Left to Right: Lauren Pankratz, Sukie Rayas, Jane Lynch, Ana Paez, Brian A. Ely
The University of Texas Health Science Center at San Antonio offers a unique fellowship opportunity for pediatric endocrinology training in a region with a rich multicultural environment. With our proximity to the U.S./Mexico border, fellows have opportunities to treat children with illnesses they would not see in other parts of the country and manage health problems that have become increasingly common in children such as Type 2 diabetes. San Antonio is among the 10 most rapidly growing cities in the US and is the 7th largest city in the US in a 2006 population census poll. The growing need for pediatric endocrinologists is great. The University of Texas Health Science Center at San Antonio is the leading research institution in South Texas and one of the major health sciences universities in terms of research funding. The fellowship was first accredited in 2004 by the ACGME, and the recent July 2010 ACGME visit led to a “clean sweep” of 5 year cycles for our program. The pediatric endocrine fellowship is designed to provide clinical training and research experience while enhancing each fellow’s skills as an educator and leader. The primary goal of the training program is to prepare fellows for independent, research-oriented academic careers in pediatric endocrinology for the ever-growing need in South Texas.
The Division of Pediatric Endocrinology has over 750 new patients each year, and more than 5,000 patient encounters annually. Each fellow attends several of the twenty weekly clinics sessions, which are supervised and run by UTHSCSA Faculty. Four divisional faculty conduct 18 half-day clinical sessions weekly at two local sites: the Texas Diabetes Institute and the Robert B. Green Campus. While on clinical service months, each fellow attends several clinics each week in addition to their continuity clinic. Clinics are conveniently staffed with nursing, diabetes educators, nutritionists, social workers and counselors. Inpatients are seen at the University Hospital with consults at local private hospitals. Fellows also take at-home call for two weeks out each clinical service month with strong support from faculty for call coverage, on-call nursing staff for educational purposes, and well-trained pediatric residents who cover the in-patient services.
In addition to clinical service, fellows attend regularly scheduled didactic sessions to enhance their education. These include weekly Pediatric Grand Rounds, Pediatric Endocrine Case Conferences, Adult Endocrine Grand Rounds, Adult Endocrine Case Conferences, and Diabetes Journal Club. The Pediatric Endocrine Case Conferences are fellow-run to best suit their educational needs and consist of Pediatric Endocrine and Interdepartmental Faculty didactics, interesting case presentations, Journal Club, review of the ABP Topics for the Pediatric Endocrine Boards, and Pediatric Endocrine PREP questions. Fellows also attend ACGME-required courses throughout the fellowship with both adult and other pediatric subspecialty fellows.
Research experiences begin during the first 12 months of fellowship, and dedicated time (18 months over 3 years) is set aside to fully benefit from the comprehensive research experience. Each fellow is encouraged to investigate their own interests and is assisted in finding appropriate supervisory support. Divisional faculty are heavily involved in research in both endocrinology and diabetes. We have incredible resources for research, including NIH TODAY study, Trial Net, multiple pharmaceutical trials for growth and T2 DM, Project SUPPORT and several type 1 diabetes immune studies. In addition, significant collaborative research is also conducted with the adult diabetes and endocrinology division with Dr. Ralph DeFronzo and Dr. Nicolas Musi. Intradepartmental collaborations with the divisions of genetics (Chromosome 18 Research Center), pulmonology (cystic fibrosis), and the Texas Biomedical Research Institute. ACGME Scholarship Oversight Committees oversee and support the scholarly activity of each pediatric fellow. The division strongly supports fellows in presenting research at local, regional, and national meetings. Fellows have commonly presented at PESTOLA (Pediatric Endocrine Society of Texas, Oklahoma, Louisiana, and Arkansas) and annual meetings of PAS (Pediatric Academic Society), PES (Pediatric Endocrine Society), ENDO Society, and ADA (American Diabetes Association).
Several additional endocrine clinic rotations may include osteoporosis, genetics, adult reproductive endocrine, adult diabetes and thyroid clinics, and an optional border medicine rotation in South Texas. In addition to clinical service, each summer fellows and staff volunteer for Camp Independence (a camp for local diabetic children and adolescents). It is a fun, rewarding experience with sports, arts and crafts and education for campers. Trainees act as medical counselors and gain expertise in the real-life management of diabetes in children of all ages.