Fellowship Program — Overview

First year: Endocrinology Consultation Service — 4 months

Pediatric Endocrinology — 2 months

Pituitary/Reproductive Endocrinology — 1 month

Laboratory Endocrinology — 1 month

Cardiac Prevention (Lipid) Clinic — 1 month

Research — 1 month

Metabolic Diseases Clinic — 1 month

Community Elective — 1 month

Second year: Endocrinology Consultation Service (Junior Attending) — 2 months

Electives (Lipid, Pituitary/Repro, Community, Thyroid) — up to 4 months

Research — 6 months (additional time for research can be arranged for fellows who are interested in pursuing a research career)

Note: Each fellow is assigned to a weekly Fellow's clinic, which occurs throughout the duration of the fellowship.

Clinics/Rotations

Endocrinology Consultation Service — the consultation service takes place in the two main teaching hospitals (VGH and SPH) and is responsible for all inpatient endocrinology care. In addition to in-patient endocrinology, there is also an opportunity to attend available ambulatory clinics at each site, including the Osteoporosis Clinic, Diabetes Clinics, Diabetic Eye Clinics, Thyroid Eye Clinic, General Endocrine Clinics, Thyroid Clinic and Foot Clinic.

Fellow's clinic — weekly general endocrinology clinic, which occurs throughout entire duration of the fellowship. Fellows are assigned a clinical supervisor for a 6-12 month period.

Pediatric Endocrinology rotation — 2-month in-patient and out-patient rotation located at BC Children's Hospital. It includes a full slate of ambulatory clinics and an in-patient consult service for pediatric endocrinology.

Pituitary/Reproductive rotation — 1-month outpatient rotation located at St. Paul's Hospital. It focuses on pituitary and reproductive issues in endocrinology, which are not seen as commonly in general practice, such as pituitary imaging, reproductive endocrinology clinics at genesis and Vancouver Hospital.

Cardiac Prevention (lipid) rotation — 1-month outpatient cardiac risk reduction (lipid) rotation located a St. Paul's Hospital. It includes 3-4 clinics per week with several clinical supervisors. The clinics see high-risk patients often with inherited dyslipidemias.

Laboratory Medicine rotation — 1-month rotation located at VGH including a lecture series on endocrine topics and bench learning about the use and limitations of endocrine assays. This is also an opportunity to review thyroid biopsies with the thyroid pathologist.

Metabolic diseases clinic — 1-month outpatient rotation located at Vancouver General Hospital. It includes 4 clinics per week. The clinic involves the diagnosis and management of patients with inherited metabolic disorders, such as Adrenoleukodystrophy, Phenyketonuria (PKU), Urea Cycle Defects, and Glycogen Storage diseases.

Thyroid clinic — 1-month outpatient elective located at St. Paul's Hospital. It includes 3 clinics per week with several clinical supervisors. It is a multidisciplinary clinic dedicated to the management of thyroid disease, with a focus on thyroid cancer. It is primarily staffed by endocrinologists with input from thyroid surgery, radiation oncology, radiology and pathology.

Community elective — 1-month elective located at either Royal Columbian Hospital (New Westminster) or at Victoria General Hospital (Victoria). This rotation is intended to expose fellows to general endocrinology care in a non-academic setting. The clinic and call schedules are determined by the supervisor at each community site.

Research

Research plays a major role in the field of endocrinology. It is expected that all endocrinology fellows will actively participate in research during their fellowship.

Research Expectations

First year — During the first (clinical) year of fellowship, research expectations are limited because it is understood that most first year fellows are preparing for their Royal College Internal Medicine examinations. Nevertheless, fellows are expected to complete at least one research project (such as a case report or a review of clinical practices etc.) during their first year. This project should be presented at the annual UBC resident research day held in May. All fellows are expected to present at Resident Research Day during their first year.

Second year — During the second (research) year of fellowship, a more ambitious research project should be undertaken. Ideally, this project should build on preparatory work done during the previous year. It is expected that each fellow will submit an abstract to a major meeting, usually for the spring/early summer of their second year (e.g. ADA, Endocrine Society). Please note that abstract deadlines are often in early January, so fellows should be prepared to submit their abstract by the end of December of their second year.

Choosing a Research Project/Supervisor

Choosing a research supervisor is an important task. A number of faculty members are available to act as research supervisors, depending on the fellow's area of interest. In June, prior to beginning the first year, fellows should meet with the Resident Research Director to discuss research expectations, areas of interest and begin to identify possible supervisors. Every fellow should have identified a research supervisor by September of their first year.

Research Director: Dr. Gordon Francis

Email: gfrancis@mrl.ubc.ca

Fellows who are considering a research career should pursue a more ambitious research project and may have up to 12 months of research elective time to dedicate to this. Fellows intending pursue a more clinical career may choose a more modest research project that allows additional time for clinical rotations during their second year. It is expected that all fellows will develop research projects that will lead to at least one presentation per year and to submission of a completed manuscript to a peer-reviewed journal by the end of their second year of fellowship.

Resident Research Day

The Department of Medicine holds an annual Resident Research Day each May. Residents and fellows are able to present research such as chart reviews, case reports, and protocols for clinical trials at this time. Oral and poster presentations are also accepted. Abstracts are published in an accompanying volume. All first year endocrinology fellows are expected to present at Resident Research Day — this is not optional.

Resident Research Practice Sessions

A practice session is held annually in April/Early May to allow fellows to practice their research presentations in front of Division faculty. These sessions are intended to encourage constructive criticism so that adjustments can be made to the presentations prior to a meeting/conference. Presentations should be discussed with each fellow's research supervisor. If additional assistance is needed, fellows should contact the Resident Research Director (Dr. Francis), or the Program Director (Dr. Paty). All necessary administrative assistance (making slides, etc) will be provided.

Other Learning Opportunities

Conferences

Endocrinology fellows are expected to attend at least one major conference per year. Funding is available each year to assist with attendance. Meals for conferences will not be funded as per new UBC regulations. In most cases, funding for accommodation will be based on double occupancy (i.e. sharing with another fellow) and therefore solo hotel accommodation is not eligible for full reimbursement. You can discuss this with the fellowship director.

Royal College Endocrinology Practice Examination

All Endocrinology Fellows are required to write the Annual Royal College Endocrinology Practice Examination. This exam takes place at the end of January each year. It is intended to provide insight into the format and content of the Royal College Endocrinology Certification Examination. It may help identify areas of strength and weakness and provide some direction as to areas upon which each fellow might improve. The results of the examination do NOT impact the evaluation of fellows either by the Program or the Royal College. Attendance is mandatory.

ACP In-training examination

Residents in the subspecialty programs are required to write the American College of Physicians (ACP) In-training examination. The exam usually occurs during the second week of October. Attendance is mandatory. The dates can be obtained from the Department of Medicine office.

Teaching

Problem Based Learning (PBL) Tutoring

All fellows will tutor the Endocrine block in PBL which is held for 5 weeks starting the first or second week of November. You need to attend a tutoring workshop prior to functioning as a tutor. PBL sessions occur on MWF from 8:00 - 10:00 with an hour tutor wrap up meeting from 10:00 - 11:00 on Fridays. Attendance is mandatory and you may not take holidays or conference leave during this time. Be prepared to bone up on carbohydrate metabolism as the students will keep you on your toes. You will be observed by an experienced tutor during this time who will give you feedback and your students will also give you feedback. You should give a copy of the feedback that you receive to the program director for your file. However, the purpose of this is to improve your teaching ability so you should not worry about showing any negative feedback you may receive to the program director as long as you plan on making improvements!!