THE FELLOWSHIP TRAINING PROGRAM
SECTION OF PEDIATRIC ENDOCRINOLOGY
DEPARTMENT OF PEDIATRICS
I. RATIONALE OF THE FELLOWSHIP PROGRAM
Pediatric Endocrinology as a subspecialty has been in existence for the past 30 years.
However, it was only in the past 10 years that graduates of a pediatric residency program have
expressed interest in this field. The seeming rarity of endocrine problems of childhood is probably
not true but more often, they are most likely unrecognized .
At present, the only existing fellowship program in Pediatric Endocrinology is at the
Philippine General Hospital which admits one fellow per year. Since priority is given to the
residency graduates from the same institution, acceptance into the program is quite competitive.
The number of endocrine cases seen at the PCMC-OPD Endocrine Clinic at the moment has not
increased tremendously for the following reasons: 1) general pediatricians are not fully aware that
there is an endocrine clinic ; 2) a general perception that when a patient needs work-up, the expense
in a semi-private hospital would be prohibitive; 3) lack of an identified “permanent” doctor to
coordinate their needs.
Most of the endocrine cases are diagnosed and worked-up on an out-patient basis and
only the true endocrine emergencies get admitted. There are however a large number of in- patients
from other disciplines who require endocrine evaluation . The OPD census ranges from 8-10
patients a week. The section believes that when the fellowship program gets in place, the patient
data base will expand .
GENERAL: To train interested pediatricians become competent in the practice of
Endocrinology as a subspecialty.
1. To provide basic knowledge in pediatric endocrine disorders , from clinical
manifestations, pathophysiology, diagnosis and management.
2. To provide intensive training in the mastery of skills needed in the evaluation of
a patient with endocrine-metabolic problem.
3. To provide training in the performance of special endocrine procedures.
4. To provide research opportunities in the subspecialty and related fields.
5. To provide an opportunity for establishing subspecialty practice in areas where
it is needed.
III . TRAINING PROGRAM
The program entails two years of clinical and research fellowship. The trainee will be
exposed to other related disciplines through referral systems and multidisciplinary approach to
patient care. There shall be one fellow per year level so that there will be two fellows per year
after the initial implementation of the program. Training starts in January or July of each year
depending on the availability of a slot.
III-A. ROTATION AND ACTIVITIES
The first 6 months is primarily clinical exposure in the wards and OPD Clinics. For in-
Patients, both in the Wards and ICU, the fellow is expected to get a complete history and
perform a thorough physical and neurologic examination. He/she makes a diagnostic and
therapeutic plan and confers with the consultant-on-call for final implementation. She will
perform pertinent diagnostic tests and procedures. Aside from daily rounds, she makes daily
progress notes and as needed during the day. She will act as a junior consultant to the resident
rotators and service residents in- charge of the patients.
On the 7th to 8th month, arrangement for observation at the Nuclear lab of Rizal
Medical Center will be made in such a way that the schedule will not disrupt her clinical rounds
and will still attend to the Tuesday afternoon and Friday afternoon
clinics at PCMC . This rotation allows the fellow to familiarize him/her with common endocrine
diagnostic tests involving radioactivity such as RAIU, Thyroid Scan.
On the 9th month, the fellow rotates in the Adolescent Service to provide her with the
technical skills in dealing with adolescent patients with endocrine problems which are usually
On the 10th month, ICU rotation will expose the fellow to management of true endocrine
emergencies in an ideal setting.
On the 11th month, fellow rotates at the Pediatric Gynecology service.
On the 12th month, regular Ward and OPD clinic rotation.
Second Year Rotation:
The second year rotation is a consolidation of clinical and research work. Genetic service
rotation will be incorporated . The Philippine Nuclear Research Institute offers an annual
course on radioactive handling and therapy for one month which the fellow will attend.
Representation with a medical school for the fellow to attend basic lectures on
physiology and biochemistry related to endocrine-metabolic issues shall be made. This will be
done during the first year of fellowship if possible depending on the period of commencement of
Research protocol should be ready by the ninth month of first year . Completed research
paper should be ready 1-2 months before completion of fellowship.
ACTIVITIES OF THE SECTION:
Monday Tuesday Wednesday Thursday Friday
8-9:30 a.m. Hosp Conference Hospital Confe-
2-4 p.m. Case Discussion General Chart Review Journal Club Endocrine/
Of OPD cases Endocrine Of Patients Diabetes Clinic
Clinic Scheduled for
Dr. Lorna R. Abad
Dr. Leticia A. Buenaluz
Dr. Melinda M. Atienza
Dr. Caridad Santos (Training Officer)
Dr. Eve Fernandez
IV. ADMISSION REQUIREMENTS
1) The trainee must be a Filipino citizen licensed to practice in the Philippines.
2) The required documents for submission include:
• Transcript of Records
• Diploma in Medicine
• Certificate of Residency Training
• Medical Board Rating
3) The trainee must have passed at least the written phase of the PPS Specialty Board Exam at
the start of the fellowship program. By the end of the program, the oral phase of the PPS
diplomate exam should have been completed to make him/her eligible to take the Philippine
Society of Pediatric Metabolism and Endocrinology subspecialty board.
4) The trainee must take the written screening test and satisfactorily meet the interview
5) The trainee must sign a contract for completion of the training program.
6) The trainee must be of good moral character and submit letters of recommendation from:
Chair / Training Officer of Residency Program
Any active consultant of the residency program where she graduated.
V. DUTIES OF THE TRAINEE
A. CLINICAL RESPONSIBILITIES
1. Coordinate all activities of the section.
2. Attend major conferences of the Department.
3. Make daily rounds of all pediatric endocrine patients and supervise residents in the
management of these patients.
4. Attend OPD Endocrine Clinic every Tuesday and Friday afternoon and keep an
organized record of all patients.
5. Maintain record and log books of all patient referrals.
6. Present and discuss cases during rounds.
7. Prepare clinical case(s) for presentation to the scientific meetings of the Philippine
Society of Pediatric Endocrinology and Metabolism.
8. Present journal reports with critical appraisal and file CATS (Critically appraised topics)
for future references.
9. Perform laboratory procedures related to patient’s problem. Keep a logbook on all
B. RESEARCH REQUIREMENTS
1. Participates actively and undertake research activities of the section. The fellow should
be able to present a research protocol at the end of 6th month.
2. Complete at least one prospective paper of which he/she is the principal investigator.
Collaborative researches may be done with the consultants and residents in addition to
the personal prospective paper.
3. Present completed paper in a research forum before completion of the program.
1. Quarterly examination based on the topics discussed or presented. Feedback on the
examination questions will be done no later than one week after the examination with the
2. Case presentation : An interesting case will be discussed on a weekly basis
3. Service Evaluation form for Ward Rounds
4. Research Paper ( This is a requirement for graduation)
5. Logbook of cases and procedures done
6. PAEC examination ( A written evaluation from PAEC will be requested).
VII. COMPETENCIES EXPECTED AT THE END OF TRAINING
Clinical competence in pediatric endocrinology is expected of the trainee at the end of 2
years. He/she should be aable to:
1. Confidently make a diagnosis and differential diagnosis of an endocrine problem based
on history and physical examination.
2. Request cost-effective diagnostic procedures.
3. Perform stimulation tests as necessary.
4. Manage confidently endocrine problems.
5. Counsel patients and families regarding complications, prognosis, and outcome of their
6. Critically appraise medical journal articles.
7. Prepare research protocols.