In past years, the program consisted of two tracks, the Research Track and the Clinician-Educator Track, which had different match lists. However, we have now reverted to a single match list. The main reason is that we would like to provide the best opportunities to everybody and we certainly acknowledge that some fellows are somewhat undecided in terms of their career path. Therefore, we continue to provide both tracks, as outlined below, but do not require a full commitment prior to starting your fellowship. We also would like to point out that appointments to all tracks are generally possible for all fellows and are not the result of internal competition. We believe that we only make a difference by supporting the individual interests, needs, and career choices of our fellows!
The Research Track is a three-year program intended only for trainees committed to careers as independent investigators in endocrinology. After a year of intensive clinical training (refer to the Clinical Training section below), the following two years are 80% protected research time. Clinical training during Year 2 includes Continuity of Care Clinic, bone clinic, thyroid sonography/FNAB training, and exposure to inpatient intensive glycemia service. In Year 3, successful fellows will have 80% research time. Clinical activities are required, but entirely elective. Most importantly, the third year is not spent as a ‘fellow’, but in the rank of faculty, providing ‘fellows’ with experience in autonomous patient care and further allowing them to continue working with their research mentors and build the basis for a future career as an independent researcher and leader in endocrinology.
Research opportunities (refer to the Research Training section below) in endocrinology at Michigan span the full spectrum, including basic science, translational studies, and clinical investigation. Applicants to this program are encouraged to explore these options and to meet with potential mentors during their interview visits.
The research years are supported via the NIH training grant T32DK007245, which has enjoyed over 40 years of continuous funding. Research Track Fellows are required to submit a F32, K08, K23, AHA, or other similar grant proposal during their second year, although funding is available from the training grant for Year 3 as well. Applicants must be U.S. citizens or permanent residents to be appointed to the training grant.
Individuals accepted to the Michigan Medicine Physician Scientist Training Program (PSTP) complete two years of internal medicine residency, followed by four years of fellowship training. PSTP residents who choose endocrinology for their fellowship will be assigned to the Research Track.
The Clinician-Educator Track is a two-year program geared for applicants who wish to become skilled clinical endocrinologists and to incorporate teaching and clinical training in their career path. The first year is intensive clinical training in an inpatient and outpatient setting. The second year is approximately 60% clinical activities, which include Continuity of Care Clinic, bone clinic, thyroid sonography/FNAB training, inpatient intensive glycemia service, and elective clinics. The remaining 40% time can be customized to include research - including research in teaching and learning methods - specific training in education skills, and additional clinical activities. Fellows in the Clinician-Educator Track may apply for a third year of research training through the training grant when positions are available.
The first-year schedule is the same for both the Research and Clinician-Educator Tracks. The second-year schedules for the two Tracks have some identical required clinical components, but differ in how the majority of the time is spent, as outlined below. The Clinician-Educator Track is a two-year program. The Research Track is a three-year program, with the third year being primarily devoted to building upon research started earlier in the fellowship.
Year 1 - Both Tracks
- 3 months of University Hospital Consult Service
- 3 months of VA Hospital Consult Service
- 6 months of Outpatient Clinics
Fellows typically rotate services at the beginning of each month.
University Hospital Consult Service - During this rotation, fellows are primarily responsible for the busy inpatient endocrine consult service at the University of Michigan Hospital. In addition to seeing the inpatient consults and rounding with the attending, the fellows contribute to the education of the team of residents and medical students who are rotating on service. During this rotation, the only outpatient clinic assigned is the U-M Friday morning Continuity of Care Clinic.
VA Hospital Consult Service - During this rotation, fellows are primarily responsible for the inpatient endocrine consult service at the University of Michigan Hospital. In addition to the inpatient responsibilities, there are usually two VA General Endocrine clinics: the VA Insulin Pump Clinic and the VA long-distance Outpatient Virtual Clinic. During this rotation, fellows also continue their U-M Friday morning General Endocrinology Continuity Clinic.
Outpatient Clinics - During this rotation, fellows continue their U-M Friday morning Continuity of Care Clinic and are required to rotate through U-M subspecialty clinics.
Elective time for further outpatient clinic rotations is scheduled during the Outpatient Clinics rotation as well. A one-week rotation during the first-year Outpatient Clinics block is spent orienting to the Inpatient Hyperglycemia Consult Service. Fellows may attend the week-long diabetes camp for children (Camp Midicha) in June as medical volunteers to experience real-life type 1 diabetes management for several days.
Year 2 - Clinician-Educator Track
Fellows in both tracks are required to complete some clinical training in the second year. In addition to the U-M Friday morning Continuity of Care Clinic, there are required rotations in metabolic bone disease and Thyroid FNA. Those fellows in the Clinician-Educator Track also rotate on the Inpatient Hyperglycemia Consult Service for one week, every two to three months, and may be assigned for up to one month on the inpatient consult service at the University or Ann Arbor VA Hospitals. The second year of the Clinician-Educator Track allows for a great deal of elective time, which can be divided between clinical electives, research, and formal didactic training in medical education.
Year 2 - Research Track
Fellows in both tracks are required to complete some clinical training in the second year. In addition to the U-M Friday morning Continuity of Care Clinic, there are required rotations in metabolic bone disease and Thyroid FNA, but little, if any, inpatient activities. While the Research Track second year is devoted to protected research time (80%), there is some limited time for clinical electives.
Year 3 - Research Track
Research Track third year is at least 80% protected research time, but as there are no required clinics, there is time for clinical electives (up to two half-days a week). Successful fellows will continue working with their research mentor, but are usually appointed as faculty in order to provide them with greater autonomy for grant application and patient care.
For the ﬁrst year, fellows rotate on a monthly basis between the University of Michigan Hospital inpatient consultation service, the Ann Arbor Veteran's Administration (VA) Hospital inpatient consultation service with outpatient clinics, and a series of outpatient clinics. The clinic rotations change every three or four months, such that each fellow has the opportunity to experience a month of several diﬀerent clinics during their ﬁrst year. Several clinics are mandatory, and others are elective.
As the year progresses, the number of elective clinic rotations increases. Fellows may repeat speciﬁc rotations, choose to work with speciﬁc faculty, or design their own rotations to suit their unique needs. The U-M Continuity of Care Clinic is Friday morning, and all fellows attend this clinic for two years.
We firmly believe that research is an integral part of endocrinology fellowship training. The University of Michigan boasts a rich history of major discoveries in endocrinology and a broad portfolio of ongoing research excellence. All fellows select a faculty mentor during their first year, with whom they will conduct research during their second and possibly additional years.
Second- and third-year fellows on the Research Track are appointed to the T32 training grant until they secure independent funding. Applicants must be U.S. citizens or permanent residents to be appointed to the training grant. The T32 provides 80% protected time for research activities. PSTP fellows are guaranteed three years of 80% protected research time. These research activities span a broad spectrum, which reflects the diversity of faculty research interests: basic laboratory research in biochemistry and cell biology; whole-animal physiology and molecular biology; human genetics, physiology, and pathophysiology investigations; pharmaceutical trials in human beings; epidemiology and outcomes research focused on endocrine diseases and their sequellae.
Second-year Clinician-Educator Track fellows are also required to conduct research. The amount of time and types of projects will vary with each fellow’s interests and other activities. Generally, 25-50% of their time during the second year will be devoted to some form of clinical investigation, as approved by the Program Director. Clinician-Educator Track fellows may apply for a third year of research training.
Every summer, we hold a series of didactic lectures on research methodology. Fellows entering the second year deliver a formal presentation describing their proposed research and submit a short written proposal for approval by the Program Director. Fellows are expected to submit at least one abstract for presentation at a national meeting during their fellowship time and to write at least one scholarly manuscript with a faculty member as well.