Goals
The purpose of the training program is to equip the trainee to diagnose and manage problems of an endocrinologic nature in childhood and adolescence. He/she will be exposed to the diagnosis and management of congenital and acquired disorders of the endocrine system. The trainee will learn the fundamentals of clinical diagnosis with special emphasis on the acquisition of a careful medical history and performance of a thorough physical examination, the related metabolic disorders, particularly those of carbohydrate metabolism as well as the pertinent aspects of genetics. Trainee will also become familiar with the diagnostic procedures in endocrinology employing radiology and nuclear medicine.
Eligibility
Candidates who have completed three years of core training in pediatrics at a recognized institution are eligible to apply for this program. Applications must be received by August 31st of the year preceding the appointment. However, early applications (e.g. before July 15th) is strongly encouraged to permit arrangement of interviews, which are usually required. American quota and non-Ministry funded positions are channeled through the Postgraduate Admissions Office. The training committee cannot process these files directly. For assistance, please see Applicant Information.
Program duration
The Division of Endocrinology and Metabolism offers a two year fellowship in Pediatric Endocrinology. The first 12 months are primarily spent at the Montreal Children's Hospital mostly in the clinical setting. One month is spent in the clinical endocrine laboratory and another at the adult hospitals in their outpatient endocrine clinics. The second year of training is mostly devoted to clinical or basic research activities. We are able to offer training beyond these first two years for individuals seeking careers in academic centres. Candidates may opt to combine their training in Pediatric Endocrinology with an MSc in Biostatistics or Education, for example. The program is approved by the Royal College of Physicians and Surgeons of Canada and the Collège des médecins du Québec.
Clinical Program
The trainee will participate in all inpatient and outpatient clinical activities, including children admitted for specialized testing to our Clinical Investigation Unit. Training is provided in the diagnosis and management of children with a wide spectrum of endocrinological disorders including disturbances of growth, thyroid, puberty, lipid, calcium, adrenal and pituitary dysfunction. As well, we follow over 400 children with Types 1 and 2 diabetes mellitus. This training will take place almost exclusively at the Montreal Children's Hospital with the exception of one month at the adult hospitals in their outpatient endocrine clinics. Our newly opened Pediatric Insulin Pump Centre, the first in Quebec, provides in-depth training opportunities for the residents. The trainee can gain additional first hand experience managing these patients while attending our summer camp for children with diabetes. There is an opportunity for close collaboration with diabetic nurses, dieticians, social workers, and other medical subspecialties. Trainees will be required to spend one month in the Endocrinology Laboratory where they will learn basic techniques such as measurement of hormones in body fluids with particular emphasis on steroid analysis and radioimmunoassay.
Research Program
In the second year, the trainee is encouraged to engage in a clinical and/or laboratory research project with one or more of the available research programs. The research projects are: (1) A developmental study of human pituitary function, with a focus on growth hormone (GH) and the different molecular forms produced during fetal versus postnatal life (C.G.Goodyer); (2) Hormone regulation of growth plate chondrocyte differentiation (C. Rodd); (3) diabetes susceptibility locus IDDM12 mapped to a region of chromosome 2q containing the CTLA-4 gene (R.Barnes); (4) high risk families for the development of type 1 diabetes (L.Legault); (5) study of subtle functional effects of DNA polymorphisms that protect from or predispose to diabetes at two of the many IDDM loci (C.Polychronakos); (6) understanding how organs are formed and patterned during embryonic development (A.K. Ryan); and (7) diabetic ketoacidosis (DKA) at presentation of type 1 diabetes is a preventable complication that affects 15 to 67% of children (H.Bui).
Educational Program
Specific rounds, journal clubs and fellows’ seminars, etc. occur on a weekly basis. Direct one to one teaching by staff occurs on an ongoing basis. Our weekly schedule includes numerous academic activities such as journal clubs and small group teaching. Through basic science seminars, the trainee will learn endocrine physiology and biochemistry, embryology of the endocrine and related systems with emphasis on differentiation, genetics including laboratory methods in cytogenetics and aspects of immunology related to understanding endocrine disease; the use of RIA’s.