UNMC_Acronym_Vert_sm_4c
University of Nebraska Medical Center

Clinical Rotations

Our Fellows gain experience in all areas of endocrinology through a detailed orientation program, robust clinical exposure including multiple endocrine subspecialty clinics, and time and support to complete a scholarly project.

Orientation 

First-year fellows spend most of July completing onboarding and clinical orientation, as well as having exposure to high-yield didactics and procedural simulation. There are no clinical duties during this time.

Fellows have hands-on exposure to subcutaneous insulin pumps, continuous glucose monitors, thyroid ultrasound, and ultrasound guided biopsy of thyroid models.

Fellows receive didactics on high-yield outpatient and inpatient topics to help them transition into their endocrine training.

Topics include:

  • Outpatient diabetes management
  • Use and interpretation of continuous glucose monitors
  • Subcutaneous insulin pump practicum
  • Inpatient diabetes management
  • Hypo/Hyperthyroidism
  • Use of thyroid ultrasound for evaluation of thyroid nodules
  • Assessment of thyroid cancer, well differentiated and advanced, including use of molecular markers
  • Assessment and management of adrenal incidentaloma
  • DEXA scan interpretation
  • Assessment and management of inpatient endocrine disorders:
  • Severe hyperthyroidism/thyroid storm
  • Myxedema coma
  • Hypo- and hypercalcemia
  • Post-pituitary surgery and diabetes insipidus
  • Hypoglycemia

Fellows also spend several days shadowing second-year fellows on the UNMC/Nebraska Medicine inpatient service and at the VA Nebraska-Western Iowa Health Care System to familiarize themselves with these rotations.

Clinical experience

Nebraska Medicine inpatient
  • Extensive exposure to management of diabetes and endocrine disorders
  • Fellows coordinate assessment of inpatient consults, overseeing rotating residents and students
  • Rounds with faculty daily
  • Only outpatient responsibility is continuity clinic half-day per week
VA Nebraska-Western Iowa Health Care System
  • Inpatient and outpatient rotation
  • VA Nebraska-Western Iowa Health Care System inpatient coverage with very modest census (1-3 total patients/day on average)
  • VA Nebraska-Western Iowa Health Care System clinics
    • General endocrine, insulin pump, group diabetes clinic, bariatrics
    • Includes exposure to telemedicine
  • Continuity clinic half-day per week
Outpatient Subspecialty
  • Encompasses general endocrine clinics and several sub-specialty clinics
  • Subspecialty clinics include:
    • Pituitary
    • Metabolic Bone Disease
    • Transplant
    • Cystic Fibrosis
    • Young Adult
    • Multidisciplinary thyroid, parathyroid, and neuroendocrine tumor clinic
    • High risk OB
    • Bariatrics
    • Insulin pump
    • Intestinal rehabilitation and chronic pancreatitis
    • Telemedicine
Thyroid
  • Encompasses all aspects of thyroid disease
    • Hypothyroidism
    • Hyperthyroidism
    • Thyroid nodule evaluation, including extensive experience in thyroid/neck ultrasound and ultrasound guided thyroid nodule biopsy
    • Thyroid cancer management, pre- and post-operative including in-office ultrasound
  • Thyroid Biopsy Clinic
    • In addition to the Thyroid Rotation, fellows also rotate through a weekly Thyroid Biopsy Clinic dedicated to thyroid nodule assessment, including thyroid/neck ultrasound and ultrasound guided thyroid nodule biopsy
    • Since 2012, fellows have averaged 65 thyroid ultrasounds and 63 thyroid nodule biopsies during their fellowship
  • Thyroid and Neuroendocrine Tumor Clinic
Research

First year

  • Half-month in the fall to identify research mentor and determine research project
  • Half-month in the spring to prepare for research project work in 2nd year (IRB submission, etc)

Second year

  • Twelve-plus weeks of protected time to perform research with goal to submit work to a national meeting
Pediatric Endocrinology
Two-week rotation at Pediatric Endocrinology Clinic at Children’s Hospital and Medical Center
Reproductive Endocrinology
Two-week rotation with clinical exposure at Heartland Center for Reproductive Medicine, and Nebraska Medicine.
Endocrine Radiology
  • Longitudinal experience through the two years of fellowship
  • Exposure to all aspects of radiology pertinent to endocrinology, through clinical, didactic, and practical sessions, including:
    • Sella MRI
    • Thyroid and neck ultrasound and CT
    • Pancreatic and adrenal CT and MRI
    • Nuclear medicine imaging – Radioactive iodine uptake/scan, Dotate, sestamibi, etc.
    • DEXA scans
  • Extensive exposure to practical endocrine imaging through attendance at Endocrine Tumor Board

Rotation Schedule

The rotation schedule is structured to provide fellows exposure to clinic, inpatient, and research during both years of training. Fellows generally rotate through rotations every ½ month.

First Year

Orientation

1 month

UNMC/Nebraska Medicine Inpatient

3-3.5 months

VA Rotation

3-3.5 months

Outpatient Rotation

1.5-2 months

Thyroid Rotation

1.5-2 months

Research

1 month

Second Year

UNMC/Nebraska Medicine Inpatient

1-1.5 months

VA Rotation

1-1.5 months

Outpatient Rotation

3-3.5 months

Thyroid Rotation

2-2.5 months

Research

3 months

Pediatric Endocrinology

0.5 month

Reproductive Endocrinology

0.5 month