Inpatient clinical services are provided at UNC Medical Center, while outpatient clinical services are provided at UNC Eastowne Medical Office Building.
Outpatient Clinical Services
Our outpatient clinical services are provided at UNC Eastowne Medical Office Building. In our clinics, we staff more than 20,000 visits, including more than 3,500 new patients each year. We use a team approach and team members include physicians, nurse practitioners, Diabetes Care and Education Specialists, pharmacists, nurses, medical assistants and a financial counselor. Fellows participate in the following outpatient clinics during both their first and second years of training.
Fellows spend approximately 9-12 sessions annually in our dedicated Metabolic Bone Clinic staffed by nationally recognized bone specialists. Fellows evaluate new cases independently. Treatment plans are created collaboratively between the fellow, faculty preceptor and patient. Following the consultative visit in this clinic, the patients are then managed by the fellow in their continuity clinic. This allows the fellows to learn and manage metabolic bone disease over the long term, preparing them for future clinical practice. Attention to bone density and x-ray interpretations are a focus of this clinic. Severe osteoporosis, Paget’s disease, osteomalacia, osteogenesis imperfecta, osteonecrosis, genetic bone disease and hyperparathyroidism are some of the conditions that are frequently referred to this clinic.
Thyroid Biopsy Clinic
The Eastowne Endocrinology Clinic has a dedicated Thyroid Ultrasound Suite. Fellows spend approximately 9-12 sessions annually performing ultrasound guided thyroid biopsies under the direction of skilled faculty who have years of experience performing ultrasound guided thyroid biopsies. In addition to becoming expert in thyroid ultrasound and biopsy techniques, fellows learn how to assess sample adequacy and make the sample slides that are sent to pathology. Fellows follow up on the pathology results and report results to the appropriate referring physician with suggestions for continued management of the thyroid nodules of interest. Graduating fellows demonstrate proficiency and unanimously report confidence in performing independent thyroid ultrasounds and biopsies.
Thyroid Nodule Clinic
Thyroid nodules are common and waiting for a biopsy if warranted can prove to be stressful for patients. To make the process more efficient we created a specialty Thyroid Nodule Clinic. Fellows spend 9-12 sessions annually assessing thyroid ultrasound images and creating management plans. If a biopsy is warranted, the fellow, under the guidance of faculty preceptors skilled in thyroid nodule assessment and biopsy, will proceed with the thyroid biopsy during the visit. Fellows follow up on the pathology results and report results to the appropriate referring physician with suggestions for continued management of the thyroid nodules of interest. This clinic is held in the dedicated Thyroid Ultrasound Suite in the Eastowne Endocrinology Clinic.
Our fellows spend 9-12 sessions each year of their fellowship in Pituitary Clinic with our pituitary expert. Fellows see a mix of new patients who need initial work ups, patients who are requesting a second opinion from an academic institution and hospital follow-up patients following neurosurgical intervention. Like the format of our Metabolic Bone Clinic, following several visits to the Pituitary Clinic, the patients are then managed by the fellow in their continuity clinic. This allows the fellows to learn and manage pituitary disorders over the long term, preparing them for future clinical practice. Fellows spend time reviewing pituitary imaging during this clinic. Teachings from this clinic are further enhanced by a once monthly multidisciplinary Pituitary Conference where cases from clinic are reviewed in a multidisciplinary setting.
Diabetes Technology and Device Clinic
Expert management of patients with diabetes is an important skill all fellows learn during their training at UNC. To ensure our fellows have ample exposure to patients who use insulin pumps, continuous glucose monitoring and closed loop systems, fellows spend one session monthly in a dedicated Diabetes Technology and Device Clinic. This clinic is staffed by a diabetologist skilled in the interpretation of diabetes device output and modification of treatment based upon device output. During this dedicated clinic fellows get focused, hands-on experience with insulin pumps and continuous glucose monitors. A fellow can choose to continue to see their patients in this dedicated clinic or patients can be moved to the fellow’s continuity clinic panel.
Weight Management Clinic
First and second year endocrinology fellows have the opportunity to work with faculty in the Weight Management Clinic during their training.
Fellows spend a majority of their outpatient clinical time in their own Continuity Clinic. Patients are directly scheduled with the fellow, not an attending physician. The fellow is the first point of contact for the patient, independently performs the clinical assessment and formulates a treatment plan under the guidance of the assigned faculty attending preceptor. Fellows follow patients longitudinally over the course of their two years in fellowship. All faculty members precept for the outpatient continuity clinic which offers our fellows a wide exposure to different treatment and management styles.
Inpatient Clinical Services
The Division of Endocrinology and Metabolism, under the leadership of Dr. Morgan Jones, MD, runs the Inpatient Consult Service which covers UNC Hospital, a large, 900+bed academic medical center operated by and for the people of North Carolina in partnership with the UNC School of Medicine. Consisting of the General Adult Hospital, Women and Children’s Hospital, Neurosciences Hospital and a dedicated Cancer Hospital, UNC Hospital is the only state-owned teaching hospital in North Carolina. Its catchment area is broad, offering care to patients from every county and from several neighboring states.
The Inpatient Consult Service is staffed by a dedicated, full-time faculty attending physician, four nurse practitioners (NP) and one endocrine fellow. The Inpatient Consult Service consists of two teams. The faculty attending oversees the NPs who run the Glycemic Management Team. The Glycemic Management Team manages most of the diabetes consultations in the hospital. Together, the fellow and faculty attending run the Endocrine and Diabetes Consult Service. This team manages all endocrine consults and select diabetes consults. Rounds with all team members occur daily. Early on in training the fellow learn specifics of inpatient diabetes management from the cases presented by the NPs. As the fellow gains experience, they are expected to assume more of a leadership role and run daily rounds with the team. This offers an opportunity to practice working in multidisciplinary teams.
- First year fellows spend 10-12 weeks on the Inpatient Endocrine and Diabetes Consult Service.
- Second year fellows spend 6-8 weeks on the Inpatient Endocrine and Diabetes Consult Service.
Endocrine fellows at UNC do not have concurrent inpatient and outpatient responsibilities. Fellows are assigned to either the inpatient service or the outpatient clinics. This approach allows fellows dedicated time to focus their attention. Fellows cover the inpatient service in one-week blocks. Following their service on the inpatient service the fellows routinely schedule hospital follow-up visits for patients they managed on the inpatient service, allowing for continuity of care during the inpatient to outpatient transition.