Fellowship Training Program

Primary Sponsor
Rainbow Babies and Children’s Hospital
University Hospitals of Cleveland
Case Western Reserve University
Collaborating Institution: The Children’s Hospital at the Cleveland Clinic Foundation

Introduction
The Pediatric Endocrinology Training Program consists of a 3-year comprehensive clinical and research experience that is designed to train future leaders in pediatric endocrinology. The program is intended for candidates who wish to pursue a career in academic medicine, combining clinical care, education, and research activities. The program is ACGME accredited and accepts up to two fellows each year. The program has two tracks, one that is more research intensive and one that focuses more on preparing individuals for careers as clinician/clinician educators. The second track is offered through a partnership between Rainbow Babies and Children’s Hospital and The Children’s Hospital at the Cleveland Clinic Foundation.

Clinical Training
The fellows entering this program are well-trained, excellent pediatricians who are Board-eligible in general pediatrics and who have graduated from accredited programs. Our Training Program builds upon this background and provides a longitudinal clinical experience that prepares the fellow to diagnosis and manage the full range of outpatient and inpatient endocrine disorders, including diabetes.

In the research intense track, fellows spend 6 months during the first year and 6 months during the third year on primarily clinical rotations that include inpatient/consultative care and 2-3 days per week of endocrine outpatient clinics. The fellows are expected to assume primary care of patients with Type I and Type II diabetes as well as the full gamut general endocrine disorders and the clinics are designed to optimize longitudinal care. The clinical rotations are performed at Rainbow Babies and Children’s Hospital, which is an active primary care hospital and a major tertiary care center. Thus, the fellows are exposed to a unique mixture of endocrine cases ranging from the more common disorders, such as diabetic ketoacidosis and growth problems, to rarer disorders, such as congenital adrenal hyperplasia, precocious and delayed puberty, and thyroid dysfunction. In addition, because of the many active clinical programs at Rainbow Babies and Children’s Hospital, the fellows are also exposed to acquired endocrine dysfunction that is secondary to systemic diseases such as cystic fibrosis, congenital heart disease, and oncologic diseases.

The clinical training portion of the second, clinician/clinician educator fellowship track is similar to the research-intensive track but with several notable exceptions. First, the clinical experience is broadened to include participation in the inpatient and outpatients services at the Children’s Hospital of the Cleveland Clinic Foundation. The splay of diagnoses is similar to that described for Rainbow Babies and Children’s Hospital but the joint program allows the fellow exposure to additional faculty and to clinics designed for children with lipid disorders and abnormalities of calcium metabolism. In addition, the balance of time between primarily research focused training and primarily clinical time changes from 24 and 12 months, respectively, in the research intense track to 15 and 21 months in the clinician/clinician educator track. Thus, one still receives substantial research training in the second track but has a greater proportion of time devoted to primarily clinical experiences.

Research
In the first track, each fellow spends 24 months (6 months during the 1st year, 12 months during the 2nd year, and 6 months during the 3rd year) in a research experience that is supervised either by endocrine division faculty or by other members of the faculty at Case Western Reserve University School of Medicine. These two years of the fellowship are usually funded by an NIH Training Grant administered within Case Western Reserve University. This grant has a residency requirement, and therefore, fellows requiring funding for their fellowship must be either US citizens or permanent residents of the United States. Acceptable research projects range from basic science to clinical, patient-based research.

In the clinician/clinician educator track, each fellow spends 15 months in research. This work can be basic or clinical, although it is expected that fellows in this track will more likely gravitate toward clinical research projects. Our goal is for these projects to involve faculty and patients from both Rainbow Babies and Children’s Hospital as well as the Children’s Hospital at the Cleveland Clinic Foundation. This track has less restrictive funding sources and is, therefore, open to a broader pool of applicants.

During the research component of both tracks, clinic time is reduced to continuity clinics only. In the research-intensive track, this is a ½ day within the Rainbow Babies and Children’s Hospital system; in the second track, continuity clinics are held at both Rainbow Babies and Children’s Hospital and the Children’s Hospital of the Cleveland Clinic Foundation.

Fellows often enter the program with prior research experience, but this is not required. Research projects and mentors are chosen during the first six months of fellowship with the assistance of the Training Program Director.