The first year of training focuses on clinical experience in basic endocrinology. Most of this occurs in the outpatient setting, consistent with the mix seen by practicing endocrinologists. The second year of training is structured to provide research experience and continued clinical exposure in general and subspecialty endocrinology. Clinical duties include the fellow’s continuity clinics (Albany Medical Center and the VA) and the weekly Lipid Clinic. The second-year fellow also attends additional clinical experiences outside the endocrine division (e.g., pediatric endocrinology, reproductive endocrinology, endocrine surgery).

Approximately 50 percent of the second year is devoted to research. On-call responsibilities are the same as during the first year.

The continuity clinic allows fellows to follow individual patients throughout the course of their training period. More challenging patients are screened, so fellows would have the opportunity to see new pathology. The fellows have a dedicated support staff including an administrative assistant and a nurse. CGMs and insulin pump downloads are printed to review prior to seeing the patient. Patients seen in the clinic include all forms of endocrine disorders, including thyroid, adrenal, pituitary, gonadal, metabolic bone disease, and other metabolic abnormalities.

This experience provides an opportunity to see challenging lipid-based disorders. Some examples of pathology seen include statin tolerance, familial hyperlipidemia, familial hypertriglyceridemia, and disorders of HDL cholesterol.

The VA offers excellent continuity of care and the same expanding patient panel for the entire duration of training. The diabetes clinic is held on Mondays for first-year fellows. On Wednesdays, there is a one-hour clinical conference, general endocrinology continuity clinic, and thyroid FNA clinic with an on-site pathologist to assess the quality of the samples.

Pathology seen during this experience can include hypogonadism, DM, osteoporosis, hyper and hypothyroidism, thyroid cancers, adrenal incidentalomas, pituitary neoplasms, and transgender health issues.

Our inpatient service exposes fellows to a variety of endocrinology pathology such as thyroid abnormalities, diabetes in pregnancy, electrolyte abnormalities, adrenal pathology, and pituitary disorders.

First-year fellows cover the endocrine service every other month. Patients who are seen on the endocrine service can be followed closely in our outpatient endocrine clinic for continuity of care.

Albany Medical Center has a busy inpatient diabetes service. Fellows get the inpatient diabetes experience during the first two months of their training. They get additional inpatient diabetes experience during monthly weekend calls when they manage the diabetes service.

Some of the high complexity inpatient diabetes cases seen on this service include diabetes management in pregnancy, transplant induced diabetes, posttransplant management of existing diabetes, post-bariatric surgery adjustment of diabetes, patients on various insulin pumps, patients on concentrated insulin forms (U-500), patients with diabetes on tube feeds or parenteral nutrition, steroid induced hyperglycemia, and Brittle DM1.

On-site ultrasound is always available for independent bedside use by fellows. The program offers dedicated FNA clinics on Wednesday afternoons at the VA as well as Thursday afternoons at Albany Medical Center. A trainee can perform over 50 biopsies within the two-year training period. The program also conducts a structured hands-on thyroid ultrasound and thyroid FNA training course in our simulation center.

The transgender endocrinology clinic is one of the two mandatory electives with a rich structured curriculum. Albany Medical Center’s Division of Endocrinology has had a well-established practice for over 20 years. There is a high-volume patient population with an all-inclusive database. Trainees have ample opportunities for retrospective studies.

Albany Medical Center is a high-volume center for renal, pancreatic, and combined pancreato-renal transplants. Transplant is a mandatory elective that is an inpatient and outpatient experience. The program holds weekly multidisciplinary transplant clinics in close collaboration with the transplant surgery team. The experience during this rotation includes transplant DM, osteoporosis, hyperparathyroidism, and hyperlipidemia.

Throughout fellowship training each fellow is on call one weekend per month (in-house) and one weeknight each week (from home). Weekend call requires managing the inpatient diabetes and endocrine consult services under the direct supervision of a faculty member. Weeknight call involves covering urgent phone calls to the outpatient endocrine division and urgent endocrine questions from hospital patients, as well as managing emergency consults (all under the supervision of a faculty member).

Transplant endocrinology, transgender medicine, endocrine surgery, ophthalmology, pediatric endocrinology, reproductive endocrinology, pathology, nuclear medicine, and clinical nutrition.

Research is a significant part of the training of an endocrinologist. The exposure to research occurs throughout the fellowship, though the major part of the research experience occurs in the second year.

A large population of endocrinology clinic patients and hospital consults are using continuous subcutaneous insulin infusion systems, therefore the program offers structured, dedicated insulin pump training sessions September through December each academic year. During this experience fellows work with all leading continuous subcutaneous insulin infusion systems and continuous glucose monitors.

Clinical Guidelines Review Sessions: This is a designated time to review various clinical endocrine guidelines. Our faculty members give lectures on Tuesday mornings. Dedicated topics include: Thyrotoxicosis, Thyroid and Pregnancy, Diabetes and Pregnancy, Primary Hyperparathyroidism, Adrenal Insufficiency, Transgender Medicine, Adrenal Incidentalomas, Differentiated Thyroid Cancer.

Challenging Endocrinology Case Discussions: This monthly conference focuses on complex patients seen in the clinic and the hospital. This experience stimulates interesting conversations between faculty and fellows.

Thyroid Multidisciplinary Conference: This monthly conference consists of Endocrinology, Endocrine Surgery, ENT, and Nuclear Medicine. This conference facilitates discussions of best care plans and different treatment modalities for patients.

Neuroendocrinology Multidisciplinary Conference: This monthly conference with neurosurgery colleagues provides an educational opportunity to review imaging such as MRIs and CT scans in addition to various pituitary pathologies including prolactinoma, growth hormone secreting tumors, Cushing disease, cyclic Cushing disease, and diabetes insipidus.

Tumor Board: Our multidisciplinary endocrine tumor board occurs every two weeks. During this experience endocrine pathology slides are reviewed. This provides an opportunity for endocrinologists, endocrine surgeons, ENT, and pathologists to discuss a plan of care for challenging cases.