Mission

Develop strong, well-rounded clinician-educators, and high-caliber Military Officers who are well-prepared for the unique aspects of practice within the Military Health System (MHS). Emphasis is placed on clinical proficiency in the full spectrum of general pediatric endocrinology, inclusive healthcare practices, military systems-based practice, relevant scholarly activity, quality improvement, and leadership.

Vision

The Tri-Service NCC Pediatric Endocrinology Fellowship trains clinically, academically, and operationally versatile endocrinologists who excel in military medicine.

Aims

• Develop strong, well-rounded, inclusive, and empathetic clinicians who are prepared for the unique aspects of evidence-based practice in the MHS and pass their boards on the first attempt.
• Develop outstanding educators who serve as core teaching faculty in military GME and undergraduate education programs.
• Develop academically proficient pediatric endocrinologists well-prepared to conduct scholarly activity and mentor others through relevant research and quality improvement projects within the military system.
• Develop high-caliber, resilient military officers, well-prepared to serve as subject matter experts and innovative leaders in military medicine.

Thursday Academic Conferences are required and occur weekly; the mornings are joint conferences with NIH and WRNMMC Peds Endo Fellows. Peds Endo groups at other military hospitals and clinics often join this conference by teleconference starting at 12 p.m. Example schedule below:

• 8:15 a.m. Board Review at NIH
• 9 a.m. Case Conference at NIH
• 10:30 a.m. Administrative/work time on own
• 12 p.m. Patient discussions and on-service hand-off at Walter Reed
• 1:30 p.m. Academic Activity (Core Topic, Journal Club, Other)
• 2:30 p.m. Williams Club (textbook reading discussion and practice board questions)
• 3:30 p.m. Administrative issues/Announcements

Other required didactics include participation in the General Pediatrics Residency morning reports (daily), Dept of Pediatrics Grand Rounds (bi-monthly), and NCC Pediatric Subspecialty Combined Fellows Core Curriculum (quarterly). We also participate in didactics with the Pediatric Endocrinology Fellows at Children’s National Hospital (CNH) with monthly combined Journal Club and quarterly Friday afternoon didactic sessions. Twice a year, Pediatric Endocrinology fellows present Grand Rounds and Journal Club to the WRNMMC Adult Endocrinology Fellowship Program.

The fellowship is organized to include both clinical and research time all three years, with an increasing proportion of research-to-clinical time from the first to the third year. The continued clinical time during the second and third years allows for continuity of patient care and progression of clinical skills. On-service responsibilities may be greatest in the first year and decrease during the second and third years. Clinical time is structured as follows:

Most Pediatric Endocrine Clinical time is at WRNMMC. Fellows perform 1-month rotations with Walter Reed Adult Endocrinology (1st year), National Institutes of Health (1st year), and Children’s National Hospital, DC (2nd year, 3rd year).

Fellows may choose optional elective rotations for 1-2 month(s) during the 2nd and/or 3rd years. Some example electives are Pediatric and Adolescent Gynecology at CNH, Nutrition elective at WRNMMC, or Multi-Disciplinary Specialty Clinics at CNH. Fellows may craft various electives based on their individual interests.

On-service responsibilities include carrying the pediatric endocrinology service cell phone, answering calls from patients and providers, and taking primary responsibility for inpatient and emergent outpatient consults, with attending supervision. Fellows take call in 1 - 2 week blocks, switching over on Thursdays during the fellowship academic meeting with a formal oral and written handoff of patients. On-service call is greatest in the first year and decreases during the second and third years. On-service months total 12 for the three years. There is no in-house call requirement.

Various opportunities arise for fellows to participate in military unique curriculum. Fellows are required to complete a military biography and official photo; fellows also complete the Military Medical Humanitarian Assistance Course during fellowship and complete consults in the Global Telehealth Portal, helping military families across the globe. There are also medical mission voluntary rotations (varies based on military needs). Fellows have opportunities to complete military specific courses, teach combat medicine at USUHS, and are supported in completion of their professional military education in-correspondence.

• Basic Life Support
• Pediatric Advanced Life Support
• Team STEPPS
• Military Medical Humanitarian Assistance Course
• A3 Yellow-Belt (Process Improvement/Quality Improvement) training

Opportunities are available to teach skills using simulation to the Pediatric Residency quarterly. Annually, fellows participate in a 2-day Diabetes Technology Seminar that includes simulation and diabetes technology instruction.

LEAD 2.0 is a military leadership curriculum that is taught during the NCC Pediatric Subspecialty Combined Fellows Core Curriculum (quarterly). Fellows are also encouraged to participate in military specific leadership training such as the Female Physicians Leadership Course, BLAST course, Iron Majors, or other professional military education opportunities.

Scholarly Activity and Scholarly Oversight Committee requirements are set by the American Board of Pediatrics. Research is completed over the three years of fellowship with three months of dedicated research possible (2nd/3rd year); current research opportunities include lab (bench-top) research, clinical research, robust quality improvement/process improvement projects, and education curriculum development. The fellowship scholarly activity curriculum incorporates:

• Core knowledge in scholarly activity
• Evidence-based medicine
• Designing and carrying out a scholarly activity project

Each fellow is expected to give a poster or oral presentation at a local, regional, or national meeting during fellowship; recent presentations by fellows have been given at the American Academy of Pediatric National Conference, AMSUS, ENDO annual conference, and the Pediatric Endocrine Society annual conference.

All fellows complete a basic curriculum in Quality Improvement and Patient Safety, including A3 Yellow-Belt training and completion of the Institute for Healthcare Improvement Basic Certificate in Quality and Safety. Fellows complete a quality improvement project, participate in pediatric ward safety huddles, and attend annual disclosure training.

Fellows as encouraged to complete Faculty Development sessions at USUHS as their schedules allow; these sessions include academic leadership, teaching, allyship, and advanced teaching modules. Professional Development topics are also included in the NCC Pediatric Subspecialty Combined Fellows Core Curriculum and occasional Thursday academic sessions. Fellows are supported in completion of PME in correspondence.

Fellows have required rotations at the NIH and Children’s National Hospital.

Third year residents interested in learning more about pediatric endocrinology are welcome to do 2 - 4 week rotations with the WRNMMC Pediatric Endocrinology fellowship; please contact the Pediatric Endocrinology program director for rotation specifics. Rotations are not required for fellowship application. WRNMMC Pediatric Endocrinology also supports fourth year medical student rotations.

All interviews are conducted virtually; interviews are offered to all applicants who apply via the Medical Operational Data System.

Program graduates take the American Board of Pediatrics (ABP) Pediatric Endocrinology Certification Exam. This exam is offered biennially. To become fully board certified, applicants must take the board certification exam within seven years of fellowship graduation. To be eligible to take specialty board exams, graduates must be board certified in General Pediatrics and complete three years of broad-based endocrinology training as required by the ABP, including scholarly activity and demonstration of clinical competency in Pediatric Endocrinology. Please see additional information regarding certification on the American Board of Pediatrics Pediatric Endocrinology website.

While on-service, fellows assume the primary teaching responsibility for the rotating residents and medical students as the Team Leader. These responsibilities include reviewing rotation cases with the learners; typically, this review occurs weekly on Friday mornings. Fellows are also expected to give informal presentations to the pediatric ward team. Fellows participate as lecturers in the pediatric department morning report core lecture series. Fellows are also encouraged to participate as instructors and small group leaders for USUHS medical student 1st and 2nd year courses. Fellows can complete Faculty Development courses at USUHS for certification in teaching, academic leadership, allyship, and advanced teaching.

The ACGME allows Fellows to spend up to 20% of their time per week in the independent practice of their core specialty (General Pediatrics). General Pediatrics activities, such as precepting in the General Pediatrics clinic or being Pediatric Ward Attending, are permitted during Fellowship training if desired.

All faculty are board certified in Pediatric Endocrinology by the American Board of Pediatrics; additional faculty training includes Diplomats of the American Board of Obesity Medicine. Faculty have a wealth of general pediatrics, operational medicine, and pediatric endocrinology knowledge.

All fellows have a research mentor for one-on-one coaching; Pediatric Endocrinologists throughout the MHS support the fellowship, forming outside mentorship networks.

NCC Pediatric Endocrinology Fellowship promotes the Performance Triad of proper sleep, activity, and nutrition, with routine program director check-in during quarterly meetings to ensure individual success. As a program, we allow flexible scheduling, celebrate birthdays/milestones, and engage in special events (ie: participate in the JDRF walk as a team, have an annual off-site retreat, host family-friendly annual department receptions). All fellows have access to confidential behavioral health and stress management resources. The fellowship also utilizes events sponsored by the GMEC Wellness Committee, the DEI Committee (both within Peds Dept and NCC wide), Staff Resiliency Services, and Military Resiliency Training.