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Endocrinology and Metabolism Fellowship Training Program at ...

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  • 1. Endocrinology and Metabolism Fellowship Training Program at the University of Virginia P h o t o g r a p h s (c l o c k w i s e, s t a r t i n g f ro m u p p e r l e f t ) : R o t u n d a a n d Th e L aw n , U n i ve r s i t y o f Vi rg i n i a ( U Va ) ; s i g n l o c a t e d c l o s e t o Fo n t a i n e R e s e a rc h Pa r k ; w i n d o w a t e n t r a n c e t o E n d o c r i n o l o g y C l i n i c ; l aw n b e t we e n b u i l d i n g s, Fo n t a i n e R e s e a rc h Pa r k ; U Va H o s p i t a l
  • 2. T he major purpose of the Endocrinology and Metabolism Training Program at the University of Virginia (UVa) is to prepare physicians for a successful career here for Fellowships Applicant Site). Interviews usually occur between January and April, and decisions are made via the National Resident Matching Program (NRMP) for in academic endocrinology by providing intensive clinical endocrinology subspecialty programs. and research training. Our graduates can then choose from a The purpose of this brochure is to briefly highlight the wide range of career paths involving varied combinations of strengths of our training program. Where appropriate, scientific investigation, clinical care, and medical education. hyperlinks are provided for those wanting greater detail. We A firm grounding in the fundamentals of endocrine research very much welcome your interest in our program, and we and clinical practice is eminently useful to the future clinician, encourage you to contact us if we can be of any help. educator, and investigator alike. The primary strength of our training program is our faculty, many of whom are nationally and internationally known for clinical and research excellence. Members of our clinical faculty have a wide range of clinical and research interests, and the division has active research programs with state-of-the-art facilities. Because of the quality and accomplishments of our faculty—in addition to the exceptional clinical environment and infrastructure at UVa— our division has been repeatedly ranked among the top 12 endocrinology programs in the country (US News and World Report). Moreover, since our most recent Residency Review Committee (RRC) visit, our division has gained exceptional standing, earning recognition as the UVa Diabetes and Hormone Center of Excellence for its leadership in both clinical care and scientific study. And of great importance for prospective applicants, each member of our faculty is fully committed to the development of our trainees. Therefore, our fellows receive the finest educational experience available, and they develop into outstanding endocrinologists.   We are approved by the Accreditation Council for Graduate Medical Education (ACGME) to accept four fellows each year. We are looking to attract highly-motivated, bright, and energetic individuals with a broad range of prior experiences Alan C. Dalkin, MD in medicine. In addition to possessing excellent clinical Program Director abilities, applicants must be interested in scientific study Endocrinology and Metabolism Fellowship Training Program and qualified to pursue research grant funding. Applications PO Box 801412, University of Virginia Health System are accepted from December 1st to March 30th through Charlottesville, VA 22908 the Electronic Residency Application Service (ERAS). (Click Phone: 434-243-2603 E-mail: acd6v@virginia.edu library. Most patient care University Hospital Endocrinology and is directed by housestaff/ fellows and staffed by UVa Metabolism Training Program: faculty; and in 2008, our medical staff managed over Educational Environment 30,000 inpatient admissions and nearly 700,000 out- patient visits. There are T he standard fellowship experience encompasses three years. Fellows generally complete approximately 80% of required clinical rotations during the first year of training, with no private patients at the University Hospital, and our fellows do not rotate to other the balance being completed in the second year. During the hospitals/clinics for training. first year of fellowship, fellows meet with potential research mentors and select an area of investigation. Research Outpatient endocrinology clinics: All clinical faculty have projects begin no later than the end of the first year, a time active clinical practices, and our division sees over 12,000 out- when clinical requirements decrease. Overall, about 25-50% patients a year. Fellows rotate through these faculty clinics, of a fellow’s time is spent in clinical endocrine rotations, with engaging faculty members in their specific areas of expertise the remainder in research training. (see page 3), which include benign breast disease and breast cancer prevention; CLINICAL TRAINING: Our fellows enjoy an excellent patient diabetes mellitus; mix and are exposed to all major endocrine disease entities. As a tertiary care referral center, the UVa Health System cares obesity; diabetes for patients from an extensive geographic area that includes and cardiovascular central, western, and southwestern Virginia, in addition to disease; metabolic parts of West Virginia, Tennessee, and North Carolina. bone disease and calcium disorders; UVa Health System: This state-of-the-art facility is located endocrine disease adjacent to the University grounds. It includes a 589-bed, (e.g., diabetes) full-service teaching hospital (opened 1989); a number of in pregnancy; modern research buildings; and an outstanding biomedical hypertension and A fellow discusses a clinic patient with Dr. Liu Page 1
  • 3. adrenal disease; Shupnik, 2007-2008) and the American Diabetes Association neuroendocrinology/ (Eugene Barrett, 2003-2004), Secretary-Treasurer of the pituitary disease; Endocrine Society (John Marshall, 2010-2013), a member reproductive of the International Society of Endocrinology Executive endocrinology and Committee (Richard Santen, 2004-2010), and the President infertility; and of the Association of Program Directors in Endocrinology, t hy ro i d d i s e a s e. Diabetes, and Metabolism (Alan Dalkin, 2007-2009). Fellows also maintain a weekly University of Virginia and Charlottesville: UVa is located longitudinal care in Charlottesville, which is nestled in the foothills of the Blue (continuity) clinic Entrance to Endocrine Clinic building Ridge Mountains and considered by many to be one of the in which they provide endocrine care to their own roster of finest cities in the country. Charlottesville and Albemarle patients while learning from faculty preceptors dedicated to County offer a broad range of cultural events and outdoor activities, in addition to a number of historical landmarks. teaching (Dalkin, Liu, Kozlow, McCartney). And with low crime rates and exceptional school systems, Endocrinology’s largest clinic is in the 415 Ray C. Hunt Charlottesville is an excellent place for families. building (Fontaine Research Park), where four nurses and a nurse practitioner complete our clinical care group. The division also supervises a large multidisciplinary Diabetes Education and Management Fellowship-related conferences Program (DEMP) involving Endocrine Pathology Conference (9:00–10:00 am, 2nd nurse educators and dietitians. Tuesday of the month): Endocrine fellows and pathology Through DEMP, diabetes and faculty review surgical/cytopathological cases using a nutrition education is available multi-headed microscope. every workday. The division Endocrinology Grand Rounds (12:00–1:00 pm, every maintains its own thyroid and Tuesday): State-of-the-art lectures on clinical and scientific ovarian ultrasound machines, topics. Lectures as well as a DEXA scanner. are given by a Dynamic endocrine testing variety of internal is performed in the clinic by and external trained endocrine nurses, and speakers. In cytology services are readily addition, each available. UVa employs a fully fellow presents electronic medical record. a clinical and/ or research topic Inpatient Consultation Service: The fellows have primary once a year. responsibility for the inpatient consultation service, which Endocrinology Clinical Case Conference (1:00–2:00 renders over 600 initial consultations annually and involves pm, every Tuesday): Fellows present 2-3 clinical cases to a wide variety of endocrine pathology. Fellow activities the clinical faculty. This is a teaching conference where include initial evaluation, daily follow-up, and being a liaison pathophysiology, diagnostic considerations (e.g., technical between the primary and consulting teams. Two fellows are aspects of hormone assays), approaches to management, on the consult service at all times, allowing them to alternate and relevant literature are routinely discussed. overnight and weekend call. Coordinated care programs are in place for pituitary, thyroid, parathyroid and adrenal Fellows’ Clinical Lecture Series (2:00–3:00 pm, each surgical procedures. Tuesday excepting Journal Club days): Faculty give didactic lectures on a wide array of clinical topics. Neuroendocrine Service: This combined endocrine and Journal Club (2:00–3:00 pm, second Tuesday of the neurosurgery service performs 150-250 transphenoidal month): Fellows and a faculty member review a recent pituitary operations and over 50 gamma knife radiosurgery scientific publication, focusing on methods (e.g., study procedures each year. This has an international reputation, design, statistical analysis) and clinical relevance. routinely drawing patients from all parts of the globe. Thyroid Cancer Case Conference (4:00–5:00 pm, last Tuesday of the month): Faculty and fellows from Specialized procedures: Fellows will gain facility with Endocrinology, Radiology/Nuclear Medicine, Pathology, thyroid ultrasound, ultrasound-guided thyroid biopsy, and Surgery review and discuss 4-6 complicated thyroid dual energy X-ray absorptiometry, ovarian ultrasound, cancer cases. The conference is primarily geared toward and ovulation induction. Additional procedures with clinical decision-making in a multidisciplinary setting. which trainees gain experience include: adrenal vein and inferior petrosal sinus sampling, adrenalectomy, bariatric Research in Progress (8:30–9:30 am, each Wednesday surgery, bone biopsy, intrauterine insemination, islet cell September through May): Faculty and research trainees transplantation, parathyroidectomy (including minimally present their research and receive constructive criticism invasive parathyroid surgery, intra-operative PTH assays, and advice regarding their work. and parathyroid autotransplanation), pancreas/kidney Pituitary Case Conference (8:00–9:00 am, fourth Friday transplantation, pituitary adenomectomy, radioisotope of the month): Details regarding 6-8 pituitary cases treatment and diagnostic scans, and thyroidectomy. are discussed by faculty/fellows from Endocrinology, Neurosurgery, Neuroradiology, and Neuropathology. Networking: Our faculty members are heavily involved in Diabetes Conference (12:30–1:30 pm, first Friday of the national/international endocrinology organizations, which month): Faculty, fellows, nurses, and dietitians discuss facilitates networking to advance the career development patient care, new therapies/technology, and recent science of trainees. Our faculty include recent presidents of the in the field of diabetes mellitus. Endocrine Society (Robert Carey, 2008-2009; Margaret Page 2
  • 4. Clinical faculty A primary strength of our program is a large number of clinical faculty committed to excellence in clinical care, teaching, and research. Our clinical faculty have diverse clinical and research interests. Click on a name for more information. Stacey M. Anderson, MD Christine A. Eagleson, MD Christopher R. McCartney, MD Clinical: general endocrinology, Clinical: general and reproductive Clinical: general endocrinology, thyroid disease endocrinology, female infertility thyroid disease Research: hypoglycemia, William S. Evans, MD Research: GnRH physiology continuous glucose monitors, Clinical: reproductive and PCOS, pubertal artificial pancreas project endocrinology, infertility hyperandrogenemia Eugene J. Barrett, MD, PhD a Research: PCOS, mathematical Shetal H. Padia, MD Clinical: general endocrinology, modeling of the hypothalamic- Clinical: general endocrinology diabetes mellitus pituitary-ovarian axis Research: hypertension, obesity, Research: insulin action on Susan E. Kirk, MD and the renin-angiotensin system carbohydrate/protein metabolism Clinical: general endocrinology; Richard J. Santen, MD Susan K. Blank, MD diabetes and other endocrine Clinical: general endocrinology, Clinical: general endocrinology disease in pregnancy benign breast disease, breast Sue A. Brown, MD Wende M. Kozlow, MD cancer prevention Clinical: general endocrinology, Clinical: general endocrinology, Research: estrogen action and metabolic bone disease/calcium metabolic bone disease, calcium breast cancer growth Research: metabolic bone disease disorders Helmy M. Siragy, MD Zachary M. Bush, MD Zhenqi Liu, MD Clinical: adrenal disease, endocrine Clinical: general endocrinology Clinical: general endocrinology, hypertension Research: neuroendocrinology/ thyroid disease Research: endocrine hypertension, pituitary tumors Research: insulin action/resistance, angiotensin receptors, renal Robert M. Carey, MD cardiovascular disease in diabetes paracrine hormones Clinical: general and cardiovascular John C. Marshall, MD, PhD Michael O. Thorner, MB, DSc endocrinology, adrenal disease, Clinical: general and Clinical: neuroendocrinology/ hypertension reproductive endocrinology, pituitary, obesity Research: hormonal control of neuroendocrinology/pituitary Research: regulation of growth blood pressure, fluid/electrolyte Research: GnRH physiology and hormone secretion, ghrelin balance, and renal function PCOS; regulation of gonadotropin physiology Margaret K. Crook, MD gene expression Mary Lee Vance, MD Clinical: general endocrinology Anthony L. McCall, MD, PhD Clinical: neuroendocrinology/ Alan C. Dalkin, MD b Clinical: general endocrinology, pituitary cardiovascular disease in diabetes Research: neuroendocrinology, Clinical: general endocrinology, metabolic bone disease/calcium Research: hypoglycemia, genetic regulation of growth hormone and cardiovascular risk in diabetes, secretion Ayotunde Dokun, MD, PhD and glucagon secretion Clinical: general endocrinology Research: peripheral arterial Our general faculty also include Terry Saunders, PhD, and Joyce Green-Pastors, disease RD, MS, CDE, who (along with Dr. McCall) spearhead the Virginia Center for Diabetes Professional Education. a Director, General Clinical Research Center b Chief, Div. of Endocrinology and Metabolism; Associate Chair of Clinical Affairs, Dept. of Medicine PARTICIPATING FACULTY William L. Clarke, MD (pediatric Edward H. Oldfield, MD (pituitary We work closely with many other endocrinology) neurosurgery) faculty to provide comprehensive Mark D. DeBoer, MD (pediatric Patrice K. Rehm, MD (nuclear medicine) endocrine care, including: endocrinology) James F. Reibel, MD (head and neck Eduard E. de Lange, MD (abdominal/ surgical oncology) Reid B. Adams, MD (pancreatic and Alan D. Rogol, MD (pediatric gastrointestinal surgery) pancreatic imaging) John B. Hanks, MD (thyroid, endocrinology) J. Fritz Angle, MD (inferior petrosal Bruce D. Schirmer, MD (bariatric sinus and adrenal vein sampling) parathyroid, adrenal surgery) surgery) Kristen A. Atkins, MD (breast Jennifer A. Harvey, MD (breast Jason P. Sheehan, MD, PhD (gamma pathology) imaging) knife radiosurgery) Christine M. Burt Solorzano, MD John A. Jane Jr., MD (pituitary Ladislau Steiner, MD, PhD (gamma (pediatric endocrinology) neurosurgery) knife radiosurgery) Kenneth L. Brayman, MD (kidney/ Paul A. Levine, MD (head and neck Edward B. Stelow, MD (thyroid pancreatic/islet cell transplantation) surgical oncology) pathology/cytopathology) David E. Bruns, MD (clinical endocrine M. Beatriz S. Lopes, MD (pituitary Brian R. J. Williamson, MB, ChB laboratory) pathology) (nuclear medicine) Page 3
  • 5. R esearch training UVa ranks in the top 30% of U.S. institutions in funded National Institutes of Health (NIH) grants. Our faculty currently have over 25 NIH R01 or equivalent grants. Research is an important part of our training program for a number of reasons: it is a major foundation of an academic career; it fosters skills (e.g., critical thinking, problem solving) that significantly strengthen clinical acumen; and it offers enhanced expertise in a specialized area of endocrinology. Second year fellows are usually supported by institutional training grants from the National Institute of Health (NIH) (see below), and all fellows are expected to submit an entry-level grant application (e.g., National Research Service Award [NRSA] from the NIH, or equivalent) during their second year of training. Pursuing grant support is a valuable component of research training, and our fellows have been highly successful in obtaining extramural support. Fellows are also expected to present their research results at local, regional, and national meetings and to submit their work for publication in peer-reviewed journals. R esearch faculty In addition to our clinical faculty who engage in clinical and/or basic Institutional training grants Research training is a large component of fellowship training at Specialized resources Research by trainees is facilitated by specialized programs at UVa. The research, we have outstanding research UVa. Institutional training grants allow following programs are available to faculty who are dedicated to both basic fellows to obtain funding for their enhance fellowship training. scientific investigation and teaching. research training and salary support Fellows may work with any of these for their second and third years of Research centers faculty to learn basic research in the fellowship. There are three training General Clinical Research Center context of their areas of expertise. Click grants—awarded to our division by the (GCRC) on a name to link to more extensive National Institutes of Health (NIH)— available to fellows: Center for Research in profile. Reproduction Cellular and Physiological Diabetes Center Sarah Aiyar, PhD (cancer therapeutics Mechanisms in Reproduction for treatment of hormone- Director: John Marshall, MD, PhD Cancer Center dependent breast cancers) Small Animal Multi-Modality Research Training in Diabetes and Imaging Center Leon S. Farhi, PhD (mathematical Hormone Action modeling of endocrine feedback Director: Eugene Barrett, MD, PhD Cardiovascular Research Center systems) Center for Biomathematical Research Training in Bruce Gaylinn, PhD (growth Neuroendocrinology Technology hormone-releasing hormone and Director: Robert Carey, MD Center for Biomedical Ethics and ghrelin physiology) Humanities Daniel J. Haisenleder, PhD An NIH training grant awarded to the Center for Contraceptive and (regulation of gonadotropin gene Division of Cardiovascular Medicine Reproductive Health expression) is also available for endocrine fellows interested in vascular biology: Center for Cell Signaling Susanna R. Keller, MD (insulin signaling; insulin-regulated Center for Cellular Imaging Vascular Biology Training Program membrane trafficking and Director: Coleen McNamara, MD Center for Public Health Genomics modification of cell surface function) Formal training programs Suzanne M. Moenter, PhD a (GnRH Accelerated PhD Program for MDs neuron function and animal Department of Public Health models of PCOS) Sciences (Master of Clinical Ralf M. Nass, MD (ghrelin physiology) Research, Master of Public Health) Craig S. Nunemaker, PhD Multidisciplinary Training program (mechanisms of inflammatory- in Clinical Investigation mediated pancreatic islet cell (MTPCI) (Certificate of Clinical dysfunction) Investigation) Suna Onengut-Gumuscu (genetics of Teaching Resource Center (TRC) type 1 diabetes mellitus) (Programs to enhance teaching Margaret A. Shupnik, PhD b ability for faculty and fellows) (regulation of gonadotropin gene Research Ethics Course expression; estrogen action in neuroendocrine tissues and breast Informational resources cancer) School of Medicine Office for Wei Yue, MD (estrogen and breast Research cancer initiation/progression) Biomedical Sciences Postdoctoral Services a Vice Chair for Research Operations, Dept. of Medicine The Aurbach Research Building (450 Ray C. Hunt b Associate Dean for Basic Research, School of Medicine Drive) houses a majority of the division’s research labs UVa Research Channel on YouTube Page 4
  • 6. For more information, contact Alan C. Dalkin, MD Program Director, Endocrinology and Metabolism Fellowship Training Program PO Box 801412, University of Virginia Health System Charlottesville, VA 22908 Phone: 434-243-2603 E-mail: acd6v@virginia.edu