Endocrinology, Metabolism and Diabetes Fellowship Curriculum

The first year of fellowship is an intensive clinical year. The trainee has the opportunity to diagnose and manage patients with a wide variety of endocrine disorders. The fellow will rotate in each of our five affiliate hospitals in five week blocks, and each site has a distinctive patient population. During each block, the fellow works in the hospital’s inpatient service and one to four of the site’s outpatient Endocrine clinics. In addition, the fellow has one half-day of continuity clinic weekly at Harris Health’s Smith Clinic. Continuity clinic extends across both years of the program.

Hospital Rotation Schedule

Second-year fellows devote the majority of their time to research training. Well-funded, world-renowned researchers from basic, clinical and translational tracks are available as mentors from multiple institutions including the Baylor Diabetes Research Center, the Michael E. DeBakey VA Medical Center, the Children’s Nutrition Research Center, the Baylor Department of Cell Biology, and MD Anderson Cancer Center.

The fellow’s clinical responsibilities include the Fellows' Continuity Clinic at Harris Health’s Smith Clinic and outpatient clinic with their mentor at their research site. A structured outpatient month long elective in female reproductive endocrinology/fertility is offered to second year fellows. 

Fellows who wish to pursue an academic career are encouraged to pursue training in the Clinical Scientist Training Program (Certificate of Added Qualification, Masters or Ph.D. degree) which provides training in areas of study design, statistics, and grant writing.
The fellows are also sponsored by the division to attend an intensive course organized by the American Association of Clinical Endocrinologists and American College of Endocrinology (“Endocrine University”), which provides training in bone density measurement, thyroid ultrasound and fine needle aspiration, and endocrine clinical laboratory supervision.

A third-year of fellowship training is strongly encouraged for fellows planning for a career in academic endocrinology. Our program is approved by the Texas State Board of Medical Examiners for a third year for research.

Held as a video conference every Monday at 7:45 a.m., this conference provides a comprehensive review of 55 core endocrine topics over two years. This core curriculum is attended by Endocrine fellows from Baylor, UT-Houston, and the Houston Methodist Hospital Endocrine fellowship programs.

Our Friday videoconference curriculum runs from 11 a.m. – 1 p.m., weekly. These conferences include:

Fellow Case Conference

This conference provides a venue for fellow case presentations and detailed, interactive case-based discussion of endocrine disorders.

Evidence-based Endocrine Practice Conference

This conference provides training in critical appraisal of the Endocrine literature.

Neuroradiology Conference

This session is devoted to reviewing pituitary/hypothalamic imaging with the neuroradiologists.

Thyroid Cytopathology Conference

This conference is held jointly with the cytopathology department to review thyroid nodule fine needle aspirates and surgical pathology.

Endocrine Surgery Conference

This conference is held jointly with endocrine surgeons to review outcomes in patients who have undergone thyroid, parathyroid, adrenal and other endocrine surgery.

Multidisciplinary Thyroid Tumor Board

This conference is held in conjunction with surgery, ENT, pathology, radiology and nuclear medicine to discuss evaluation and management of complicated thyroid cancer patients

Endocrinology Grand Rounds

This twice a month conference is held in conjunction with the endocrine divisions of The University of Texas Health Sciences Center at Houston, MD Anderson Cancer Center, and Texas Children's Hospital. The format includes lectures on basic and clinical endocrinology by local faculty and visiting speakers.

Training in Quality Improvement

Baylor’s Quality Academy program, initiated in the 2020-2021 academic year, is a program jointly attended by fellows from multiple Internal Medicine subspecialty programs. It consists of 7 hours of didactics and a group project with a faculty mentor.  

Affiliate-Specific Conferences

All the affiliate sites have their own internal conferences the fellows attend while on rotation. For example, multidisciplinary endocrine tumor boards occur at MD Anderson Cancer Center, Baylor St. Luke’s Medical Center, and the Michael E. DeBakey VA Medical Center. While rotating at Texas Children’s Hospital, endocrine fellows join the Thursday afternoon pediatric endocrine academic conferences. Most affiliates have their own journal clubs.

Research Retreat

Once a year, in the fall, faculty present their research programs and training opportunities to all fellows in a half-day seminar in preparation for choosing a research mentor and transitioning to the second year of fellowship.

An integrated research program in any area of basic endocrine science involving faculty with joint appointments in the Section of Endocrinology, Diabetes and Metabolism of the Department of Medicine and the Department of Molecular and Cellular Biology (see faculty list).

A research training opportunity, which is offered to all senior fellows at Baylor. This didactic and research-oriented program leads to diploma, masters or doctorate status in clinical research. Read more about the Clinical Scientist Training Program.

Dr. Ashok Balasubramanyam studies molecular aspects of muscle development and characterizes novel phenotypes and mechanisms of ketosis-prone diabetes. His group is also studying the molecular and metabolic basis of HIV-associated lipodystrophy.

Dr. Mandeep Bajaj conducts clinical and translational metabolic research related to the pathophysiology of lipotoxic insulin resistance and type 2 diabetes.

Dr. Rajagopal V. Sekhar directs the Translational Metabolism Unit and uses human and mouse models to study glutathione turnover and oxidative stress in diabetes and aging; and metabolic defects in HIV lipodystrophy, aging and growth hormone deficiency.

A comprehensive research program in molecular aspects of endocrine neoplasias by Dr. Robert R. Gagel.

Dr. Steven I. Sherman conducts extensive clinical research in the field of thyroid cancer.

Drs. Victor R. Lavis and Naifa Busaidy conduct clinical research in diabetes related to cancer.

Drs. Camilo Jimenez and Mouhammed Habra conduct clinical research into neuroendocrine tumors.

Dr. Anita K. Ying conducts outcomes and health services research into optimal delivery of endocrinology care.

Clinical research studies in the areas of hypogonadism, growth hormone deficiency, diabetes and wasting disorders take place at the Michael E. DeBakey Veterans Affairs Medical Center Clinical Research Unit under the direction of Dr. Marco Marcelli. He also conducts basic and translational research in the areas androgen receptor and ghrelin physiology using in vitro and animal models.

Dr. Nalini Ram conducts outcomes research in the optimal management of diabetic complications and ketosis-prone diabetes.

Drs. Steven G. Waguespack and Mimi I. Hu conduct clinical research into metabolic bone disorders.

Drs. Sanjay Mediwala and Madhuri Vasudevan conduct research into optimal delivery of diabetes care using new information technologies.

Drs. Dennis Villareal and Reina Villareal study the effects of exercise in the elderly with regard to metabolism, body composition and bone health

Clinical research programs in diabetes and its complications, lipids, pituitary tumors, thyroid pathophysiology, BPH and androgen deficiency are integrated into the basic research programs. As a trainee advances, the development of independent ideas, communication skills, and the art of grant writing are also stressed so that upon completion of the training period, the individual is well prepared for an academic career.

For detailed information, please view our Faculty Research Interests brochure.

Ben Taub Hospital is the tertiary care referral center for the residents of Harris County, Texas, the third most populous county in United States. It is an elite Level I Trauma Center and serves as one of the two major public hospitals in Harris County. Staffed by Baylor College of Medicine, it has 444 licensed beds and cares for more than 80,000 emergency patients each year. While rotating at BTGH, Endocrine Fellows see a wide array of complex pathology, including thyroid emergencies and other endocrine disorders. Fellows also work in several specialized endocrine clinics: the Diabetic Ketoacidosis Clinic, which has published important work in the area of ketosis prone diabetes; the OB-Endocrine clinic, where fellows see endocrine complications in pregnant women including diabetes, thyroid, adrenal and pituitary pathology; FNA clinic, where fellows are trained in thyroid ultrasound and fine needle aspiration of thyroid nodules; and Non Alcoholic Fatty Liver Disease (NAFLD) clinic (in conjunction with Gastroenterology), where fellows learn management of metabolic diseases. Smith Clinic, the General Endocrine continuity clinic for fellows over the two years of fellowship, is also within the Harris Health System. Here the fellows have their own panel of patients with a wide array of endocrine disorders and they are also trained in the numerous endocrine dynamic testing protocols and interpretation. 

MD Anderson Cancer Center is ranked as the top hospital for cancer care by U.S. News & World Report. It is recognized around the world for research and patient care. The faculty at MD Anderson are leaders in thyroid cancer, multiple endocrine neoplasia and adrenal neoplasia. The rotation also provides exposure to endocrine issues in the context of active treatment of malignancy. Trainees manage post-operative thyroid and pituitary surgery patients and see endocrine immune related adverse events from checkpoint inhibitor therapy. Fellows are also exposed to the use of systemic therapy (TKIs, immunotherapy) for advanced thyroid cancer patients.  

Baylor St. Luke's Medical Center, is a private teaching hospital for adult patients at Baylor College of Medicine. Jointly owned by Baylor College of Medicine and Common Spirit Health, it is part of the CHI St. Luke’s Health System. BSLMC is an 881-bed hospital with active programs in heart, liver and renal transplantation. Diabetes is a major focus of training in both the inpatient and outpatient experience. Fellows learn how to manage complex patients with diabetes on parenteral nutrition and learn to operate & interpret the latest insulin pumps/continuous glucose monitors. Fellows also train in thyroid ultrasound/FNA and learn about molecular gene testing in the Thyroid Clinic. They attend Multidisciplinary Endocrine Neoplasia clinic (under the umbrella of the Dan Duncan Cancer Center) and learn management of endocrine malignancies, especially thyroid cancer. While at BSLMC, the fellow also sees consults of adult patients from the Texas Children’s Hospital Pavilion for Women, which provides state of the art care in obstetrics and gynecology and is a source of referrals for gestational endocrine disease.

The Michael E. DeBakey Veterans Affairs Medical Center serves as the primary health care provider for more than 113,000 Veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, liver transplant, renal transplant and treatment of spinal cord injury and diseases. The hospital is a state-of-the-art facility with 350 acute care beds, a 40-bed Spinal Cord Injury Center, and a 141-bed Community Living Center. Diabetes in patients who have had cardiothoracic surgery or organ transplant is a major focus of the inpatient service, as well as the evaluation of patients with fragility fractures, and endocrine disorders and complications in hospitalized Internal Medicine patients. The outpatient general endocrinology clinics see a broad range of pathology including pituitary, thyroid and adrenal neoplasia, hypogonadism, transgender medicine, and metabolic bone disease, and the insulin pump / continuous glucose monitoring program is one of the largest such programs within the VA system.

Texas Children's Hospital is one of the largest pediatric hospitals in the country with 650 beds, and a premier academic institution. Texas Children's has 30 pediatric endocrinologists on staff. The fellow rotates with Pediatric Endocrinology fellows and faculty and participates in the care of both inpatients and outpatients. For the inpatient rotation, the fellow rotates on a diabetes service and a general endocrinology consult service, seeing children with newly diagnosed T1 and T2DM as well as a broad range of general endocrinology. The outpatient rotation provides a broad exposure to pediatric endocrinology including more DM technology (insulin pumps and continuous glucose monitors) and a gender medicine multidisciplinary clinic. The endocrine fellow on the Texas Children's rotation also sees newborn consults in the NICU at the Pavilion for Women.