Summary of Program and Processes

The information below is intended as a quick summary of various aspects of the fellowship program. 

The Endocrine Fellowship consists of supervised outpatient and inpatient responsibilities; training in thyroid ultrasound and fine needle aspiration procedures; education of medical students, interns, and residents; and research experience. 

In general, the fellow’s mornings for two weeks of each month are spent on the inpatient consult service; for the other two weeks, it is expected that the fellow will be working on scholarly activities, to include reading, preparing for lectures, or planning or performing research activities.  The afternoons are spent either in the clinic, on an elective rotation or scholarly activities.  While on call, the fellows do not round or are responsible for phone calls on the weekend.

Outpatient Clinics 

The fellows' outpatient clinics are staffed by an endocrine faculty member.  The first-year fellow has four to five afternoon clinics per week; to allow time for research, the second-year fellow has only three to four afternoon clinics per week. All required clinics occur at the Endocrine and Diabetes Clinic at 62 Tilley Drive, South Burlington, Vermont or at The University Vermont Medical Center, 111 Colchester Avenue Burlington, Vermont. Fellows may wish to spend time with the endocrinologists at our partner hospitals within The University of Vermont Health Network during their elective time.

Each fellow’s clinic is a continuity clinic; new patients are followed by the fellow for the duration of their fellowship training. The fellow interviews and examines the patient and then leaves the room to present the history, exam findings, assessment, and plan to the staffing faculty. After discussing the patient and agreeing on a treatment plan, the fellow returns to the exam room with the faculty member, who confirms the key points in the history and exam with the patient and answers any questions the patient may have. This process occurs with both new and returning patients, for both first- and second-year fellows; hence, no patient leaves the clinic without being seen and evaluated by both the fellow and the faculty.

Inpatient Experience

The endocrine faculty and fellows operate a consult service at The University of Vermont Medical Center (UVMMC); patients are not admitted directly to the endocrine team. The fellows are not responsible for admitting or discharging patients, nor for transferring patients between units (e.g., Medical ICU to floor). The endocrine unit performs consults only at UVMMC.

The second-year fellow is on the inpatient consult service from the 1st through the 15th each month (except for December, January and April); the first-year fellow is on the consult service from the 16th through the end of each month.  From 5:00 p.m. Wednesday through 8:00 a.m. Thursday, the fellow who is not on service covers the pager for outpatient calls.  The fellows have no in-house night call, and the fellows are not on call on the weekends even during their call weeks.

While on the consult service, the fellows are the first call for inpatient consults, hospitalized patient issues, and outpatient calls from 8:00 a.m. on Monday through 8:00 a.m. the following Sunday.  There is no call (at-home or in-house) for the 24-hour period from 8:00 a.m. on Saturday through 8:00 a.m. on the following Monday.  The attending on consult service is available 24 hours a day for questions from the fellow on the consult service. 

New consults are typically seen by the fellow on the day they are called in, or if called in after 3:00 p.m., the following morning.  Consults are seen first by the fellow, then presented to the attending.  After the attending has discussed the case, the fellow places a holding note in the chart and/or completes a full consult note with all the appropriate sections and discusses recommendations with the referring medical providers.  The attending sees the patient the same day, if possible, or the following morning if the consult is performed while the attending is offsite staffing a clinic.

Fellows may follow inpatients, such as patients on insulin therapy, for several days.  The fellow sees these patients each morning before work rounds.  The fellow makes treatment recommendations in a daily progress note, although house staff may be paged to facilitate changes in insulin orders.  Each progress note is reviewed and signed by the attending on daily work rounds after the patient is discussed.

Teaching and Supervising Medical Students and Residents

The fellow on consult service is responsible for teaching and supervising the medical students and residents on the elective while on inpatient work rounds; this may involve assigning consults, discussing treatment plans, and bedside teaching.  The fellow will also complete required evaluations on the students and residents, including the comments sections. 


The research experience formally occurs in December and January of the fellow’s second year, although planning for it begins during the fellow’s first year.  To allow additional time for research, the second-year fellow does not have consult responsibilities during December or January. 

A research mentor will be identified during the first year of fellowship; the fellows will meet with the Division of Endocrinology and Diabetes faculty (MD, DO, PhD) to review current opportunities in clinical and basic science research.  The first-year fellow will work with his/her mentor on a formal basis to determine research interests and opportunities and develop a research plan to ensure that everything is in place for research to be completed by the endo of the two-year fellowship.  It is expected that research work will be diligently completed to allow for timely submission of an abstract to a national endocrine professional society meeting and/or a paper to peer-reviewed journal. 

Thyroid FNA Biopsies

Training and performance of thyroid FNA biopsies occurs at our Multidisciplinary Thyroid Biopsy Clinic with collaboration between the Division of Cytopathology, The Department of Otolaryngology, The Department of Radiology and The Division of Endocrinology.  For FNA biopsies performed on patients, the fellow is supervised from beginning (obtaining informed consent) to end by the faculty, who completes an evaluation form at the end of the procedure. 

Outpatient Electives

Outpatient electives occur during the second year of the fellowship.  Planning for these electives begins at the end of the first fellowship year and is done in collaboration with the Program Director. 

Patients seen on outpatient electives in other departments are not the primary responsibility of the fellow and remain in the care of the attending in that specialty (e.g., lipid clinic, pediatric endocrine, reproductive endocrinology, ophthalmology etc.).  The attending on a non-endocrine elective is required to supervise all patient contacts and complete an evaluation of the fellow.

Night Call

The Endocrine fellows have no in-house night call.  While on the consult service, they carry the pager for inpatient consults or issues and outpatient calls Monday through Friday night.  One night a week, Wednesday, the fellow who is not on service covers the pager for outpatient calls.  On Saturday starting at 8 am, the attending covers the pager for inpatient and outpatient calls.  The attending on consult service is available every night for questions from the fellow on first call.  


Moonlighting is allowed.  There is a Moonlighting policy that is reviewed by the Program Director and the fellows on a regular basis.

Continuing Medical Education

Endocrine Grand Rounds are each Wednesday, from 12:00pm to 1:00pm.  Attendance by the fellows is mandatory.  The first Wednesday of each month is journal club organized by a faculty coordinator.  The second and third Wednesdays are case conferences presented by the first- and second-year fellow, respectively.  The fourth Wednesday is a board review session.  If there is a fifth Wednesday in the month, white board presentations are made by the fellows.  The fellow will work with the Program Director a month in advance to determine the content of the following month’s case conference. 

The fellow will meet with the journal club faculty coordinator prior to the Journal Club to select an article from a list of approved journals, evaluate the paper, and discuss the presentation; the faculty coordinator will also review the presentation before delivery.  Articles can be selected for the second-year fellow with the aim of addressing areas for improvement highlighted by his/her ESAP-ITE scores. 

Didactic lectures and diabetes rounds are presented on Thursdays, from 12:00pm to 1:00pm.  Attendance by the fellows is mandatory.  The lectures cover a wide variety of topics in Endocrinology and are given by faculty in other departments as well as the Endocrine faculty.  This lecture series incorporates lectures on various topics from several national experts via Zoom.

Continuing medical education outside of UVMMC is supported by the Endocrine Department in several ways. 

  1. An allowance is provided to each fellow per academic year for CME activities approved by the Program Director.  The fellow must notify the Program Administrator of the approved activity prior to any expenses being incurred. 
  2. Each fellow takes the EASP-ITE exam during both fellowship years with the enrollment fee paid by the division.
  3. The first- and second-year fellow are expected to participate in AACE’s Endocrine University with the registration fee and reasonable expenses paid by the division. 
  4. Each fellow is expected to become a member of the American Diabetes Association (ADA), the American Association of Clinical Endocrinologists (AACE), the American Thyroid Association (ATA), The Endocrine Society and (if appropriate) Women in Endocrinology.  Most of these groups offer free membership to trainees; if a membership fee is charged it will be covered by the Endocrine Division.

Leave Time

Residents and Fellows are entitled to twenty (20) workdays (Monday-Friday) of vacation time per academic year and, when a Resident/Fellow takes a full week of vacation, they will be entitled to take off the weekend (Saturday and Sunday) either before or after the week.  Residents and Fellows are also entitled to five (5) sick or personal days each academic year.  Fellows are discouraged but not prohibited from taking vacation leave during their on-call weeks. 

During the appropriate year of training, Residents/Fellows are further allowed at least five (5) work days to participate in post graduate interviews.  Additional interview days may be granted at the discretion of the program director.  Interview days granted are not transferable to vacation or sick/personal days.

For holidays: If you are not on call and the clinic is closed you will have the holiday off.  If you are on call, it is up to the attending whether they have you round or not.  Note that there are some holidays (such as July 4th) where the day off for the holiday is not always the actual date of the holiday. 

Resident and Fellow leave benefits are set in place by the current Agreement by and between The University of Vermont Medical Center and The Committee of Interns and Residents/SEIU(CIR).