Clinical training & rotations

The first year of the program is dedicated primarily to clinical training in pediatric endocrinology while fellows begin planning their research project. The primary pediatric endocrinology clinical site is on campus at St. Louis Children’s Hospital. Each fellow is provided a clinical mentor from faculty. In the second and third years of training, fellows spend the majority of time developing their research projects and have more limited clinical time.

Outpatient clinics

Beginning in the first year, each fellow establishes a Continuity Clinic with patients assigned from inpatient admissions and referrals from the community. First year fellows have two continuity clinics per week. Senior fellows have 1 continuity clinic per week. Fellows collaborate with diabetes educators, dietitians, social workers, nurse practitioners and psychologists to provide optimal care to their patients.

Fellows attend one to two monthly specialty clinics: Differences in Sex Development, Turner Syndrome, Transgender Care, Neuro Oncology and Metabolic Bone Disease (at nearby Shriners Hospital St. Louis Center for Metabolic Bone Disease and Molecular Research). Additionally, fellows have the option to complete a rotation in Genetics and may choose to rotate through the following sub-specialty clinics: Cystic Fibrosis, Healthy Start (Obesity) and Type 1 Diabetes Transition Clinic.

Inpatient diabetes & endocrine service

The Inpatient Diabetes and Endocrine Service sees a high volume of diabetic patients, and a vast variety of endocrine disorders. Fellows work closely with the attending physician on service and lead daily rounds. During service, fellows’ academic time is protected so that they can attend didactic seminars without interruption. Night call is taken from home.

Below is a table of clinical requirements during fellowship.

Currently call is taken from home.

YearInpatient service *
1~16 weeks
2~ten weeks
3~six weeks**
* Fellows complete a minimum of 32 weeks of inpatient service over the three-year program. Fellows pursuing basic science careers or other specialized training during fellowship may shift more inpatient weeks to the 1st year to give more protected time for research during the 2nd and 3rd years.

** Often called the “pre-tending” time, 3rd year fellows are encouraged to act as the supervising physician for the endocrine team during their inpatient service time while still under the supervision of an attending physician.

Didactic learning

Fellows are provided with a comprehensive core didactic lecture series in which the full spectrum of endocrine physiology and pathophysiology is presented over a two-year cycle. Weekly lectures are given by faculty within both the pediatric and adult endocrine divisions. Recognized experts invited to speak from outside Washington University further add to the rich educational experience. Participation at these conferences is a required component of the training program. Fellows’ attendance time is protected from clinical duties during these lectures. Throughout the year, fellows are expected to present at a variety of conferences, from journal clubs to case discussions.

Teaching opportunities

Fellows complete a QI project each year, and present their work within the division and frequently to other divisions within the hospital. Fellows lead daily rounds during inpatient service and have the opportunity to teach residents informally in this setting and at the bedside. They also prepare weekly American Academy of Pediatrics PREP slides and lead the discussion amongst faculty and fellows. In addition, fellows present at our yearly community Diabetes Caregiver course and teach at the regional Diabetes Camp (Camp EDI) and in our Diabetes Support Group for children and their families.

Education & meetings

Fellows present their research semi-annually at the Washington University Endocrine Research day and during their third year at the Washington University Pediatric Research Retreat. Fellows are encouraged to attend and present at one national meeting each year. Fellows have presented at PES (Pediatric Endocrine Society), ASBMR (American Society for Bone and Mineral Research), the ADA (American Diabetes Association) and the Endocrine Society.