The main goal of this rotation is to advance general knowledge in the principles and practice of pediatric endocrinology. During this four-week rotation the Fellow is expected to learn the principles of pediatric endocrinology and the specific endocrine issues affecting this group, to analyze the endocrine abnormalities learned during the training with adults during the first year as a Fellow and identify similarities and differences particular for this critical period of age. The Fellow will also learn and understand the normal endocrine physiology and the endocrine abnormalities that are more specific for this age group such as the normal growth physiology and the evaluation and management of the disorder of growth such as short stature and gigantism. To be familiar with the process of normal sex differentiation and the abnormalities of sexual determination and differentiation, to be familiar with the physiology of puberty and learn the evaluation and management of delayed puberty and precocious puberty, adolescence endocrinology and the factor to consider during transition to adulthood. In coordination with the other second year Fellow the trainee is responsible for contacting the Pediatric Endocrinology Program Director in order to arrange this rotation and the trainee will have direct supervision by the designated Attending. At the end of this rotation the trainee will receive a formal evaluation that will be returned to the Endocrinology Division within seven days of completion.

During this four-week rotation the Fellows are expected to be familiar with the anatomy of the female and male reproductive system. To learn the normal physiology of the male and female reproductive system to recognize common causes of infertility, to learn the evaluation and treatment of the male and female infertility and the approach to this issue as a couple, to understand the indications, contraindications and complications of some techniques such as in vitro fertilization and gamete intrafollicular transfer and to understand psychological, economic, demographic, and medical implications of infertility. In coordination with the other second year Fellow is responsible for contacting the reproductive endocrinologist section chief to arrange when to start this rotation; the trainee will have direct supervision by the designated attending. At the end of this rotation the trainee will receive a formal written evaluation that will be returned to the Endocrinology Division within seven days of completion.

Based on the trainee's interest and clinical need, the trainee can assist and participate at the VA, Moffitt or USF Clinical Services for training or exposure in other endocrine and non-endocrine issues such as: high-risk pregnancy, genetic inborn errors of metabolism, disorder of the appetite including bulimia or anorexia, obesity, pain management, end of life care, bone density reading and interpretation. If there is interest in receiving training in those areas the trainee should contact the Endocrinology Program Coordinator for additional information.

This rotation is 4 hours/week in the ultrasound Department at the VA. The main goal of this rotation is to learn the techniques used to perform thyroid FNA and at the end of this rotation the trainee will demonstrate competency in this procedure. Another objective is that the trainee have a comprehensive understanding of the indications, contraindications, limitations, and complications of the thyroid FNA, to learn the proper technique used to perform thyroid FNA, to be familiar with the anatomy of the thyroid, blood vessel, nerve and other important structures in the neck, should be able to perform thyroid FNA using thyroid U/S. Faculty supervision will occur during every procedure until proficiency has been acquired. In coordination with the other second year Fellow the trainee is responsible for contacting the attending radiologist to arrange when to start this rotation and you will have direct supervision by him/her. At the end of this rotation and after proficiency has been documented the trainee will receive a written formal evaluation. The endocrine Fellow must provide a logbook documenting at least ten FNA’s initiated and completed by the trainee and with the initial or signed by the supervising attending.

The main goal of this rotation is to advance ones knowledge of the basic principles of research including how research is conducted, evaluated, explained to the patient and applied to patient care and the responsible use of Informed Consent. The trainee will spend at least six months participating in research; he/she will have appropriate protected time for research while maintaining essential clinical experience. The trainee will participate in one (required) or more (elective) research projects involving either clinical studies or basic bench-type laboratory work or both. USF Endocrinology is involved in ground breaking research in Insulin Resistance and Cardiac Hormones and it is recommended that the trainee be involved in one of them. If the trainee elects, he or she can be involved in clinical research in which the trainee will have an Attending who will mentor he/she during this period. It is expected that before graduation the trainee will submit at least one paper for publication, present at least one poster in a scientific or research meeting and a completed research project.

Effective July 1, 2009; this rotation is two hours/month until six visits are completed. The main objective of this rotation is for the trainee to be able to demonstrate a comprehensive understanding of the indications and interpretation of bone mineral density. The second year fellow is responsible for contacting the attending rheumatologist to arrange this rotation.

Based in the trainee's interest and clinical need, the trainee can assist and participate at the VA, Moffitt or USF Clinical Services for training or exposure in other endocrine and non-endocrine issues such as:

High-risk pregnancy, genetic inborn errors of metabolism, disorder of the appetite including bulimia or anorexia, obesity, pain management, and end of life care. These are elective rotations. If there is interest in receiving training in those areas the trainee should contact the Endocrinology Program Coordinator for additional information.

As a second year Fellow the trainee responsibility will progress, it is expected that during the first six months, the senior fellow provide a more direct interaction, teaching and supervision of the first year fellow, during the last 6 months it is expected that the senior fellow be more involved in the care and supervision of more complex patients. Under the guidance of the Program Director the trainee is responsible for organizing the Tuesday Noon Endocrine Conference lecture series. With the supervision of the VA Chief of Endocrinology, will help assist the first year Fellow in answering VA outpatient consults as needed or when one of the first year Fellows is on leave. The second year Fellows will be involved in direct patient education, specifically in the monthly diabetes basic class, and will be responsible for participating and teaching at least twice a year in these classes. The second year Fellow, in close coordination with the Program Director, the VA Endocrinology Section secretary, and the USF Endocrinology Division secretary, will be responsible for organizing and participating in the interview process of candidate Fellows applying for a position in the Endocrinology Program.