Training and Curriculum

Clinical Training

The clinical experience is broad-based and supervised in a graded way that promotes the development of fellow autonomy over the three years. The program aims to educate fellows in the care of children and adolescents with endocrine disorders, including complex care, team management skills, and interprofessional education and cooperation.

Fellows typically have 7-8 clinical inpatient months during their first year of fellowship, with 2-3 clinical months per year during second and third year. Inpatients followed by the pediatric endocrinology team include patients on the primary endocrinology team and consults. Both of these services are led by the fellow with direct supervision by the attending faculty. Inpatient consults include disorders of thyroid, glucose metabolism, bone/calcium, adrenal, gonadal/genital, pituitary, hypothalamus, and pancreas. Consults come from general pediatrics and subspecialty teams such as oncology, surgery, PICU, NICU, cardiac ICU, full-term nursery, and bone marrow transplant. Our interprofessional inpatient teams include nurses, pharmacists, dietitians, case managers, social workers, residents, and medical students. 

Fellows have 3 continuity clinics per month (1 focused on diabetes and 2 on endocrine), supervised by different faculty to allow fellows to gain experience in different management styles. In clinics, fellows see a diverse group of patients with common and rare endocrine diagnoses. Common outpatient diagnoses include disorders of thyroid, type 1 and type 2 diabetes, prediabetes, obesity, hypoglycemia, bone/calcium, adrenal, gonadal/genital, pituitary, hypothalamus, growth disorders, puberty disorders, and polycystic ovary syndrome. Emphasis is placed upon the fundamentals of clinical diagnosis, including taking a clinical history, physical examination, interpretation of laboratory tests, and the proper approach to hormonal therapy and counseling. Fellows order and interpret stimulation testing as part of patient evaluations and gain experience interpreting bone age X-rays, brain MRIs, continuous glucose monitoring, and insulin pump downloads. Continuity clinic locations have onsite labs and radiology services.

Throughout fellowship, fellows can rotate through sub-subspecialty clinics including the Pediatric Lipid Clinic, Pediatric Comprehensive Thyroid Clinic (specializes in thyroid nodules and cancer, including genetic predisposition to thyroid cancer), the multidisciplinary DSD clinic, and the Child and Adolescent Gender Care Clinic. Our interprofessional outpatient teams include nurses, dietitians, social workers, certified diabetes nurse educators, advanced practice providers, residents, and medical students. 

Fellows participate in a variety of conferences and teaching sessions throughout fellowship. During weekly Pediatric Endocrine Division Conferences, fellows give informal presentations on a variety of endocrinology topics, including disease management guidelines and journal clubs. Fellows and faculty also present interesting and rare cases for review and discussion. Fellows attend a national/international meeting annually, such as the Endocrine Society, American Diabetes Association, or the Pediatric Endocrine Society. Fellows are strongly encouraged to submit research or clinical abstracts to these conferences.

As part of a large academic medical center, fellows can collaborate and learn from not only their colleagues within pediatrics, but also their colleagues in adult endocrinology and reproductive endocrinology, with whom they hold joint conferences. During the third year of fellowship, fellows participate in a month-long elective experience where they can rotate with genetics and metabolism, adult endocrinology, and other subspecialty clinics to broaden their clinical expertise and/or gain extra training in a niche within endocrinology.

Research Opportunities

The Division of Pediatric Endocrinology provides an active and highly interdisciplinary scientific environment that promotes the research and career development of our fellows. Fellows can pursue basic, clinical, and/or translational research within endocrinology, and research projects are formulated with and conducted under the supervision of mentors from the Division of Pediatric Endocrinology or other clinical or basic science divisions in the Duke School of Medicine. Research mentors and projects are selected by fellows during their first year of fellowship and are tailored to their interests and career goals.

The research component of fellowship comprises approximately 21 of the total 36 months of the fellowship training period. This is typically apportioned as 4 months in year one and an additional 17 months divided between years two and three.

Outstanding potential research mentors and resources are available across the Duke School of Medicine. We work closely across departments and with other institutions. Please see links below for additional information.

Additional Information

Current Fellows Research

Grace Hendrix, MD: Skeletal muscle health and glycemic control in children with type 1 diabetes.
Mentor: Pinar Gumus Balikcioglu, MD

Kathryn Blew, MD: Sleep quality and predisposing factors for impaired sleep in an adolescent transgender health clinic.
Mentors: Deanna Adkins, MD; Pinar Gumus Balikcioglu, MD