Training Sites


 
Duke University Hospital, Duke North is a tertiary medical center and phase I trauma unit that serves North Carolina and surrounding states. The hospital has a total of 900 beds with planning underway for another hospital tower.
 
Duke Inpatient Consult Service
During the Duke Inpatient Consult Service rotation, the fellow serves as the team leader and primary organizer for the Diabetes Management Service/Endocrine Consult Service and thus has the opportunity to manage complex inpatient diabetes cases as well as a broad array of general endocrine diseases.  The fellow rounds with the Duke Endocrine Faculty on the entire service every day.  The accessibility of the senior staff creates a fertile learning environment for the fellow on-service, who also receives additional training in mentoring and teaching the internal medicine residents and, occasionally, medical students who are an important component of the rounding team. Clinical Volume for the whole team generally consists of, on average 4-5 new patient consults daily, in addition to follow-up of 10 to 15 patients daily of whom the service has previously been consulted and have ongoing endocrine issues.
 
 
 
The Durham VAMC is located directly across the street from Duke University Hospital . Faculty members who supervise at the VA are also Duke faculty members.
 
Durham VA Inpatient Consult Service
During the VA Inpatient Consult Service, the fellow consults on inpatients with endocrine issues.  Consults come from all departments of the hospital including post-surgical, medical, and psychiatric cases.  The VA fellow has the opportunity to discuss cases with the VA Endocrine Chief and other VA Endocrine attendings. Clinical Volume is variable – it typically ranges from 4 to 8 consults weekly, for which the fellow is primarily responsible as this service does not include resident or student participation. 
 
 Durham VA Endocrine Clinic
The DVAMC Endocrine Clinic provides fellows with a wealth of general endocrine
continuity experiences.  Each fellow has a continuity clinic, which meets for half-a-day weekly, and the fellow is responsible not only for the patient encounter, which occurs during the visit, but also for all follow-up associated with that encounter. The VA Clinics include a General Endocrine clinic that takes place twice weekly, as well as a Bone/Calcium Disorder clinic and Lipid/Risk Reduction clinic that each occur weekly.  These clinics provide exposure to a wide range of Endocrine disorders.  These include, but are not limited to, conditions such as diabetes mellitus; a variety of thyroid conditions including thyroid cancer; adrenal and pituitary disorders; osteoporosis; hyperparathyroidism; and lipid disorders.  As there are no other VA Endocrine clinics in North Carolina, a wide variety of patients are referred to the Durham Clinic for management.  The consultation service provides experience in the management of these same conditions in the inpatient setting.  Although the majority of patients seen at the VA are male, it is anticipated that the recent establishment of the Bone/Calcium disorder clinic will attract more female patients to the Endocrine service.  In addition, the increasing presence of women in the armed forces will likely result in larger numbers of women seeking medical care through the VA system. 
 
 
 
Duke Outpatient Center, Duke South was the original hospital at Duke and is now home to clinics, and faculty offices.
 
Duke Clinics 
During four months of the initial fellowship year, fellows will attend a pre-specified block of Endocrine subspecialty clinics at Duke Clinic.  These clinics are staffed by Adult Endocrine, Pediatric Endocrine and Reproductive Endocrine faculty members who have specific interests in a number of endocrine disease states, including but not limited to diabetes mellitus, lipid disorders, polycystic ovarian disease, thyroid disease, metabolic bone disease, pediatric endocrinology (including juvenile-onset diabetes mellitus and disorders of growth and development) and disorders of reproductive endocrinology, including infertility.  In addition to the Duke site, fellows will also rotate through the Durham VA lipid and bone clinics while participating in this elective rotation.  Fellows will also attend the Duke Outpatient Clinic on selected rotation blocks.  In addition to direct patient interaction with faculty observation, the fellows will also be allotted one to two half-day sessions per week in order to facilitate self-directed education, well as initial identification and development of a mentored-research project, which will be pursued in earnest during the second year of fellowship training. 
 
 
 
Duke Outpatient Clinic
“DOC” Endocrine Clinic is a one-half day clinic per week.  The clinic serves as an
Endocrine continuity clinic for an Endocrine second-year fellow and is also attended by a first-year Endocrine fellow as well as an internal medicine intern.  There is on-site supervision and teaching by faculty in the division of Endocrinology.  The clinic serves as a referral site for the ambulatory clinics at DOC, Duke General Internal Medicine clinics, Lincoln clinics, and other clinics and hospitals in the area.  Patients seen in this clinic have a variety of endocrine and other medical problems including, but not limited to, diabetes mellitus, hypertension, dyslipidemia, obesity, cardiovascular diseases, endocrine tumors, and diseases of the pituitary, thyroid, parathyroid, adrenals, reproductive system, electrolytes, and bone.  In these clinics, trainees serve as the providers for a panel of patients and are fully responsible for the coordination of their care.  Additionally, trainees have the opportunity to work with a multidisciplinary team of health professionals including pharmacists, psychologists, social workers, and diabetic educators. 
 
 
 
Person Memorial Hospital Endocrine Outreach Clinic
The Outreach Endocrine Clinic provides fellows with further exposure to continuity of care, but with a particular ‘real-world’ experience in underserved areas of the state.  Although there are numerous outreach locations throughout NC, each fellow is assigned to one specific clinic and returns to that clinic one-day per month, ensuring continuity.   Typically, the fellow will see about 3 new-patient consultations (initial visits) and 3 to 4 return-patient visits in a single clinic session. The disease mix is again excellent as the population presents with issues from all areas of general endocrine.
 
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