Clinical Program

A. Clinical and Continuity Experience

The UCSF Program in Pediatric Endocrinology is typically 3 years in duration, and includes progressive clinical, technical and consultative experiences that lead the trainee to acquire expertise as a pediatric endocrinologist and leads to eligibility to take the American Board of Pediatrics Subspecialty Examination in Pediatric Endocrinology. The program emphasizes scholarship, self instruction, development of critical analysis of clinical problems, and the ability to make appropriate decisions.

The clinical service duties typically consist of 6 months on the inpatient consultation service, all under the supervision of the attending teaching faculty. During this time, night call is taken from home, and an average of 1 day in 7 is free of clinical duties. During the other 2 and a half years of the 3 year program, trainees provide care under faculty supervision in the outpatient pediatric endocrinology clinic and pediatric diabetes clinic. Trainees attend both clinics once each week for 18 months and both clinics on alternate weeks in the third year. Trainees in year 2 and 3 regularly cover for first year trainees to provide time off.

The program affords trainees the opportunity to diagnose and treat a wide variety and complexity of endocrine disorders in patients ranging in age from newborn to young adults, including adolescents with normal and abnormal puberty.

The clinical experience includes, but is not limited to, patients in the following categories:
1. Short stature, including constitutional delay
2. Disorders of anterior pituitary hormone physiology, including growth hormone deficiency
3. Disorders of posterior pituitary hormone physiology, including diabetes insipidus
4. Disorders of hypothalamic regulation of hormonal secretion
5. Disorders of thyroid hormone physiology; secretion and synthesis
6. Diagnosis and management of endocrine neoplasia
7. Disorders of the adrenal gland physiology; secretion and metabolism
8. Disorders of androgen and estrogen metabolism; including adolescent reproductive endocrinology
9. Disorders of sexual differentiation and development
10. Disorders of calcium, phosphorous, and vitamin D metabolism
11. Disorders of parathyroid gland physiology
12. Disorders of fluid and electrolyte balance
13. Disorders of carbohydrate metabolism, including diabetes mellitus and hypoglycemia
14. Disorders of nutrition, including eating disorders

B. Laboratory Experience

Trainees receive instruction in the proper choice and use of various laboratory techniques for the measurement of hormones in body fluids, with particular emphasis on recognizing the limitations of such data and the pitfalls in interpreting laboratory results.

Trainees learn the proper interpretation of endocrine stimulation and supression tests, including normal variations in laboratory results at different ages and at different times of the day. Trainees interact directly with specialists in radiology, neuroradiology, nuclear medicine, ultrasonography, CT scanning and magnetic resonance imaging to enable them to utilize current diagnostic procedures for endocrinology.