Research Program, Division of Pediatric Endocrinology at the University of Minnesota

All full-time faculty of the Division participate actively in research programs. This provides the fellows with an environment in which intellectual inquiry is intrinsic to all patient care and education experiences. The Pediatric Endocrinology Fellowship program consists of two separate tracks, clinical research or basic laboratory bench research. It is intended that each fellow be sufficiently well grounded in the fundamental underpinnings of their respective track to be able to undertake original research under their own direction by completion of the fellowship.

Regardless of the track chosen, each first-year fellow must select a faculty research mentor at the start of the fellowship. They will work together to select a research project, and the role of the fellow in that project will be defined. The Fellowship Director must approve of the choice of project and mentor, based on the likelihood of success in achieving fellowship goals. The fellow may be involved at this stage in acquiring funding for the project. The project chosen will allow the fellow to learn the broad fundamental concepts of development of scientific hypotheses and specific aims, pertinent background literature review, formation of a research plan, statistical evaluation, a variety of methodologies, and data interpretation and presentation. They will be expected to prepare a peer-reviewed manuscript resulting from this research project and present the data at a national meeting. For fellows on the clinical track, this work will also form the basis for the required master's research thesis. The preliminary success of the research project, the quality of the performance of the fellow, and the quality of the mentor are assessed annually. If necessary, adjustments are made. Appropriate library and office facilities and computer equipment will be available to each fellow.

Clinical Research Track

The clinical track involves completion of a Master's Degree in Clinical Research. The University of Minnesota Medical School in conjunction with the School of Public Health has established an innovative Master's Degree program in the education and training of individuals in the conceptualization, design and implementation of clinical research. This program is designed to be compatible with a clinical fellowship training program. 38 credits are required over a three year period, with the following course content:

Fundamentals of Clinical Research (3 credits)
Ethics (1 credit) (includes IRB certification)
Biostatistics I (4 credits)
Biostatistics II (4 credits)
Epidemiology (4 credits)
Epidemiology Methods (2 credits)
Human Genetics (4)
Clinical Trials (3 credits)
Grant Writing (2 credits)
Research Seminar (2 credits)
Master's Thesis (10 credits) (fellowship research project)

Basic Laboratory Research Track

Each fellow who chooses the basic laboratory track will enroll in appropriate advanced basic science courses to assist them in learning and applying fundamental laboratory based disciplines. Formal courses, in addition to basic discipline courses, will include, but not be limited to:

Ethics (1 credit) (includes IRB certification even if the fellow's primary research does not involve human subjects)
Biostatistics I (4 credits)
Biostatistics II (4 credits)
Human Genetics (4)
Grant Writing (2 credits)

Laboratory space will be provided for each fellow within the space allotted to the faculty mentor. It is expected that the fellow will become an integral part of that laboratory team, and that the major portion of the fellow's instruction will occur in that setting. Regularly scheduled laboratory research meetings and seminars will be required.

Additional Training for All Fellows on Either the Clinical or Basic Research Tracks

All endocrinology fellows, whether on the clinical or basic laboratory research tracks, will have formal training in the following:

1. One week in the second year of fellowship in the FUMC Cytogenetics Laboratory learning basic procedures in diagnostic cytogenetics including cell culture, metaphase banding techniques, FISH, and the principles of karyotype evaluation with particular reference to the X and Y chromosomes. Each year all of the fellows also meet with Dr. Petryk or Dr. Sarafoglou for 1-2 hours at the time the second year fellow is doing the cytogenetics week to review the basics of molecular biology.
2. Annual day long seminar in the FUMC Endocrine Laboratory and quarterly meetings with Dr. Michael Steffes, the Endocrine Laboratory Director. Emphasis is placed upon the general principles of ELISA, ICMA, IRMA, and RIA assays, actual performance of specific peptide and steroid assays, evaluation of sensitivity an specificity of results, use of varying immunologic detection procedures, organic extractions, and principles of varying endpoint detection systems. In addition, the fellows present clinical cases to discuss the use of endocrine tests in the context of patient care.
3. The goals of the nuclear medicine curriculum are to understand fundamental aspects of nuclear medicine particularly as they relate to endocrine disorders (thyroid and parathyroid imaging, I131 treatment, diagnosis of neuroendocrine tumors, CNS irradiation). The curriculum includes the following:
   1. Monthly thyroid cancer rounds with adult endocrinology fellows, surgeons and nuclear medicine physicians led by Dr. Lynn Burmeister from the Department of Medicine. The fellows take turns and present cases and lead the discussion related to a focused area of thyroid cancer. Pediatric endocrine fellows present the cases once a year.
   2. Annual lecture given by Dr. Jerry Froelich or one of his colleagues on the diagnostic and therapeutic applications of nuclear medicine with respect to endocrine diagnoses.
   3. One day rotation per year in the Nuclear Medicine Division under the direction of Dr. Froelich.
   4. Participation in nuclear medicine procedures in pediatric patients with endocrine or neuroendocrine disorders on an ongoing basis.
4. Peds endo didactic reviews: Twice a month the fellows will meet with Dr. Moran alternating with Dr. Petryk to review basic pathophysiology. The monthly topics include lipid metabolism, adrenal steroidogenesis/CAH, fluid and electrolyte metabolism, puberty, growth, ovarian failure, thyroid disease, MEN and polyglandular failure, bone and mineral metabolism, hyperandrogenism, testicular failure, Cushings syndrome/adrenal insufficiency.
5. Fellows Training Curriculum: All fellows in the Department are required to attend 18 one-hour seminars over a three-year period. The content of the program is as follows: Cardiopulmonary resuscitation, Physiology I, Physiology II, Laboratory Medicine I, Laboratory Medicine II, Statistical Methods I, Statistical Methods II, Grant Preparation, Manuscript Preparation, Research Design, Critical reading of literature, Laboratory techniques, Professionalism, Research Ethics, End-of-life Issues, Employment after fellowship, Balancing personal and professional life.
6. Peds endo board review: Eight times per year at the Division meetings the second and third year fellows will present topics which follow the outline content of the endo boards as published by the AAP. Over the course of three years the entire curriculum will be covered.