Rotations

Dr Goldner and Dr. Polavarapu

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 have the entire month of July dedicated to on-boarding, clinical orientation, and 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
    • 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 have several days of dedicated time to shadow 2nd 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
UNMC/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, ½ 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, ½ 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
  • Thyroid and Neuroendocrine Tumor Clinic
Research  
First year
  • 1/2 month in the fall to identify research mentor and determine research project
  • 1/2 month in the spring to prepare for research project work in 2nd year (IRB submission, etc)
Second year
  • 12+ weeks protected time to perform research with goal to submit work to a national meeting
Pediatric Endocrinology  
2-week rotation at Pediatric Endocrinology Clinic at Children’s Hospital and Medical Center
Reproductive Endocrinology  
2-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