Overview and Objectives Clinical and Educational Activities Research Current Trainees Faculty Benefits Career Paths of Recent Graduates Contact Information and How to Apply

OVERVIEW AND OBJECTIVES
Postdoctoral training in the Division of Endocrinology, Diabetes & Metabolism is designed to prepare physicians to serve as specialists in the diagnosis and treatment of endocrine and metabolic diseases. In addition, for those so inclined, this training program provides an opportunity to initiate a career in academic endocrinology. Applicants for the program will have completed their training requirements in internal medicine by the time their fellowship commences. Applicants with clinical training in other medical specialties or with other advanced degrees may also be considered for the program. The training program is designed and approved by the Accreditation Council for Graduate Medical Education (ACGME) to qualify trainees for the subspecialty examination in endocrinology. Fellows also have the opportunity to participate in research activities under the supervision of a division faculty member, an experience aimed at introducing trainees to clinical or basic investigation and providing the basis for development as an independent investigator.

Goals

• To learn basic and advanced endocrinology, including related biochemistry, physiology and pathophysiology;
• To accumulate a critical mass of fundamental information and practical experience for the diagnosis and management of endocrine disorders;
• To acquire the technical and practical skills required by a consultant in endocrinology, diabetes and metabolism;
• To acquire clinical skills in a progressive fashion and with increasing responsibility appropriate for a consultant in endocrinology, diabetes and metabolism;
• To acquire knowledge and skills necessary for providing cost-effective, ethical and humanistic care of patients with diabetes and disorders of endocrinology and metabolism;
• To acquire skills and understanding for design and performance of hypothesis-driven endocrine research, and to participate in such research or equivalent scholarly activity. This may include gaining experience in grant writing and scientific presentation.

Objectives
The program will provide training in:

• Endocrine biochemistry, physiology and pathophysiology;
• Hormone action and inter-relationships;
• Diagnosis and management of endocrine diseases including:
  • History and physical examination with emphasis on the key features of endocrine diseases.
  • Selection and interpretation of diagnostic tests, including measurements of plasma hormones and imaging procedures such as sonography, radionuclide scans, computerized axial tomography, magnetic resonance imaging and positron emission tomography.
  • Fine needle aspiration of the thyroid and interpretation of cytology and pathology. Understanding pharmacotherapy for endocrine disorders and appropriate use of surgery, radiation therapy, treatment with radioisotopes, etc.
• Procedural and technical skills required by the endocrine subspecialist,
• Professionalism, including peer interactions, communication with patients, their families and other health care providers, confidentiality and avoidance of conflict of interest,
• Endocrine clinical and basic research,
• Understanding of existing and emerging endocrine literature,
• Personal scholarship and self-instruction.

CLINICAL AND EDUCATIONAL ACTIVITIES

Clinical Activities
The division has an active inpatient consultation service and weekly subspecialty clinics in diabetes and general endocrinology at The University Hospital and the Veterans Affairs Medical Center. Subspecialty trainees also rotate through pediatric endocrinology, diabetes in pregnancy, reproductive endocrinology, and osteoporosis/bone mineral disorders clinics, and work with faculty endocrinologists in a private practice setting. The division also has a monthly clinic to perform thyroid ultrasound and thyroid fine needle aspirations guided by ultrasound.

Clinical Site Information:

• The University Hospital is a 660-bed hospital providing care for patients of all types.
• Veterans Affairs Medical Center is a 397-bed general hospital located on the University of Cincinnati campus with full clinical programs in all teaching services of the university.
• Cincinnati Children's Hospital Medical Center is a 330-bed hospital fully equipped to provide pediatric care to the metropolitan area.

Clinical research facilities are available for both ambulatory and inpatient studies. The Division of Endocrinology, Diabetes & Metabolism leads one of the core facilities of Cincinnati Children's/University Hospital General Clinical Research Center.

Educational Activities
Division faculty participate in both clinical and didactic teaching of medical students, house-staff, and clinical fellows and in the Department of Internal Medicine joint teaching exercises (i.e. medical grand rounds and clinicopathologic conferences). A clinical case conference is held once a month, and there are two journal clubs focusing on basic research and clinical topics, respectively. A fellow's core conference series features monthly didactic clinical topics.

There are multidisciplinary interactions providing numerous opportunities for collaborative research activities and conferences. These include a bi-weekly combined endocrine conference with corresponding divisions in medicine, pediatrics and ob-gyn. An endocrine surgery pathology conference (with pathology, ENT and endocrine) is also held once a month to discuss patients with endocrine diseases requiring surgery, in particular those with endocrine neoplasms.

The division also holds a monthly, case-based conference with the Division of Nuclear Medicine within the Department of Radiology. Endocrinologists and diabetologists in the community also contribute to the division's teaching programs.

RESEARCH
The investigators in the Division of Endocrinology, Diabetes & Metabolism are recognized for excellence in the fields of endocrine autoimmunity, metabolic bone disease and diabetes.

The major areas of interest are:

Cardiovascular complications of diabetes: The division is participating as a clinical site in the recently NIH-funded multi-center Prevention of Cardiovascular Disease in Diabetes (PCDD/ACCORD) Trial.

The biologic and clinical role of discordances in hemoglobin A1c (HbA1c): Although HbA1c is the gold standard for measurement of glycemic control in diabetes, it is common to see discrepancies between it and other measures of glycemic control. Studies are in progress to address the mechanism(s) underlying these discrepancies and their possible role in the development of complications of diabetes.

Regulation of glucose metabolism and food intake by incretins: Regulatory peptides secreted from the GI tract have an important role in the stimulation of insulin secretion by ingested nutrients, as well as actions to induce satiety. Studies using GLP-1, one of the primary intestinal insulin secretagogues, are in progress examining the secretion, metabolism, and action of GLP-1 in healthy diabetic humans. Additional research is focused on the regulation of food intake by GI hormones. This project is tied to a larger study of the mechanisms by which high-fat diets induce obesity. Experiments are conducted in rats on several well-controlled diets to determine the interaction of dietary composition and the secretion of and responsiveness to gut satiety peptides.

The effects of hyperglycemia on mortality and morbidity in hospitalized patients: Hyperglycemia is now recognized as a risk factor in patients with critical illness. Studies to understand the underlying basis for this association are in progress using databases of hospitalized patients and direct study of metabolic function in patients after critical illness.

The physiology and clinical utility of islet auto-transplantations: Pancreatectomy is frequently necessary and effective in treating patients with pancreatic diseases but causes severe diabetes. Removal of islets from the surgical specimen and return to patients in the form of autologous transplants is feasible. This procedure has been performed on 70 patients at UC in the past six years. Studies are ongoing to understand the physiology of islet function after auto-transplantation and to track the outcomes of these patients.

Regulation of food intake and body weight: The biology of body weight regulation and obesity is a highly developed area of great clinical importance. Ongoing research at the UC Obesity Research Center is focused on understanding the fundamental neural connections and cellular signaling pathways involved in the control of energy balance. Emphasis is on the role of circulating hormones and regulatory factors and their interaction with the CNS.

Research Facilities:
The The Division of Endocrinology, Diabetes & Metabolism occupies space in the Vontz Center for Molecular Studies, the Medical Sciences Building at the University of Cincinnati College of Medicine and the Genome Research Institute. This includes laboratory facilities equipped to perform state-of-the art experiments in molecular and cellular biology, as well as facilities for the development of transgenic mouse models, tissue culture, data analysis and high performance liquid chromatography. Maintenance facilities and operating rooms for large and small animals are supervised by the Department of Laboratory Animal Medicine. Facilities for clinical research are available at the NIH funded General Clinical Research Center located at Cincinnati Children's Hospital Medical Center and the VA hospital.

SCHOLARSHIP OF ENDOCRINOLOGY, DIABETES, AND METABOLISM FELLOWS
Fellows are actively engaged in mentored research projects throughout their clinical training. Recent fellows have been productive in launching projects and publishing results from basic science activities and clinical research protocols.

CURRENT TRAINEES
Katherine Miller, MD
Medical School: University of Cincinnati College of Medicine
Residency: University Hospital, Cincinnati, OH

Sadia Ali, MD
Medical School: Aga Khan University Pakistan
Residency: University of Cincinnati Medical Center

Marvin Bishop, MD
Medical School: University of Kentucky
Residency: University of Cincinnati Medical Center

Meenakshi Iyer, MD
Medical School: Mahadevappa Rampure Medical College, India
Residency: The Christ Hospital, Cincinnati, Ohio

FACULTY

Name	Position
Cohen, Robert M. - MD	Professor, Fellowship Program Director
D'Alessio, David - MD	Professor, Division Director
Diab, Dima - MD	Assistant Professor of Clinical Medicine
Goldenberg, Naila - MD	Assistant Professor of Clinical Medicine
Falciglia, Mercedes - MD	Assistant Professor, Assistant Fellowship Program Director
Jacobson, Eric - PhD	Assistant Professor of Clinical Medicine
Ramlo-Halsted, Barbara - MD	Assistant Professor, Director, The Diabetes Center at the University of Cincinnati
Salehi, Marzieh - MD	Assistant Professor of Clinical Medicine
Sharma, Sona - MD	Assistant Professor of Clinical Medicine
Tong, Jenny - MD	Assistant Professor of Clinical Medicine
Watts, Nelson - MD	Professor, Director, Bone Health and Osteoporosis Center
Yaqub, Nadia - MD	Assistant Professor of Clinical Medicine

BENEFITS
You may find benefit information on the web site for the Health Alliance Office of Graduate Medical Education at www.med.uc.edu/residency.

CAREER PATHS OF RECENT GRADUATES
Michael Canos, MD
Years in Program: 2006-2008
Current Position: Private Practice
Patient First Physician Group, Crestview Hills, KY

Bradley Eilerman, MD
Years in Program: 2006-2008
Current Position: Private Practice
Patient First Physician Group, Crestview Hills, KY

Ina Villano, MD
Years in Program: 2005-2007
Current Position: Private Practice, Lynnfield, MA
Lynnfield, MA

Babak Pazooki, MD
Years in program: 2004-2006
Current Position: Private Practice

Mabel Ryder, MD
Years in program: 2004-2006
Current Position: Memorial Sloan Kettering Cancer Center

Amanda Denney, MD
Years in program: 2003-2005
Current Position: Private Practice Christ Hospital Medical Group, Cincinnati, OH

Linda Hermiller, MD
Years in program: 2003-2005
Current Position: Private Practice
Patient First Physician Group, Crestview Hills, KY

Mercedes Falciglia, MD
Years in program: 2001-2003
Current Position: Assistant Professor of Clinical Medicine
University of Cincinnati, Division of Endocrinology

Sharon Miller, MD
Years in program: 2001-2003
Current Position: Private Practice
Diabetes & Endocrinology Associates, Cincinnati OH

CONTACT INFORMATION AND HOW TO APPLY
Angela J. Bauer
Fellowship Program Coordinator
University of Cincinnati
Department of Internal Medicine
Division of Endocrinology & Metabolism
PO Box 670547
Cincinnati, OH 45267-0547
(513) 558-4444 Phone
(513) 558-8581 Fax
angela.bauer@uc.edu

We accept and review applications throughout the year. We typically interview candidates 1 ½ years in advance, interviewing most candidates between December and February. You may apply via ERAS. For more information about applying via ERAS please visit http://www.aamc.org/audienceeras.htm.