and problem solving. 

Thyroid Clinical Conference and Tumor Board 
This multidisciplinary conference is scheduled every fourth Thursday. Attending physicians from Endocrinology (adult and pediatric), ENT, Endocrine surgery, Medical Oncology and Radiation Oncology as well as fellows and residents review thyroid and parathyroid cases. Cases presented are those of patients undergoing evaluation of thyroid and/or parathyroid concerns with Endocrinology and/or ENT and/or Endocrine surgery.  The conference is an interactive forum for real-time case discussion, thyroid imaging and lab review and problem solving. 

Pathology Conference 
Division faculty and the fellows meet quarterly to biannually with an attending pathologist to review clinical cases in which endocrine division members have been involved, and a cytologic or pathologic sample has been obtained. 

Nuclear Medicine Conference 
Division faculty and the fellows meet quarterly to biannually with an attending Nuclear Medicine physician and residents to review clinical cases in which endocrine division members have been involved, and a nuclear medicine study (PET/CT, WBS, Thyroid uptake and scan, DXA, Sestamibi or MIBG) has been obtained to review imaging and discuss the clinical case for which the imaging was obtained.