Training & Education
Fellowship Program Overview
The training program in the Division of Endocrinology and Diabetes provides broad clinical training and education in the field of endocrinology and metabolism toward eligibility for board certification by the American Board of Internal Medicine. The overall goal of our training program is to provide comprehensive clinical and didactic training in endocrinology, diabetes and metabolism as defined by the ACGME.
Fellows may participate in the clinical program or a dedicated physician-scientist research fellowship.
The program’s curriculum is organized into four components:
- Hospital consultation services
- Outpatient clinics
- Didactics and conferences
Clinical training primarily occurs in three settings: Los Angeles General Medical Center, Keck Hospital of USC and USC/Norris Cancer Hospital. Our three hospitals provide trainees with exposure to a wide range of endocrine and metabolic diseases in patients from varied ethnic and socioeconomic backgrounds.
Inpatient Consultative Services
This service provides trainees with direct consultation experience (diagnosis and management) in the care of hospitalized patients with the full spectrum of endocrine and metabolic disorders. The service frequently includes evaluation and management of pituitary, thyroid, and adrenal disorders, diabetes, hypoglycemia, hypercalcemia, perioperative endocrine management, and endocrine emergencies.
Los Angeles General Medical Center
The Endocrinology and Diabetes inpatient service provides consultative care across a full spectrum of adult endocrine diseases. Fellows evaluate patients directly and supervise the evaluation of patients by house staff and students who rotate through the consult service. Cases, including pertinent diagnostic test results (hormone levels, MRI/CT scans, ultrasounds), are reviewed with full-time faculty members during faculty rounds, which are held for approximately two hours per day on weekdays.
Fellows will gain teaching experience in the education of medical students, house staff and peers related to the endocrinological problems encountered by the service.
During this consult service rotation, fellows are responsible for the performance of all thyroid fine-needle biopsies (2-4 per week). Jonathan LoPresti, MD and a cytopathologist conduct a formal case conference to review cytology material.
Keck Medical Center of USC
The Division of Endocrinology and Diabetes provides full consultative services for Keck Hospital of USC and Norris Comprehensive Cancer Center. Fellows provide evaluations under the supervision of full-time faculty members. The USC Pituitary Center offers fellows ample experience in pituitary radiology and the endocrinologic and neurosurgical management of pituitary and hypothalamic disorders. Fellows in addition have the opportunity to evaluate patients with diabetes and endocrine disease with faculty in their outpatient clinics. During this rotation, fellows also perform evaluation and management of endocrinology patients with attending faculty in Keck Medicine of USC ambulatory clinics.
These activities provide trainees with diagnosis and management experience in the care of ambulatory patients with a variety of endocrine and metabolic disorders.
Fellows have Continuity of Care Clinics in General Endocrinology, Thyroid, and Diabetes.
In addition, fellows spend 2-3 months each year on the ambulatory clinic rotation. Clinic experiences for fellows include:
- Type 1 Diabetes
- Type 2 Diabetes
- Thyroid cancer
- Thyroid biopsy
- Thyroid disorders
- Lipid disorders
- Pituitary disorders
- Pediatric endocrinology
- Diabetes/Endocrine disorders in pregnancy
- Calcium and Bone Metabolism
Visiting Professor Program
This program brings nationally recognized leaders in areas of endocrinology and diabetes to USC to give grand rounds and meet with our fellows to discuss their clinical endocrinology, research activities and career development. Special events include the Florence and Jorge Mestman Visiting Professors (3 per year) and the Richard Horton Visiting Lectureship.
Conferences and lectures complement clinical training, providing education in normal endocrine physiology, mechanisms of endocrine disease, laboratory techniques, and research techniques in endocrinology and metabolism.
Division of Endocrinology and Diabetes Grand Rounds, in partnership with DORI (Diabetes Obesity Research Institute): weekly, topic-oriented one-hour conference, with presentations by both USC and visiting faculty. Fellows gain experience in academic presenting by presenting their own Grand Rounds during training.
Endocrine-Metabolism Core Curriculum: weekly didactic series covering pathophysiology, endocrine evaluations, and management of disease.
Journal Club: monthly session focusing on both structural aspects of publications and ongoing review of new literature.
Keck Endocrine Case Conference: Bi-monthly meeting where Keck Fellow presents an interesting case and pertinent literature review to faculty and fellows.
Pituitary Tumor Conference: weekly session to review current patient cases and discuss management.
Research Conference: session in which fellows present and receive feedback on research progress and/or upcoming presentations.
Thyroid Conference: weekly session focusing on the clinical management of thyroid disease. Case presentations and summary of relevant literature are presented for discussion by fellows and faculty.
Thyroid Pathology Conference: bi-monthly session to review results of thyroid biopsy and discuss management.
The Department of Medicine offers a special research focus Fellow training for select individuals interested in academic careers. The training combines ABIM clinical experience with a greater focus on research than the standard fellowship. The Division of Endocrinology participates in this program, leveraging mentors in the Division and co-mentors across USC with strong clinical and basic research in diabetes, pituitary disease, thyroid disease, lipid metabolism and metabolic origins of Alzheimer’s Disease.
Primary Division Research Fellowship
The focus of our NIH-funded research of our endocrine faculty is on obesity, diet and the brain. They two primary mentors are Drs. Yassine and Page.
Hussein Yassine, MD
The Yassine Lab specializes in how genetics, changes in lipid metabolism, nutrition, and diabetes affect cognition and the risk of developing Alzheimer’s disease (AD). The team utilizes a translational approach that spans basic laboratory studies with animal models, novel imaging modalities and clinical trials. Dr. Yassine directs the Roybal AD Research program focused on understanding how risk factors in Los Angeles’s Latinx populations affect cognition and AD risk using longitudinal studies with cerebrospinal fluid and brain imaging biomarkers.
Over the past decade, the Yassine lab demonstrated that lower levels of serum omega-3 fatty acid docosahexaenoic acid (DHA) associated with greater amyloid deposition in cognitively healthy older adults. Using PET scans, Dr. Yassine’s team reported an increased incorporation coefficient for brain DHA in APOE4 suggesting a deficit in brain DHA delivery in younger healthy APOE4 carriers decades before the onset of AD. These findings led to a randomized clinical trial to understand how APOE4 affects DHA brain delivery and metabolism in persons at risk of developing AD.
Fellows joining the Yassine lab will focus on studying how diabetes and dyslipidemia in ethnic minorities increases dementia risk using imaging and biomarker studies, and will train designing and conducting clinical trials or longitudinal cohorts. Dr. Yassine leads the Research and Education Core of USC’s Alzheimer’s Disease Research Center (ADRC) training post-doctoral fellows and junior faculty. Dr. Yassine has an outstanding record of training junior scholars. Over the past decade, he has trained over 47 undergraduate, graduate and postdoctoral fellows in the areas of obesity, diabetes, lipids and AD in clinical and translational research. He was recognized with several awards including the Case Western “Resident Teacher of Year Award” in 2007. He organizes and directs the annual Finch AD annual symposium where students and fellows meet to present research and have the opportunity to receive awards! More information can be found at www.yassinelab.com
Kathleen Page, MD
Dr. Page is a physician scientist with two major research programs: (i) neuroendocrine regulation of appetite and feeding behavior (ii) maternal-fetal programming for obesity and diabetes and is the principal investigator of the BRANCH Lab for Brain Regulation of Appetite, Nutrition, Cognition at USC (for details, see www.drkatiepage.com).
Dr. Page also serves as director of the USC Diabetes and Obesity Research Institute Clinical Research Unit. She has a background in endocrinology and neuroimaging and over 15 years of experience in integrating fMRI and endocrine data to understand the neuroendocrine regulation of appetite, cognitive function, and risk for obesity and diabetes in children and adults. Her laboratory uses state-of-the-art neuroimaging methods combined with rigorous metabolic and dietary assessments and objective measures of physical activity and sleep to provide a comprehensive understanding of neuroendocrine regulation of eating behavior and metabolic risks, and the impact of lifestyle factors on these processes. To date, her studies have shown that acute ingestion of fructose compared to glucose leads to much smaller increases in circulating levels of insulin, greater activation of brain appetite and reward regions, and increases in appetitive behavior. These studies provide mechanistic insights into epidemiological evidence linking fructose consumption to overeating and obesity. Current studies in her laboratory are aimed at understanding effects of sugar and non-nutritive sweeteners on brain reward and appetite pathways and eating behavior in obese, overweight, and lean individuals and the role of in utero exposures to maternal gestational diabetes mellitus and obesity on brain development and obesity and type 2 diabetes risk in children. Dr. Page’s long-term vision is to identify mechanisms and markers of disease in people at highest risk for obesity and diabetes, whether related to in utero exposure to maternal metabolic disorders or other environmental influences, and to develop at test interventions to prevent obesity and its related complications. Her multidisciplinary team includes collaborators in neuroimaging, psychology, preventive medicine and statistics, and trainees at all levels including undergraduate students, medical students, graduate students, post-doctoral fellows, and junior faculty. She is committed to providing exceptional mentorship to endocrine fellows and to teaching trainees about the roles of neuroendocrine regulation of appetite and early-life programming in health and disease and applying these concepts into valuable experiences in clinical-translational research.
Faculty Co-mentors from Across USC
|Britni Belcher, PhD||Pediatric Obesity, Physical Activity, Sedentary Behavior, Epidemiology, Behavior||https://profiles.sc-ctsi.org/britni.belcher|
|Helena Chui, MD||Alzheimer disease and vascular cognitive impairment||https://profiles.sc-ctsi.org/helena.chui|
|Genevieve Dunton, PhD||Explain and promote participation in physical activity and healthy dietary behaviors||https://profiles.sc-ctsi.org/genevieve.dunton|
|Michael Goran, PhD||Causes and consequences of childhood obesity||https://goranlab.com|
|Megan Herting, PhD||Brain and cognitive development in healthy and at-risk populations||https://hertinglab.usc.edu|
|Scott Kanoski, PhD||Neurobiological control of food intake and body weight regulation||https://kanoskilab.com|
|Rohit Kohli, PhD||Pathogenesis of obesity related fatty liver disease||https://www.chla.org/research/kohli-laboratory|
|Christian Pike, PhD||Obesity, hormones and Alzheimer’s disease pathogenesis||https://gero.usc.edu/labs/pikelab|
|Richard Watanabe, PhD||Pathophysiology and genetics of type 2 diabetes mellitus||https://profiles.sc-ctsi.org/richard.watanabe|
Research track schedule, rotations and expectations
Year 1: Focused on fulfilling ACGME clinical requirements for board certification in endocrinology, plus introduction to research. Fellows participate in clinical fellowship including Endocrine and Diabetes consults at both Los Angeles General Medical Center and Keck; continuity of care and in general outpatient endocrine and type 1 diabetes clinics as well as clinics in pediatric endocrinology and diabetes, endocrine disease and pregnancy, diabetes and pregnancy, lipids clinic and type 2 diabetes.
Year 2: Focused on research with assigned mentor plus required clinical activities including weekly continuity clinic and weekend call.
Year 3: Primarily research with limited clinical responsibility if needed for consults/weekend call coverage.