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Curriculum

First year:

The fellowship's first year main focus is the development of clinical skills to diagnose and manage pediatric endocrinology patients in the inpatient and outpatient setting. The first year fellow spends eight months of the year on the clinical service, which includes the inpatient Diabetes and Endocrinology Service, inpatient consults, and Outpatient Clinics. The remaining four months are dedicated to developing a research project.

The Inpatient Diabetes and Endocrinology Service includes assessing and following patients with a variety of primary endocrine disorders and diabetes mellitus. The fellow works closely with the attending physician and leads rounds. During the inpatient service, the fellow interacts closely with a multidisciplinary team including diabetes educators, dieticians, and social workers. During daily rounds, the fellow has the opportunity to provide teaching to residents and medical students.

After daily rounds, the inpatient team provides consultation services to patients on multiple other services. Consults include common as well as rare and complex conditions. Most of the consults are at the main campus at Rady Children's Hospital, with the exception of NICU patients at UCSD-Jacobs Medical Center in La Jolla and at Sharp Mary Birch Hospital. The fellow also responds to phone consults from community pediatricians and Emergency Departments outside of RCHSD.

In the Outpatient Clinics, the fellow has the opportunity to see patients with different attending physicians and is exposed to a wide variety of conditions. The fellow also has the opportunity to learn within several multidisciplinary Specialty Clinics, including the Turner Syndrome Clinic, Prader Willi Syndrome Clinic, Differences of Sex Development Clinic, the clinic at the Center for Gender Affirming Care, Neuro-Oncology Comprehensive Clinic, and Post-transplant Diabetes Clinic. In addition, the fellow can get hands-on education about various insulin pumps, continuous glucose monitors, and other diabetes related technology from our experienced team of diabetes educators.

Fellows are on call for one week per month, along with a supervising attending physician, throughout the three years of fellowship. Fellows are not expected to be on call during holidays. Weekend calls involve morning inpatient rounds and management of consult patients in the hospital. Weeknight calls are taken from home.

Each year, our fellows are invited to participate in Camp Wana Kura, a 4-day summer day camp located in San Diego County for children with type 1 diabetes. This camp is sponsored by the American Diabetes Association and usually takes place in July. Fellows may also volunteer at Camp Conrad-Chinnock, an overnight camp for youth with type 1 diabetes located in the San Bernardino Mountains.

Fellow Continuity Clinic:

During the first year of fellowship, the fellow establishes their Continuity Clinic which occurs once a week during the three years of training. In this clinic, fellows manage and follow their own general endocrine patients under the supervision of an attending physician. Patients for this clinic are scheduled directly with the fellow rather than attending physician to ensure that each fellow can provide true continuity of care. The supervising faculty members rotate each week which allows fellows to be exposed to different styles of patient care and teaching.

Second and Third Year:

The second and third years focus primarily on developing a research project. Ten months of each year are dedicated to their research project, and the other two months are spent on the clinical service to continue to enhance clinical knowledge and skills.

The research project is developed and executed under the guidance of a mentor chosen by the fellow. The fellow gains expertise in designing and conducting a research project, and has the opportunity to present their research at local and national meetings.

The Division has a broad range of research interests that range from basic science and translational research to clinical research. Current areas of interest within the division include islet cell regeneration, treatment of precocious puberty, transgender health, genetics and immunology of type 1 diabetes mellitus, continuous glucose monitoring in infants, insulin signaling, fat metabolism, and pharmacokinetic studies for agents relevant to pediatric endocrinology.

The Division can also support the fellow's participation in a National Institutes of Health-sponsored course on research methodologies conducted at UCSD. In addition, the San Diego biomedical community, including UCSD, the Salk Institute, the La Jolla Institute for Immunology, and the Scripps Research Institute, provides a broad range of research areas outside of the Division in which fellows can participate. Fellows are also invited to apply for the Davies Endowed Fellowship in Pancreatic Research, awarded annually to qualified candidates.

Both RCHSD and UCSD are leaders in endocrine research. Our endocrine division is consistently ranked among the nation's best by the U.S. News & World Report. At UCSD, endocrine and diabetes research are particularly strong and include basic, translational and clinical research components. The Diabetes and Endocrinology program for adult patients at UCSD is also ranked among the nation's best by the U.S. News & World Report.

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