Clinical Training

The clinical component of the Yale Endocrinology & Metabolism Fellowship Training Program consists of 12 months, equally divided between inpatient (endocrine consult service) and outpatient (endocrine clinics) training. During training, our fellows are provided with the opportunity to achieve the knowledge base, clinical and interpersonal skills, professional attitudes, and practical experience required of an outstanding endocrinologist. The training program emphasizes scholarship, professionalism, self-instruction, development of critical analysis of clinical problems, and the ability to make appropriate diagnostic and treatment decisions. By the end of the training program, our fellows develop expertise in the evaluation and management of diabetes and endocrine disorders, including disorders of the parathyroid, pituitary, thyroid, adrenal glands, and gonads; endocrine function of the kidney and brain; as well as lipid disorders and obesity.

The Endocrinology, Diabetes, and Metabolism Fellowship Program is based at Yale-New Haven Hospital, a 1,541-bed teaching hospital, which is the primary hospital for the Yale School of Medicine. All sub-specialty services and excellent ancillary support are available at this institution. Our fellows receive the bulk of their inpatient consultative experience at this medical center, as well as the major portion of their outpatient training. The secondary site of training is VA-Connecticut Medical Center in West Haven, CT, (just minutes away from the main medical campus) where inpatient consultations are also performed and one of the fellows’ continuity clinics takes place. During both of the first two years of the fellowship, the outpatient experience is attained and enhanced through rotations in several clinics per week at Yale-New Haven Hospital and the Yale School of Medicine. These clinics sub-specialize with focuses on: diabetes, thyroid disease, bone disease, and two general endocrine clinics -- which encompass reproductive medicine, pituitary and adrenal disorders, pediatric diabetes, and general pediatric endocrine disorders. Continuity clinics occur at the VA and in several affiliated private practices of our volunteer faculty.

Consultative rounds with faculty members of the Endocrine division are held for two hours five or more times per week. The program provides clinical exposure to a wide variety of acute and chronic endocrine problems and offers our fellows with the opportunity to participate actively in the diagnosis and management of patients with endocrine disease. When our fellows enter the second half of their first training year, there is a gradual increase in independent patient care activity.

Yale Endocrine Consult Service

• During your time on the inpatient endocrine consult service, fellows perform all consults on endocrine cases at Yale-New Haven Medical Center, including Yale-New Haven Hospital (Y-NHH), Yale Psychiatric Hospital (YPH), and Connecticut Mental Health Center (CMHC), under the guidance and support of one of our endocrine faculty members, serving as the attending physician. You may also occasionally be called for an urgent consult within the outpatient clinics of Y-NHH or the School of Medicine (Yale Medical Group). The Consult Fellow also supervises the Inpatient Diabetes Nurse Practitioner, with the diabetes cases being integrated as part of the Consult team. Daily Attending Rounds with regular educational sessions are conducted with the attending physician on service [daily on weekdays and as needed on weekends and holidays].

Clinics 1 rotation schedule

• The ‘Clinics 1’ Fellow rotates through morning (AM) and afternoon (PM) sub-specialty endocrine clinics at various locations, all on the main Yale medical campus (8-9 sessions per week).
  

VA/Clinics 2 rotation schedule

• The 'Clinics 2' Fellow primarily covers the inpatient consults at the VA Connecticut Health Care System in West Haven, with additional focus on outpatient endocrinology, including elective rotations.

~Community-based Endocrine Practice
~Bone Densitometry
~Endocrine Surgery
~Pituitary Surgery
~YNHH Gamma Knife Center
~Thyroid Cytology
~Diabetes in Pregnancy/Maternal Fetal Medicine Clinics
~Nuclear Medicine
~Reproductive Endocrinology & Infertility Clinics
~Retina Clinics
~Insulin Pump and CGM Training
~Thyroid Ultrasound
~Pediatric General Endocrine Clinics
~Pediatric Bone Clinic
~Childhood Obesity/Type 2 Diabetes Clinics

The Fellows’ Continuity Clinic is an active general endocrine specialty practice, held at the VA in West Haven. Fellow providers function as the primary Endocrinologist for their patients and thus gain experience in managing endocrine diseases over time in a given patient. The case mix includes a gamut of conditions, from common endocrine diseases (eg. diabetes, osteoporosis) to more complicated conditions (eg. metastatic thyroid cancer, pituitary tumors, neuroendocrine tumors, etc.). Endocrine faculty provide fellows with teaching and guidance in clinical science, practical issues of disease management, and how to effectively function within an integrated healthcare network. The clinic works closely with the primary care providers within the VA Connecticut Healthcare System. Clinics are held Mondays, 1-5:30pm, beginning with a clinical teaching conference at 1pm, followed by patient appointments from 1:30-4pm. All fellows participate during the entirety of their two clinical years, though many continue on for additional years.” Varman Samuel, MD, PhD is the Endocrinology Section Chief at the VA.