- Clinical Training
- Research Training
- Training as a Subspecialty Teacher
- Evaluation, Feedback, & Career Development
- What Happens to Program Graduates?
For more than forty years, The Johns Hopkins Endocrinology and Metabolism Fellowship Program has trained academic endocrinologists who plan careers as physician-scientists, clinical-investigators, or health services investigators. The program is based in the Division of Endocrinology & Metabolism in the Department of Medicine. We have the faculty, facilities, and curriculum to provide fellows with both excellent clinical training and outstanding research experience.
The Division faculty have broad clinical expertise in all major areas of specialty in endocrinology, diabetes, and metabolism. Their clinical teaching is augmented by faculty in the Divisions of Pediatric and Reproductive Endocrinology at Johns Hopkins. Fully staffed and equipped outpatient and inpatients facilities provide an effective environment for patient care and clinical teaching. The institution is one of the principal tertiary referral centers in the nation and the world for patients with endocrine disorders. It is also the provider of primary endocrine consultative services to a large urban and suburban population in the mid-Atlantic region. Consequently, fellows in clinical training are exposed a large number of patients with the full spectrum of endocrine conditions, ranging from all common disorders to the most exotic diseases.
Fellows can pursue one of two research training pathways: 1) the Physician-Scientist Pathway, learning how to perform cellular and molecular studies in Endocrinology & Metabolism; 2) the Clinical-Investigator Pathway, pursuing clinical research training related to the human laboratory or epidemiological studies of endocrine and metabolic disorders. Resources for research training include fully equipped molecular and cell biology laboratories, four NIH-funded Clinical Research Centers, a Clinical Studies Unit, and a Comprehensive Diabetes Center. In addition, fellows may pursue investigative training study in one of several closely affiliated laboratories and clinical research facilities at the Johns Hopkins Medical Institutions. The Division holds two NIH-funded training grants--one for Endocrine Molecular and Cell Biology Research Training, and the second for Clinical and Epidemiological Research Training in Diabetes and Endocrinology. These grants along with additional NIH training programs in affiliated departments, institutional endowments, and other funds provide ample support for basic, clinical, and health services research training.
Intensive clinical training is the primary aim of the first fellowship year. First-year fellows spend each weekday morning and several afternoons in endocrine subspecialty clinics and 11 months on our inpatient consultation services. Fellows also rotate through the Pediatric Clinics. Throughout the three-year program, fellows maintain their own weekly endocrine consultative practice in their own Fellows Clinic. Fellows participate in multiple weekly and monthly conferences that cover the entire spectrum of Endocrinology & Metabolism.
The program emphasis on ambulatory subspecialty training reflects the fact that most contemporary practice of endocrinology and metabolism occurs in the outpatient setting. Half day clinic sessions are held throughout the week at the Divisions' two institutions: Johns Hopkins East Baltimore Campus and at Hopkins Bayview Medical Center. The clinics occupy recently renovated, fully equipped offices with nursing, laboratory, and administrative support. Adjacent special procedure and conference rooms are available. During each of their approximately 200 sessions during the first year alone, fellows see an average of 3 new consultations and 4 follow-up patients: a total of 300 new endocrine consultations and 500 endocrine follow-up visits in the first year alone. Faculty actively supervise fellows in every clinic.
Fellows pursuing laboratory research training work in an exemplary environment. The division faculty have 6,500 square feet of recently renovated wet laboratory space equipped with all necessary facilities for endocrine investigation, including centrifugation, chromatography, nucleotide hybridization and cloning, scintillation counting, cell culture, cell sorting, radioimmunoassay, and radioreceptor assay. Adjacent facilities are available in the institution for genotyping, peptide and nucleotide sequencing and synthesis.
Program fellows have access to outstanding facilities for clinical investigation. Johns Hopkins has four NIH-funded Clinical Research Units. These are valuable and versatile resources for clinical investigation by the program's fellows.
Fellows pursuing epidemiological research training have access to additional faculty preceptors and didactic training opportunities in the Division of General internal Medicine, the Welch Center for Clinical Epidemiology and Prevention, and the Johns Hopkins School of Hygiene and Public Health. Some fellows have chosen to pursue a Masters of Health Science degree as a part of the fellowship-training curriculum.
All fellows are encouraged to have a didactic component to their investigative training. A special institutional course is offered in clinical investigation, covering principles of clinical research, trial design, biostatistics, and informed consent. Another departmental course offers an introduction to the techniques of molecular biological research. Faculty tutor fellows regarding medical writing and publication, including an opportunity for them to participate in the review of articles currently being submitted. In addition, a Research Ethics Conference and Internet Resources Conference are each held several times during the year.
Fellows share responsibility with the faculty attending for teaching, supervising, and evaluating medical students, internal medicine residents and other fellows rotating on the service. These trainees provide fellows with an opportunity to hone teaching and supervisory skills.
A team consisting of a faculty member and a fellow coordinates each of the Division's conferences. This leadership involves format definition, topic selection, scheduling, and evaluation. In addition, fellows are expected to present in rotation at Endocrine Journal Club (all three years), Endocrine Research Conference (second and third years), and Endocrine Subspecialty Conference (all three years). Furthermore, the fellows themselves orchestrate a series of Core Clinical Endocrinology Conferences, which are held two times per week to present basic topics in clinical endocrinology and metabolism for the residents and students rotating on service. By the end of their three years, fellows have accumulated a repertoire of brief talks on most major areas of clinical endocrinology.
We individualize details of each fellow's program to meet her or his goals and needs. A major feature of this effort is selection of an Advisory Committee assigned to each fellow. The Committee consists of 4 or 5 faculty members who meet twice a year to discuss the fellow's progress and to give the fellow the advantage of having experienced faculty suggest routes toward a successful pursuit of his or her targets. Each fellow meets with the program director to discuss the fellow's research experience and initial and long term goals. For first year fellows, the Advisory Committee is composed of faculty who will be concerned mainly with the fellow's progress as a clinical endocrinologist. Research issues and career concerns are the focus of committee meetings during the last two years of training.
The composition of each Advisory Committee is changed for the second and third year fellows to reflect the fellow's research interest. The fellow's research mentor is a member of the Advisory Committee, but cannot be its chairperson. Members of the Advisory Committee may be drawn from any appropriate department of the Johns Hopkins University, and even from outside the University. For example, for a fellow taking the clinical investigator route, faculty from the Department of Biostatistics or of Epidemiology in the Bloomberg School of Hygiene may serve on the Committee. The Committees discuss the fellow's training progress, any impediments to success and potential grants and awards to support training and career development. During the third year the Committee is also concerned with development of the fellow's career plans and identification of suitable positions following completion of the fellowship. Minutes of Advisory Committee meetings are incorporated in each fellow's file to help provide continuity of advice and recommendations.
First-year fellows are evaluated each month based on the criteria of the American Board of Internal Medicine by attending faculty members on their inpatient and outpatient services. Second and third-year fellows have semiannual clinical evaluations. Their progress with laboratory, clinical, or health services research training is evaluated in writing by their individual faculty preceptor, who reports to the fellow's Advisory Committee every six months. The Committees then review these reports personally with each fellow. In addition, the Program Director reviews all fellows' evaluation forms and regularly meets with them to assess their progress.
Following each rotation the Fellows evaluate faculty and once each year Fellows evaluate all elements of the program
Monthly Fellows Luncheons with the Program Director provide an opportunity for fellows to discuss areas needing improvement.
First-year fellows who have completed three years of Internal Medicine residency receive a salary set by the National Institutes of Health and the University. New fellows with additional years of postgraduate training may receive higher salaries. Fellows' salaries increase by approximately $1,000 per year; fellows garnering individual fellowship awards are permitted to accept larger salaries if they are provided. Fellows receive personal health, disability, life, and malpractice insurance coverage. Each fellow is given $1,000 per year for professional travel to meetings and courses; each fellow is given $300 for professional expenses, e.g., journal subscriptions, books, and dues.
The Johns Hopkins Endocrine Training Program invests substantial effort and takes great pride in the success of its graduates. Hopkins fellows taking the subspecialty board examination in Endocrinology, Diabetes, and Metabolism have passed without exception. Recent program graduates have accepted academic positions at a number of academic institutions.
Lewis T. Bleveins, MD University of California San Francisco Todd T. Brown, MD, PhD Johns Hopkins University Michael Boyne, MD University of the West Indies Anne Cappola, MD University of Pennsylvania Chee Chia, MD National Institute on Aging Sherita Hill Golden, MD, MHS Johns Hopkins University Elizabeth Hopkins Holt, MD, PhD Yale University Rita Kalyani, MD, MHS Johns Hopkins University Julia Kharlip, MD University of Pennsylvania Alan Krasner, MD Pfizer Pharmaceuticals Jennifer Mammen, MD, PhD Johns Hopkins Bayview Medical Center Kendall Moseley, MD Johns Hopkins Bayview Medical Center Matthew D. Ringel, MD Ohio State University Steven I. Sherman, MD MD Anderson Kristy Silver, MD University of Maryland Chee Chia, MD National Institute on Aging Shezad Basaria, MD Boston University Amin Sabet, MD Brigham and Women's Vanessa Walker Harris, MD Johns Hopkins Bayview Medical Center