The pediatric endocrine physician faculty members are directly responsible for all patient care. The pediatric endocrine fellow will be supervised at all times by a faculty member and will provide inpatient care, outpatient care, and consultative services on under direct supervision. Goals and objectives of each clinical rotation (as described by the six ACGME competencies) will be distributed to each pediatric endocrine fellow and faculty member within the section.
During the first year of training, the pediatric endocrine fellow will attend most of the outpatient clinics and be available for in-patient consultations most of the time. It is anticipated that the clinical exposure will be great, and under the direct supervision of faculty, the fellow will develop clinical expertise in the types of clinical problems cared for by practicing pediatric endocrinologists. Over the following 2 years, the fellow will have the opportunity of following patients longitudinally, under the supervision of experienced faculty, to gain a greater understanding of the chronic nature of the endocrine and diabetes-related disorders of childhood. In addition to patient-care experiences, the fellow will receive regular, didactic instruction regarding endocrine disorders and diabetes mellitus.
The pediatric endocrine fellows will have scheduled fellow’s endocrine continuity clinics, as well as fellow’s diabetes continuity clinics throughout the month. Patients new to our practice, or established patients interested in being followed by the pediatric endocrine fellow, will be scheduled into a designated clinic. A faculty member will directly supervise each of those clinics
The first year pediatric endocrine fellow will be on call one half of the inpatient call per month, giving the fellow 2 full weekends free and 2 weeks free of night call, on average. All of the night and weekend call will be from home. On rare occasions, the fellow and attending may need to come into the hospital from home to evaluate a patient. The fellow will have the first month call free.
The second year fellow will be on night call for one week and take one weekend of call per month, on average. The third year fellow will be on night call for one week and take one weekend of call per month, on average. Holidays will be divided among the fellows, as per their preference. Third year fellows will also take 2-4 weeks of inpatient service divided between the beginning and end of the year.
As stated above, all call is in home call. The call does not change from rotation to rotation. The evening call will generally begin at 5pm and end at 8am the following day, and from 4pm Friday until 8am Monday morning.
2. Scholarly Activities
In addition to participating in a core curriculum in scholarly activities, all fellows will be expected to engage in projects in which they develop hypotheses or in projects of substantive scholarly exploration and analysis that require critical thinking. Areas in which scholarly activity may be pursued include, but are not limited to: basic, clinical, or translational biomedicine; health services; quality improvement; bioethics; education; and public policy. In addition to biomedical research, examples of acceptable activities might include a critical meta-analysis of the literature, a systematic review of clinical practice, a critical analysis of public policy, or a curriculum development project with an assessment component.
Work Product of Scholarly Activity
Involvement in scholarly activities must result in the generation of a specific written "work product" as outlined by the ABP (www.abp.org). Examples of include, but are not limited to:
A peer-reviewed publication in which a fellow played a substantial role
An in-depth manuscript describing a completed project
A thesis or dissertation written in connection with the pursuit of an advanced degree
An extramural grant application that has either been accepted or favorably reviewed
A progress report for projects of exceptional complexity, such as a multi-year clinical trial
The fellow’s Scholarship Oversight Committee (SOC) will be instrumental in guiding the fellow’s activity towards an acceptable product. In addition to the work of the SOC, the department will provide all subspecialty fellows with the opportunity to participate in a departmental research, education, and scholarship forum to present their work product and receive feedback from department faculty.
Scholarship Oversight Committee (SOC)
The SOC in conjunction with the trainee, the mentor, and the program director will determine whether a specific activity is appropriate to meet the ABP guidelines for scholarly activities (www.abp.org). These activities require active participation by the fellow and must be mentored. The mentor(s) will be responsible for providing the continuous ongoing feedback essential to the trainee’s development.
Review of scholarly activity and the written work product will occur at the local level with each fellow having a SOC responsible for overseeing and assessing the progress of each fellow and verifying for the ABP that the requirement has been met. The SOC must consist of three or more individuals, at least one of whom is based outside the subspecialty discipline; the fellowship program director may serve as a trainee’s mentor and participate in the activities of the oversight committee, but should not be a standing (i.e. voting) member. Particular emphasis will be placed on encouraging identification of committee members whose professional and research responsibilities encompass elements of the trainee’s scholarly interest, but who do not necessarily have a primary appointment in the Department of Pediatrics. Examples of such individuals include faculty in clinical departments in the University of Minnesota Academic Health Center (AHC), faculty in basic science departments, or faculty in the Schools of Public Health or Education.
This committee will:
Determine whether a specific activity is appropriate to meet the ABP guidelines for scholarly activity.
Provide guidance in charting a course of preparation beyond the core fellowship curriculum to ensure successful completion of the project.
Evaluate the fellow's progress as related to scholarly activity.
Meet with the fellow early in the training period (within 6 months of initiation of fellowship training) and regularly thereafter.
Require the fellow to present/defend the project related to his/her scholarly activity.
Advise the program director on the fellow's progress and assess whether the fellow has satisfactorily met the guidelines associated with the requirement for active participation in scholarly activities.
The fellow, in conjunction with the fellowship director or designee and research mentor, should identify the direction for the fellow’s scholarly activity. At the first SOC meeting, the purpose will be to hear the general path the fellow has chosen, to help further outline the path, and determine the specific steps for the fellow to meet the outlined path. The SOC should meet again within 4-6 months of the first meeting and at least semi-annually thereafter to further update and guide the fellow on developing their scholarly path.
A written report by the chair of each trainee's SOC should be completed twice a year and forwarded to the fellowship program director. The Department Education Office will provide the subspecialty training programs with standard forms for documenting each SOC meeting. The fellowship director and the head of the fellow's SOC are expected to monitor whether additional SOC meetings are necessary for fellows who need more help or may be changing their scholarly activity.
The final responsibility of the SOC is to review and approve the final scholarly “work product” of the applicant prior to submission to the ABP.
A program’s ability to provide a satisfactory scholarly experience for all trainees will be evaluated periodically, as described below.
The Pediatric Residency Review Committee (RRC) of the ACGME will be asked to review the training program’s structure as it relates to the scholarly activity requirements.
External periodic peer review of the quality of the training environment related to scholarly activity, in addition to that undertaken by the RRC, is highly recommended.
Responsibilities of the Training Program Director
In addition to meeting the requirements of the ACGME related to the six general competencies, the responsibilities of the training program director shall include the creation of a core curriculum in scholarly activities, the identification of a mentor, the creation of the Scholarship Oversight Committee responsible for overseeing and assessing the progress of each trainee, and providing verification to the ABP of the successful completion of training.
It is the responsibility of the training director to review the SOC documentation and clarify the responsibilities and outcomes for each fellow. The SOC and the Fellowship Program Director are both accountable for scholarly progress of individual fellows and will share their recommendations with the Department Chair.
Verification of Scholarly Activity
Upon completion of training, the ABP will require:
Verification from the training program director that the clinical and scholarly skills requirements have been met
A comprehensive document (i.e. personal statement), written by the fellow, describing the scholarly activity that includes a description of his/her role in each aspect of the activity and how the scholarly activity relates to the trainee’s own career development plan
The actual “work product” of the scholarly activity as described above
Signature of the fellow, program director, and members of the Scholarship Oversight Committee on both the personal statement and work product of the fellow as described above
The fellow will need to produce the work product and personal statement, as well as obtain approval from the SOC to be eligible to sit for the Subspecialty Board Examination. The decision about the adequacy of the work product is the responsibility of the SOC and the program director.