JOAN C. EDWARDS SCHOOL OF MEDICINE (JCESOM)
MARSHALL UNIVERSITY (MU)
TRAINING PROGRAM IN ENDOCRINOLOGY,
DIABETES, METABOLISM, AND NUTRITION
Description of the Program
The training program consists of a two-year period of combined clinical endocrinology and
endocrinology research activities. An optional third year is provided for those trainees who
want to continue their research activities on a full-time basis. During the program, the trainee
learns to diagnose and manage the full spectrum of endocrine and metabolic disorders and
complications. He/she maintains his/her competence in general internal medicine,
particularly those states leading to endocrine complications and those medical problems
arising from primary endocrine diseases. At the completion of the program, the trainee will
be qualified to enter the practice of general internal medicine with a subspecialty interest in
endocrinology, the full-time practice of clinical endocrinology, or as an endocrinologist in
academic medicine. The trainee also will be eligible for the subspecialty examination in
endocrinology and metabolism offered by the American Board of Internal Medicine.
Selection of Candidates
Policy for Application, Recruitment, and Selection.
Candidates must have completed successfully a 3-year general internal medicine
residency in an ACGME accredited program and be eligible for the American Board of
Internal Medicine examination for certification. The recruitment process begins two years
prior to the beginning of the start time for the fellowship. Applicants apply for the
position. In the past applications have been submitted directly to the program director.
Applications were available at our web site. Starting July 1, 2005, candidates will apply
through ERAS. As of July 1, candidates can open a My ERAS account. Applicants are
directed to the ERAS site www.aamc.org/eras to open their ERAS accounts through
the MyERAS website. As of November 15th, ERAS is open to candidates for official
submission of application materials. Similarly, around that time, ERAS updated software
(PDWS Software kit) will be sent to us to install in our offices. This gives us access to all
the electronic applications. On December 1, all fellowship programs will have access to
the application files. At that time, faculty in endocrinology will review applications, rank
candidates and begin to offer interviews to candidates. This will continue through the
end of February 2006. Letters of recommendations and Step 1-3 scores are reviewed.
At least three letters of recommendation including one from their internal medicine
program directors are required. After interviews, in early March, candidates are selected.
. The Internal medicine program director reviews selections for the fellowship. Final
decisions on selection of endocrine applicants remain with the endocrine program
director. Offers are extended. The process of selecting fellows and their acceptance of
offers should be completed by the end of March 15 months prior to the July 1 starting
time. Out-of-Season Periods may occur in some years in selected cases for candidates
applying off cycle.
Bruce Chertow, M.D. is Professor of Medicine and Anatomy at Joan C. Edwards School of
Medicine (JCESOM) at Marshall University and Chief of Endocrinology and Metabolism at
Marshall University School of Medicine and the Department of Veterans Affairs (DVA), Veterans
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Affairs Medical Center (VAMC). Dr. Chertow is the medical director of the Marshall University
Diabetes Center. He is board certified in general internal medicine, endocrinology and
metabolism, and nuclear medicine. His research interests include cellular mechanisms of
hormone secretion and in particular insulin secretion and abnormalities in secretion that may be
important in the pathogenesis of diabetes mellitus. Dr. Chertow is the Program Director of the
Endocrine Training Program.
John W. Leidy, Jr., M.D., Ph.D. is Professor of Medicine and Physiology at JCESOM at Marshall
University and Staff Physician and Research Coordinator at the Veterans Affairs Medical Center.
He is board certified in general internal medicine and in endocrinology and metabolism. His
research interests include growth hormone releasing hormone and hypothalamic pituitary
secretion. Dr. Leidy is also Associate Director of the Endocrine Training Program.
Henry Driscoll, M.D. is Professor of Medicine at JCESOM and Staff Physician at the VAMC. He
is board certified in general internal medicine and in endocrinology and metabolism. His research
interest is in the immunopathogenesis of diabetes.
Jamie Bailes, Jr., M.D., is an Assistant Professor of Pediatrics, board certified in pediatrics. He
has a special interest in type 1 diabetes and obesity. He is presently performing research using a
high protein, low carbohydrate diet for children.
Kimberly Matthews, M.S., is a research associate in our section of endocrinology. She is an
integral part of fellowship training program for over 15 years. She has over 15 years of
experience in medical research. Currently, Ms. Matthews is involved in laboratory projects
concerning the role of vitamin A in islet development and hormone secretion. Mrs. Matthews
manages the laboratory projects, orients and teaches fellows research methods, molecular
biology including PCR and recombinant DNA techniques, radioimmunoassay, and handling of
radionuclides. In addition, she is a member of the Research Safety/Biosafety Subcommittee and
Animal Studies Subcommittee at the VA.
Shailini Singh, M.D. is the director of the fetal diagnostic and therapy center in the Department
of Obstetrics and Gynecology and has a particular interest in diabetes and pregnancy. Our
fellows have opportunity to take a one-month elective with her. Dr. Singh also gives a lecture to
our fellows on state of the art approaches and management of the high-risk diabetic pregnancy.
William Burns, M.D is Chief of the Division of Reproductive Endocrinology and Infertility and
Assisted Reproduction Center in the Department of Obstetrics and Gynecology. This center offers
a full range of assisted reproduction techniques such as in vitro fertilization and gamete intra-
fallopian transfer. Our fellows have opportunity to take a one-month elective with him. Dr. Burns
also gives a lecture to our fellows on state of the art approaches to infertility.
Fred Zangeneh, M.D. is a board certified pediatric endocrinologist on the West Virginia
University (WVU) faculty at Charleston Area Medical Center (CAMC) in Charleston. Fellows have
an opportunity to take a one-month elective with Dr. Zangeneh.
Mary Beth Hummel, M.D. is Associate Professor of Pediatrics at WVU and is board certified in
Pediatrics and Medical Genetics. She visits MUSOM monthly and gives a formal lecture every
other month. Selected patients with inherited disease are presented to her for discussion of the
molecular basis of disease, management and family counseling.
Donald Primerano, Ph.D., is professor of medicine in the Department of Microbiology,
Immunology and Molecular Genetics. He serves as the director of the Appalachian
Cardiovascular Research Network (ACoRN) and director of the MU Genomics Core Facility. He
advises faculty, fellows, and Kim Matthews on approaches and methods using microarray, RT-
PCR, recombinant DNA techniques.
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Richard Niles, PhD, is Chairman of Microbiology and Biochemistry and is collaborating with Dr.
Chertow in research. Dr. Niles and Dr. Chertow have a common interest in the role of retinoids in
gene transcription and cellular growth. Dr. Niles group participates in the basic science and
William Rhoten, PhD, is Chairman of Anatomy, Cell and Neurobiology and is collaborating with
Dr. Chertow in his research effort. Dr. Rhoten has special interest in islet structure and function
and the role of intracellular calcium binding proteins. Dr. Rhoten and his group participate in the
basic science and research conference
Podiatrists. The VAMC has a Podiatry Service. Our section is consulted on diabetic patients with
neuropathic feet and diabetic foot ulcers. This is an excellent resource for teaching our fellows
about diabetic foot management. Additionally, patients are referred to Karen G Lo, DPM, in the
Department of Orthopedics or Jeffrey Shook D.P.M., and Seth Stinehour D.P.M., practicing
Pam Neal, RN, BSN, MSN-NA, C-FNP is a graduate of Marshall University. Ms. Neal received
her Bachelor of Science in Nursing in 2000 and a Master of Science in Nursing, Nursing
Administration in 2002. She received her Post-Graduate Certificate as a Family Nurse
Practitioner in 2004. She works with members of the Endocrinology section of University
Physicians & Surgeons. She also is a Clinical Research Coordinator for Drug Trials for the
Department of Medicine, Joan C. Edwards School of Medicine. She is responsible for
administrative activities and conducting patient visits in endocrinology trials.
Anise Nash R.N., CDE, is a Certified Diabetes Educator. She is the coordinator of our ADA
recognized Diabetes Self-Management Education Program. Fellows work closely with her in the
education and care of their patients.
Kristen Legleitner, R.N. is staff endocrine nurse of for the members of the Endocrinology
Section. She acts as a liaison between patients and endocrinology physicians and arranges and/
or performs diagnostic tests on patients.
Jennifer Stallings, R.D., CDE, is a Certified Diabetes Educator and Registered Dietitian in our
ADA recognized program. Our fellows work closely with Mrs. Stallings in the diabetes education
and dietary management of their patients. She shares in the care of patients and gives individual
and group education sessions for our patients.
RESOURCES AND FACILITIES
The fellowship training program is one of the subspecialty training programs of the Department of
Medicine at Joan C. Edwards School of Medicine at Marshall University. The program is an
integrated program of two or three years' duration based at the three teaching hospitals affiliated
with the School of Medicine, the Huntington Veterans Administration Medical Center (federal, 80
beds), Cabell Huntington Hospital (private, 300 beds), and St. Mary's Hospital (private, 400
beds). The VA Medical Center has veteran patients and the Cabell Huntington and St. Mary's
Hospitals have mainly private patients.
The medical clinics and diabetes center are located in the Marshall University Medical Center, an
185,000 square-foot, $32.2 million facility constructed in cooperation with and adjacent to Cabell
Huntington Hospital. The Medical Center complex consists of the University Physicians Center,
the Robert C. Byrd Center for Rural Health and a six-story atrium that connects the facilities to
each other and to the Hospital.
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The Veterans Administration Medical Center has 65 beds in medicine; the Cabell Huntington
Hospital and St. Mary's Hospital each have approximately 100 beds in medicine. All three
hospitals are geographically close to each other and to the Medical School. All hospitals have
modern facilities and provide extensive medical services including nuclear medicine, radiology,
pediatrics, obstetrics and gynecology, and laboratory that are particularly important to the
diagnosis and management of endocrinology problems and diseases. Modern library facilities
with internet access to the National Library of Medicine are available at the Huntington VA
Medical Center and Marshall University School of Medicine.
Clinical. The first year of training will be devoted mainly to developing expertise in clinical
endocrinology. The trainee will care for patients with a variety of endocrine problems. The
sources of patients will be the Huntington VA Medical Center; St. Mary's Hospital, Cabell
Huntington Hospital, and the University Physicians and Surgeons. Fellows see about 1-3 new
and 5-7 return patients in an office setting. The differing nature of the patient makeup and
endocrine problems and diseases at these different institutions provides a broad complement of
endocrine problems and diseases for teaching purposes. The trainee will view patients from
many perspectives including that of the primary physician or the endocrinology consultant.
His/her involvement in the care will be direct or in a general supervisory role when directing PG-1
and PG-3 residents on the endocrinology service during an elective month. The attending
endocrinologist will make consulting rounds several times a week and daily rounds on private
patients. During rounds, the trainee will present the patient to the attending endocrinologist and
review various aspects of the patient's problem or problems. During these rounds, bedside skills
will be emphasized, and when appropriate, the physiology and biochemical basis of disease
processes will be discussed.
Dr. Chertow, the Chief of the Endocrinology Section, is in charge of endocrine imaging and
DEXAs in Nuclear Medicine. He trains fellows in imaging of the thyroid, bone and adrenal with
nuclides and the use of other diagnostic studies and laboratory tests using nuclides. He conducts
two clinics at the VAMC, one for patients requiring radiotherapy for thyroid disease and the other
for patients needing evaluation for osteoporosis. Radiology personnel will provide training in the
radiographic evaluation and treatment of pituitary tumors; the indications for, and interpretation of,
MRI and CT scans for endocrine tumors; angiography for the diagnosis of extension of pituitary
tumors outside the sella turcica and for localization of pancreatic islet tumors; and catheterization
studies for localization of ovarian, testicular, parathyroid, and adrenal tumors or hyperplasia.
Close interaction with faculty in the Department of Pediatrics provides for access to children with
endocrine problems and diabetes at the community hospital and allows for training in growth and
development, childhood obesity, disorders of puberty, genetic diseases, and inborn errors of
metabolism. Interaction with faculty in the Department of Obstetrics and Gynecology will provide
patients for training in diagnostic approaches to disorders of menstruation and fertility problems
and the diagnosis and treatment of thyroid and other endocrinology problems during pregnancy.
The University Physicians and Surgeons, Inc, the school’s ambulatory care facility and the VA
Medical Center will provide an outpatient setting for training and the management of general
endocrine problems and ambulatory patients. After discharge from the hospital, patients from St.
Mary's and Cabell Huntington Hospitals receive long-term ambulatory care at University
Physicians and Surgeons. Also, veteran patients are seen at the VA endocrinology clinics. The
clinics at both the University Physicians and Surgeons and VA Medical Center focus on the
management of diabetes and its complications as an outpatient as well as other endocrine
The following varieties of clinical conferences are scheduled throughout the two-year training
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1. Endocrinology Grand Rounds (monthly) - Focuses on an endocrinology problem or disease.
The trainee has the main responsibility with the assistance of the attending endocrinologist of
presenting a case or lecture on a topic of his/her interest. In this role, the trainee not only
learns from his/her preparation for the conferences but also develops experience as a
2. Endocrinology Journal Club (monthly) - This conference provides training in the critical review
of articles on recent developments in endocrinology.
3. Endocrinology Curriculum Lectures (biweekly) - A staff endocrinologist will lecture on a timely
topic 2 hours every other week.
4. During the two years of training, a research/basic science conference is held every two
weeks where members of the Endocrinology Section and trainees present their research as it
develops. These conferences provide training in scientific approaches and analyses,
emphasizing creativity with critical thinking and review.
Elective Experience. During the two-year experience year, a one-month clinical elective may be
taken in specific areas such as reproductive endocrinology, pediatric endocrinology, or pregnancy
Marshall University Diabetes Center is a cross-departmental diabetes center recognized by the
American Diabetes Association. Patients from the tri-state region and southern West Virginia are
referred to the center. Its staff uses the team approach, and offers one-on-one and group
education sessions. Anise Nash R.N., CDE, is the coordinator of our ADA-recognized Diabetes
Self-Management Education Program. Jennifer Stallings, R.D., CDE, provides dietary education
and medical nutrition therapy. Fellows work closely with staff in the MU Diabetes Center.
Research Experience. Research performed by Drs. Chertow, Leidy, and Driscoll involves
basic mechanisms, and these investigators have an excellent knowledge in the basic sciences.
All members of the endocrine section provide instruction in the basic sciences.
At the beginning of his training, the trainee is assigned a preceptor for research activities with
whom he can work closely in developing his research project. During the first year of clinical
training, the fellow becomes familiar with other ongoing research activities in the Section of
Endocrinology as well as in the Department of Medicine and other departments of the school.
He/she will gain insight into the methods available for research studies. At the end of the first
year, an area of investigation is chosen with the advice and consent of the assigned preceptor for
research. A protocol is presented to the members of the Endocrinology Section and, after review,
the trainee pursues the project during his second year of training. If the trainee elects, he/she
may be offered and sometimes encouraged to take a third year of research to complete research
activities. At the end of training, the trainee is expected to summarize, present, and consider his/
her work for publication. In addition to the endocrinology research conference, fellows can attend
the basic science seminar given for graduate students by basic science faculty monthly.
Evaluation of Core Competencies
Core Competencies and Assessment
The ACGME core competencies encompass the basic knowledge and skill necessary for the
successful of practice of endocrinology. The core competencies are listed in the first column and
required skill components of each competency listed in the second column of Table 1, which is
attached, and on Internet link HTTP://WWW.ACGME.ORG/OUTCOME/ASSESS/TOOLBOX.ASP
and evaluation methods are listed across the second row. Definitions of the tool box assessment
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methods are attached and can be found at link
Evaluation forms covering the competencies and developed by the American Board of Internal
Medicine are employed for this evaluation, and the attending and trainees should discuss the
evaluation before the end of the review period and before the evaluation form is given to the
program director and maintained in the trainee’s file. Fellows are required to keep their portfolios
and log of procedures up to date. Fellows keep their own record of FNA procedures, indicating
who supervised the procedure, and copies of the procedure logbook or equivalent documents are
provided to the program director for the trainee’s file annually. Fellows are evaluated at 3-month
intervals by all attendings. The fellow’s folio is reviewed at each evaluation by the program
director. At 3, 9, 15 and 18 months interval evaluations using ABIM forms are reviewed with the
fellows. At 6 months fellows get a written formative review and at 12 months get a summative
review with a decision to promote the fellow or not to the PG 5 level (see promotion policy below).
At 18 month another formative review is written and at 24 months a final summative review is
written with a decision to graduate the fellow or not.
The research mentor, using forms developed by the American Board of Internal Medicine, will
evaluate the research performance of each trainee. Those evaluations will be discussed with the
trainee and then forwarded to the program director for review and inclusion in the trainee’s file.
Evaluation of the program by the graduates will be done periodically after completion of training.
The evaluation will employ a survey instrument that asks the graduates’ perception of the
program’s relevance to their current activities, suggestions for improvement and ideas for
additions and/or changes to the curriculum.
Policy for Promotion of Fellows.
Interval Evaluations and Counseling of Fellows. All attending physicians that have contact
with the residents formally evaluate residents every 3 months. Faculty contact with residents
usually comes in periods of one to two month rotations as an attending consultant. Residents are
also supervised by each attending 1 to 2 times a week in the clinic setting. Each faculty member
evaluates the fellow and completes an evaluation form at 3-month intervals, and the written
records are maintained in the program directors office. The evaluation by a faculty member at six
months includes experience with the resident during about 2 months inpatient experience and
approximately 12-48 clinic contact experiences. Evaluations include the new competencies of
practice-based improvement and information systems-based practice. The fellows are expected
to document competencies in a folio developed for each fellow. They are given a time schedule of
evaluations, which describes what documents and competencies will be reviewed at each
evaluation. After each evaluation the program director meets with the fellow and reviews the
evaluations. The program director and fellow sign off on the evaluation.
At 6-month intervals, the program director writes a formative narrative evaluation and makes
recommendations for improvement, if any, to the fellow. If problems occur prior to that
evaluation, the faculty member calls it to the attention of the training program director for formal
documentation and discussion with the fellow. Annually, a summative formative evaluation is
performed and documented formally.
Monitoring Data Base of Knowledge. Fellows take an annual self-assessment that includes
exam items comparable to test questions for the specialty boards in endocrinology. One is the
Endocrine Self Assessment Program (ESAP), published by the Endocrine Society and Up-To-
Date, and the other is the American Association of Clinical Endocrinologists Self-Assessment
Program (ASAP), published by the American Association of Clinical Endocrinologists. They
review the results of their tests for self-assessment of their progress. The faculty uses this
information to assess the knowledge and progress of individual fellows.
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Monitoring and documentation of each trainee's acquisition of skills in the performance of
the procedures utilized in this subspecialty. Fellows are given a checklist of procedures.
Every time they perform a procedure, the procedure must be signed by the attending indicating
successful completion of the procedure. The list of procedures is submitted to the program
director for the formal record. At the completion of their fellowship, fellows are competent in
interpreting various laboratory tests and performance of different procedures.
Resident performance of ultrasound-guided thyroid aspirations are observed and evaluated
closely. The resident’s skill for thyroid aspirations is developed with repeated procedures. First,
the fellow observes thyroid aspirations. When the attending endocrinologist is confident that the
fellow is knowledgeable about a procedure, the fellow is allowed to perform the procedure under
supervision. When the performance is judged satisfactory, the fellow can then perform a
procedure in the absence of an attending physician. In general, the physician of record is present
at all procedures.
Promotion. Performance at the end of the PG4 year including evaluations in the six
competencies, thyroid aspiration, and ultrasound skills are reviewed by the program director. If
the fellow is judged to be competent by objective evaluations and achieved a level of competence
and independence of action in the care of his patients, and there is a consensus among the
faculty, the fellow is advanced to the second year of fellowship.
The evaluation process is repeated during the second year of training. Upon successful
completion of the second year, the fellow is graduated from his/her fellowship.
Response by Resident. The program director reviews the evaluations with the fellow during a
scheduled meeting every 3 months. The fellow has an opportunity to read and respond to their
evaluations. The fellow signs off on the evaluations. The fellow can review his/her evaluations at
any time between scheduled evaluations.
If the fellow fails in a particular competency, the program director gives the fellow a warning about
his/her deficiencies and develops a remedial plan with the fellow to correct the deficiency within a
3-month period. If the fellow continues to fail, the fellow is put on probation and given a 3-month
period to correct the deficiency. The two-year program cannot be ended on probation or with a
warning, and the training period must be extended 3-6 months if such a situation occurs. If the
fellow fails again after being place on probation, the fellow is dismissed from the program. The
fellow can appeal the decision with due process following GMEC policy.
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