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About the Endocrine Fellowship Program

Introduction

For more than 40 years, The Johns Hopkins Endocrinology 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, Diabetes & 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 and scientific expertise in all major subspecialty areas housed within endocrinology, diabetes and metabolism. Their clinical teaching further is augmented by Johns Hopkins faculty in outside specialties including pediatrics, cardiology and gynecology. Fully staffed and equipped outpatient and inpatients facilities provide an ideal environment for exceptional 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. Johns Hopkins is also a top 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.

The Division of Endocrinology, Diabetes & Metabolism provides both two and three-year fellowship opportunities (see below for further detail).  In the two-year, Clinical Scholar Track, fellows are given the opportunity over the course of their training to develop the skills necessary to become exceptional subspecialists and clinicians within a scholarly academic setting.  In the three-year, Clinical and Basic Science Research Track, fellows can pursue one of two research training pathways: 1) The Clinical-Investigator Pathway, pursuing clinical research training related to human subjects or epidemiological studies of endocrine and metabolic disorders, or 2) the Physician-Scientist Pathway, learning how to perform cellular and molecular studies in Endocrinology & Metabolism.

Resources for research training on the Clinical and Basic Science Research Track 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.

Curriculum

Intensive clinical training is the primary aim of the first fellowship year. First-year fellows divide their time between endocrine subspecialty clinics and inpatient consultation services. Fellows also rotate through pediatric endocrinology clinics. Fellows are given the opportunity to train at both the Johns Hopkins Hospital as well as the Johns Hopkins Bayview Medical Center. Throughout the two- or three-year program, fellows maintain their own weekly endocrine consultative practice in their own continuity clinic. Fellows participate in multiple weekly and monthly conferences (case-based, journal clubs, didactic sessions, etc.) that cover topics spanning all dimensions of endocrinology, diabetes and metabolism.

Clinical training

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, 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.

Research training

Fellows on the three-year pathway who choose to pursue laboratory research training work in an exemplary environment. The Division faculty have 6,500 square feet of 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.

Those fellows pursuing clinical research on the three-year pathway 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.  For those fellows pursuing epidemiological research training, there are abundant opportunities for training within the Division as well as through faculty preceptors 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 three-year 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 counsel fellows regarding medical writing and publication and there are multiple opportunities for fellows’ participation in manuscript review and publication.  In addition, a Research Ethics Conference and Internet Resources Conference are each held several times during the year.

Training As a Subspecialty Teacher

Fellows share responsibilities with the faculty attendings 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 two to three years), Endocrine Research Conference (second and third years), and Endocrine Subspecialty Conference (all two to 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 two to three years, fellows have accumulated a repertoire of brief talks on most major areas of clinical endocrinology.

Evaluation, Feedback & Career Development

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 career goals. Each fellow meets with the Program Director to discuss the fellow's training experience as well as short and long-term goals. For first year fellows, the Advisory Committee is composed of faculty who focus on the fellow's progress as a clinical endocrinologist. For two-year fellows, this focus continues into the final year of training to ensure that fellows are well-poised to become clinical scholars ideally associated with an academic setting.  In the case of fellows on the three-year pathway, research progress and academic career navigation are the focus of committee meetings during the last two years of training. 

The unique clinical and research interests of the fellow help to tailor the composition of each Advisory Committee. 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 three-year fellow pursuing clinical research, 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. 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 also evaluate faculty; yearly, fellows will evaluate all elements of the program.  With this feedback, the program can be strengthened for future trainees. While our doors are always open to discuss all aspects of the fellowship, monthly fellows’ luncheons with the Program Director provide additional opportunity for fellows to discuss areas needing improvement.

Salary

First-year fellows who have completed three years of Internal Medicine residency receive a salary of $61,000. Fellows receive personal health, disability, life, and malpractice insurance coverage. Each fellow is given personal development funds to use towards professional travel and/or professional expenses, e.g.,hotel, airfare, journal subscriptions, books, and dues.

What happens to program graduates?

The Johns Hopkins Endocrine Training Program invests substantial effort and takes great pride in the success of its graduates. There is a 100% pass rate for Johns Hopkins fellows taking the sub-specialty board examination in Endocrinology, Diabetes, and Metabolism. Recent program graduates have accepted academic positions at a number of academic institutions.