MGBfC endocrinology - Fellowship program

Overview

The Pediatric Endocrinology Fellowship Program at MassGeneral for Children and Harvard Medical School prepares physicians to be outstanding practitioners and leaders in clinical care, research, education, and advocacy for our patients. Program leadership and clinical and research mentors work with each fellow to develop individualized training plans, customized to each trainee's interests and career goals.

Originally accredited by the Accreditation Council for Graduate Medical Education (ACGME) in 1985, our program fulfills ACGME requirements for board eligibility in pediatric endocrinology by the American Board of Pediatrics.

Clinical training

The first year of training affords intensive clinical experience.

Inpatient: First-year fellows cover the inpatient service for 26 weeks and approximately 8-10 weekends. Trainees see consults on the general pediatrics wards, the newborn and special care nurseries, and the neonatal and pediatric intensive care units.

Outpatient: First-year fellows see patients in their continuity clinic for one session a week, establishing a panel of patients that they will continue to follow throughout their training. Fellows also maintain urgent clinic slots, seeing patients with endocrine concerns that need to be evaluated rapidly. Fellows will also work with a range of faculty in general endocrinology and subspecialty clinics for a total of 3-5 outpatient sessions per week.

Elective: 4 weeks of elective time in the first year enable fellows to work with faculty outside our division to gain additional relevant skills. Elective options include thyroid medicine, obesity medicine, genetics and metabolism, laboratory medicine, and neuroradiology. We are happy to work with fellows who are interested in alternative electives relevant to their interests.

In the second and third years, clinical responsibilities are decreased to allow fellows to focus on their research efforts (for more information, see Research). Fellows continue to see outpatients for one session per week in their continuity clinic and cover the inpatient service for 8-10 weekends per year. Third-year fellows are encouraged to serve as the "pre-attending" for 1-2 weeks to build their confidence and teaching skills as they begin to transition to faculty roles.

Patients we serve

Fellows on the pediatric endocrinology service see patients with a wide range of concerns and diagnoses. Patients with diabetes (type 1, type 2, cystic-fibrosis related, and monogenic) are seen both in general endocrinology clinic as well as in our multidisciplinary diabetes clinic, where patients see a physician, nurse educator, nutritionist, and psychologist in a single visit. Fellows will also become very familiar with the common endocrine concerns including faltering growth, precocious or delayed puberty, and thyroid dysfunction.

Several specialty clinics at MGH afford fellows the opportunity to get deep exposure to more rare conditions. These include:

Pediatric radiation oncology: MGH was one of the earliest centers to offer proton beam therapy for pediatric patients with central nervous system tumors. Fellows will become very familiar with the long-term endocrine care of cancer survivors, both in their own clinics and the endocrine survivorship clinic spearheaded by Dr. Eray Savgan-Gurol
Neuroendocrine clinical center: MGH has an internationally renowned neuroendocrine group with radiation oncologists and surgeons with specific expertise. MGfC is thus a referral center for pediatric patients with neuroendocrine tumors.
Pediatric weight center: the pediatric program at the MGH weight center is a pioneer in the treatment of childhood obesity, through lifestyle management, pharmacotherapy, and metabolic and bariatric surgery.
Bone and mineral metabolism clinic: co-directed by Dr. Deborah Mitchell and Dr. Rebecca Gordon, this clinic treats patients with skeletal fragility and with rare disorders of calcium and phosphate metabolism including hypoparathyroidism, pseudohypoparathyroidism, and X-linked hypophosphatemic rickets.
Leukodystrophy clinic: Fellows will develop proficiency in the treatment of patients with adrenal insufficiency and monitoring of patients at risk for adrenal insufficiency.
Turner syndrome clinic: Working with Dr. Lynne Levitsky, fellows will see patients in this clinic which provides a medical home for girls and women with Turner Syndrome.

Didactic curriculum:

Guided by the principles of adult learning theory, the bulk of teaching in our program occurs on walk rounds with attendings and in precepting interactions with faculty in outpatient clinics.
In addition, we have several formal teaching series to supplement and complement experiential learning:
- In July and August, we hold "summer school", an intensive series of didactic lectures intended for first-year fellows to be prepared to manage endocrine emergencies and to initiate diagnosis and therapy on patients. Second and third-year fellows are encouraged to attend these conferences as well as a form of "spaced learning" to refresh and deepen their knowledge.
- Our weekly division meeting includes a 30 minute case conference in which faculty and fellows present interesting and challenging cases seen over the prior week. This is followed by a formal case presentation by a fellow - an opportunity to dive into a question raised by a clinical encounter and to hone speaking skills.
- Our weekly division didactic conference offers a formal learning opportunity from a member of our staff or an outside speaker. Once a month, this is replaced by a faculty-led journal club.
- Our fellow-journal club meets 10 times per year and follows a national curriculum to review key papers in the pediatric endocrinology literature, learn about study design and statistical analysis, and improve critical reading skills.
- Our weekly board review course, led by senior fellows, enables our fellows to take ownership of their learning.

Fellows are also encouraged to attend Department of Pediatrics Grand Rounds as well as MGB Endocrine Division Grand Rounds (a joint meeting of the pediatric endocrine, endocrine, neuroendocrine, reproductive endocrine, diabetes, thyroid, and nutritional metabolism units).

Gathering in the MGH Ether Dome for Endocrine Grand Rounds

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