Accreditation

The program is an unaccredited one-year fellowship.

Certification

Upon completion of the Advanced Endocrinology Fellowship program, you will receive a certificate indicating completion of a 12-month program in the specific subspecialty area (for example, Advanced thyroid disease/Pituitary-gonad or -adrenal disorders, etc.).

Program history

The Division of Endocrinology and Metabolism at Mayo Clinic in Rochester, Minnesota, has graduated 215 endocrinologists, with the first trainee graduating in 1979. The majority of our trainees will pursue careers in Academic Medicine. Our Endocrine Board pass rate for the past 20 years has been 99%

The Advanced Endocrine Fellowship training program at Mayo Clinic in Rochester, Minnesota, is one of only a handful in the United States, and will be starting in July of 2026. Three positions will be available each year on a competitive basis.

Mayo Clinic's academic environment, favorable faculty ratio, large patient population, and state-of-the-art diagnostic, therapeutic, and research facilities combine to create a truly integrated and comprehensive educational experience. The "Mayo Clinic way" of graduate medical education ensures the finest teaching and the broadest patient care experience possible during a busy, hands-on fellowship.

Positions

Three positions are available on a competitive basis each year in the Advanced Endocrinology Fellowship at Mayo Clinic's campus in Rochester, Minnesota. These fellowship positions are open to both internal as well as external candidates. Fellows typically begin the fellowship July 1.

Qualifications

To apply to the Advanced Endocrinology Fellowship, you need to have successfully completed accredited training in internal medicine and endocrinology in the United States or Canada. Applicants must be U.S. citizens, permanent residents, or be eligible to hold an H1B visa and eligible for a full Minnesota medical license.

Also see general admissions requirements.

How to apply

Mayo Clinic School of Graduate Medical Education does not process printed applications to this program. You must apply through Recruit, a third-party application service. No matching program services are used.

Mayo Clinic's academic year begins in July. Applications are accepted and reviewed on an ongoing basis. You are encouraged to apply as soon as possible.

If you have not yet taken the United States Medical Licensing Examination Step 3 examination by the application date, you must declare your intent to pass it by January, six months prior to the start date. Adequate time to obtain licensure by July is a requirement for starting the fellowship.

Complete the following steps to apply:

1. Create an account to begin the online Application for Admission
2. All applications to Mayo Clinic School of Graduate Medical Education programs must include these application materials:

• • After submission, view the required Supplemental Items and Documents
    • Upload each required item in the Supplemental Items section (if applicable)
    • Complete the Recommendation Request section (if applicable)

In addition to the standard application materials required by Mayo Clinic School of Graduate Medical Education, this program requires:

• • Letters of recommendation from your fellowship and residency program directors, as well as at least from two additional letters from faculty members from the specialty of interest. These must be completed in the Recommendation Request section. Each recommender will receive an email with a link to upload a letter.

 Applicants considered for an appointment will be invited for a personal interview with the program director and selected faculty.

The goals for the Advanced Endocrinology Fellowship (also known as Advanced Fellow or AF) are to develop a broad knowledge base, clinical expertise and judgment, as well as an understanding of advancing the science of endocrinology during your training.

You will develop the skills necessary to become master clinicians and researchers, with a commitment to advancing empathic quality patient care through excellent clinical skills and quality research. Each AF’s progress is monitored and documented by quarterly evaluations and assessments using standardized tools.

Through regular meetings with the program director, it is determined if you are satisfactorily advancing as would be expected through the fellowship. By reviewing all evaluations with ACGME-competency-based standards, rotational evaluations, allied health evaluations, patient evaluations, conference evaluations, conference attendance and procedure completion, the program director provides ongoing formative feedback and determines whether the you may need additional support to achieve the intended outcomes

Specific educational goals

1. Patient care

Learn best approach to evaluation and treatment of endocrinologic diseases.

• Learn cost-effective use of diagnostic procedures, radiology studies, and laboratory testing relevant to the practice of Endocrinology.
• Master procedures related to the practice of Endocrinology.
• Develop expertise in the full range of patient care, from early-stage diagnosis, management, though recurrent disease and including end-of-life care.

2. Medical knowledge

• Learn the presentation of more rare and complex endocrine disorders.
• Learn the pathophysiology of these disorders.
• Learn management of endocrine disorders.
• Develop a program of regular reading of the medical literature in general and of the Endocrinology literature in particular.

3. Practice-based learning

• Evaluate patient care practices in order to find and correct areas in need of improvement.
• Use on-line resources to allow use of the most current evidence-based management options and apply them to the practice.
• Engage in clinical projects that lead to quality improvement in the clinical practive and patient care.

4. Interpersonal and communication skills

• Learn to clearly communicate with patients and families dealing with endocrine diseases, including the natural history of the disease, communication of bad news, risks and benefits of therapies, procedures and follow up.
• Learn to communicate safely and accurate clinical information to professional colleagues.
• Learn to teach staff, residents, medical students and others by preparing and providing oral presentations for various internal conferences.

5. Professionalism

• Place the interest of the patient first.
• Manage patients with sensitivity to diversity.
• Display highest ethical standards in all aspects of daily activities.
• Complete charting in a timely manner.
• Adhere to Mayo Clinic School of Graduate Medical Education and program-specific policies related to continuous professional development, ethical practice, mutual respect, principles of confidentiality, sensitivity to diversity, and a responsible attitude towards patients and professionals.

6. System-based practice

• Understand use of on-line resources to provide the best care to every patient.
• Learn the Mayo Model of Care and apply it to patient consultation.
• Develop an understanding administration and systems based practice through participation in committees.

Endocrinology inpatient services

The inpatient teaching for the Advanced Endocrinology Fellowship (also known as Advanced Fellow or AF) is conducted on inpatient hospital services and an inpatient consultation service. On these services, the AF will function as a supervisor for the junior endocrine fellow, internal medicine residents, medical students, and mid-level providers, and work closely in conjunction with the consulting staff.

• Maintain direct communication with supervising staff consultant regarding major decisions involving patient management, initiation or discontinuation of treatments, and management of complications for hospitalized patients.
• The AF will provide direct supervision and informal day-to-day teaching/training of junior endocrine fellow and internal medicine residents on the hospital service during which time the junior fellow is on-call. When the AF is absent, this shall be done by the supervising staff consultant.
• The AF will provide direct backup for the resident for any emergencies that arise on the hospital service. When the AF is absent, this will be the responsibility of the supervising staff consultant.
• The AF will be encouraged to provide appropriate resources and pertinent patient-oriented education literature to the patients involved. The AF is expected to maintain a close liaison with the inpatient nursing staff regarding the monitoring and management of the patients, especially regarding any side effects of therapy.
• The AF shall manage the day-to-day activities of the hospital inpatient team/consult service to attempt to optimize patient care, length of stay, and appropriate use of ancillary resources.
• The AF can expect to have continuous, direct telephone backup and, if requested, in-person backup from the responsible staff consultant assigned to the hospital team.
• The AF will be asked for direct input from the supervising staff consultant regarding resident evaluations.
• The AF is expected to be available to supervise the care of outpatient hospital returns with the advanced practice providers if needed. When the AF is off of the service, this responsibility shall be that of the supervising staff consultant.

Endocrinology outpatient services

AF will be assigned a weekly floor calendar in the subspecialty clinic of their interest (for example, thyroid, PGA, diabetes, nutrition, or bone). In these outpatient clinic rotations, they will learn to see patients in a timely and efficient manner and cultivate meaningful patient-physician relationships. Each patient will be assigned to the AF responsible for patient care, while a staff supervising physician will be available for questions/ decisions and education of the AF. Face-to-face review of the patient will occur for new patients as needed, at the discretion of the AF and supervising consultant. The AFs are responsible for all aspects of their patient's care, including evaluation, management, prescription writing, follow-up, correspondence, documentation, record-keeping, billing and phone calls. AFs will be issued business cards that may be used to keep continuity with patients.

Specific goals/objectives will depend on the area of interest selected by the AF.

General goals

Develop a broad-based understanding of the evaluation and care of patients with common and complex endocrine disorders. AFs are expected to have exposure to a broad variety of endocrine disorders, depending on the area of focus of their fellowship.

In order to accomplish this, they need to successfully rotate through the following areas, depending on their selected area of focused training.

Note: Although inpatient care will not be a routine aspect of your experience, you may be asked to see and assist with complex inpatient thyroid cases.

Orientation includes required institutional training and outpatient practice patterns.

Clinical rotations

Note: You will be excused from assigned rotation to see less common disorders that may or may not be known to be present in advance.

• Thyroid teaching clinic, working with endocrinology fellows and PGY-2 or PGY-3 IM residents rotating on elective (PGY-1 residents do general endocrine clinic)
• Thyroid personal calendar. Focus on new patient consultation, thyroid cancer and thyroid dysfunction (hyper-, hypothyroidism) patients.
• Individual consultant 1:1 clinical teaching on their personal calendar. New and established tending toward more complex patients, rarer conditions (for example, metastatic PTC, MTC, FTC, rare genetic thyroid disorders-THR, dysalbuminemia, etc.) and longitudinal care issues.
  • Note: You will be asked to create a list of thyroid pathologies you have not seen and ask individual consultants about identifying such cases (thyroid lymphoma, Riedel’s thyroiditis, pretibial dermopathy, etc.) on their calendars.
• Thyroid cancer survivorship
• Thyroid Eye Disease (TED) clinic, jointly endocrinology and ophthalmology – able to follow a patient in endocrinology, ophthalmology, and ENT for longitudinal care

Rotations pertaining to thyroid disease conducted outside of endocrinology

• Advanced thyroid cancer with endocrine oncologist (in medical oncology): Experience in use of TKIs and other systemic therapies

Procedural

• FNA (TNOD) clinic (extensive training in both free-hand and guide assisted technique)
• Observation/meeting or similar non-clinic experiences with non-endocrine specialists managing thyroid patients
• Endocrine surgery (thyroidectomy, lobectomy) with endocrine or ENT surgeons
• Ethanol ablation of cystic thyroid nodules and nodal metastases in interventional radiology
• Radiofrequency ablation of solid thyroid nodules
• Clinical Laboratory Medicine (pertaining to thyroid assays as organized by clinical lab medicine consultants)
• Nuclear medicine (iodine WBS, PET scan, thyroid uptake/scans)
• Cytopathology (observe and interpret thyroid FNAs alongside a cytopathology specialist)

Note: Although inpatient care will be a routine aspect of your experience, you may be asked to see and assist with complex inpatient PGA cases.

Clinical rotations

Note: You will be excused from assigned rotation to see less common disorders that may or may not be known to be present in advance.

• PGA consultant floor calendar – new patient consultations and high-yield established patients. 1:1 teaching on nuances of clinical evaluation and management of common and rarer PGA disorders. The fellow will be asked to keep a list of PGA disorders that they have seen and can actively seek out patients with certain disorders on other consultant calendars.
• Ad hoc hospital PGA to see consults (as part of the team) and to follow patients that were seen in the outpatient setting.

Rotations pertaining to PGA disorders conducted outside of endocrinology

• Neurosurgery (pituitary tumors), endocrine surgery (adrenal masses)
• Medical genomics

Procedural

• None
• Observation of adrenal vein sampling and IPSS procedures and interpretation of results with consultants
Endocrine surgery (adrenalectomy) with endocrine or surgeons

Observation/meeting or similar non-clinic experiences with non-endocrine specialists managing PGA patients

• Endocrine surgery (adrenalectomy) with endocrine or surgeons
• Clinical Laboratory Medicine (pertaining to PGA assays as organized by clinical lab medicine consultants)
• Nuclear medicine (dotatate PET, MIBG)

Clinical rotations

Note: You will be excused from assigned rotation to see less common disorders that may or may not be known to be present in advance.

• Bone and calcium teaching clinic, working with endocrinology fellows and PGY-2 or PGY-3 IM residents rotating on elective (PGY-1 residents do general endocrine clinic)
• Bone and calcium personal calendar. Focus on new patient consultation, primary prevention, and lower-risk osteoporosis patients.
• Individual consultant 1:1 clinical teaching on their personal calendar. New and established tending toward more complex patients, rarer conditions (for example, hypoparathyroidism), and longitudinal care issues.
• Rare bone disease clinic/pediatric bone disease consultation (specific consultants based on case availability)
• Post fragility fracture clinic with orthopedic trauma surgery (SMH outpatient clinic) – secondary fracture prevention clinic

Rotations pertaining to bone and calcium conducted outside of endocrinology

• Women’s health (menopausal medicine) – elective
• Physical medicine and rehabilitation to include degenerative spine clinic, spinal cord injury clinic, and ROPE (rehab after osteoporotic fracture) clinic
• Healthy Living Program – physical therapy led class on exercise for osteoporosis

Procedural

• DXA BMD (extensive training both technical and clinical application)
• Nuclear Medicine (Parathyroid sestamibi, C11 PET Choline) for primary hyperparathyroidism and TIO (tumor-induced osteomalacia)
• Bone Histomorphometry Analysis and Interpretation. Fellow will participate in interpretation of all clinical bone histomorphometric biopsies performed or referred to Mayo Clinic during the year. Consultants will teach interpretation using teaching slide set.

Observation/meeting or similar non-clinic experiences with non-endocrine specialists managing bone and calcium patients

• Endocrine surgeon (primary hyperparathyroidism; observe patient consultation with surgeon in clinic and observe procedures)
• Ethanol ablation of parathyroid tissue in interventional radiology
• Non-malignant bone pathology cases with pathology (Jeremy Molligan, M.D.)
• Clinical Laboratory Medicine (pertaining to bone and calcium assays as organized by clinical lab medicine consultants)

Note: Orientation includes required institutional training and outpatient practice patterns.

Clinical rotations

Note: The fellow will be excused from the assigned rotation to see patients with less common disorders.

• Weight management clinic
  • Fellows begin by working with faculty with supervision similar to that provided to endocrinology fellows new to weight management
  • Fellows progress to seeing new weight management patients with limited supervision and focused on teaching toward advanced skills
• Post-bariatric surgery longitudinal follow-up clinic (individual and group-based protocolized follow-up at three, six, and 12 months, and long-term annual visits)

Observation or clinical care experience with other specialists managing overweight and obese patients

• Clinical health psychology (initial consultation and behavioral health group-based interventions pertaining to medical weigh medicine, motivational interviewing)
• Bariatric surgeon (observe patient initial consultation, surgery, post-operative hospital rounds, initial outpatient follow-up at three to four weeks with surgical team)
• Endoscopic bariatric procedures (sleeve gastroplasty, TORe - endoscopic transoral outlet reduction, intragastric balloon)
• Resting energy expenditure assessment (pulmonary function laboratory)
• Cardiovascular health clinic (exercise testing and exercise prescriptions for those with cardiopulmonary disease
• Healthy Living Program – wellness coaching, exercise and nutrition counseling for healthy persons for prevention of weight gain, weight loss, and overall health
• Sleep clinic – elective
• NASH clinic, women’s health clinic, pediatric/adolescent weight management clinic – elective

Note: For outpatient and obesity focused fellows, developing knowledge and skills related to malnutrition and nutrition interventions will enhance their evaluation and management skills of the obese patient before and after bariatric procedures. For fellows who plan to be engaged in hospital medicine with a focus on inpatient metabolic and nutrition management, up to 8 weeks on an inter-professional nutrition support team is offered.

Among other outcomes, fellows will be eligible to take ABOM certification and/or National Board of Physician Nutrition Specialists certification.

Clinical rotations

Note: The fellow will be excused from assigned rotation to see less common disorders which may or may not be known to be present in advance.

• Diabetes technology clinic, working with junior endocrinology fellows
• Diabetes personal calendar. Focus on new patient consultation:
• Individual consultant 1:1 clinical teaching on their personal calendar. New and established tending toward more complex patients, rarer conditions (for example, genetic forms of diabetes, post-pancrectomy diabetes) and longitudinal care issues.
• Complex patients: Diabetes in the bariatric population, Immune checkpoint inhibitor-induced diabetes, mitochondrial diabetes, monogenic diabetes, diabetes in patients with cancer receiving chemotherapy
• Continuous glucose monitor reporting

Rotations pertaining to diabetes conducted outside of endocrinology

• Clinical genomics of monogenic diabetes, lipid disorders (lipid disorders is elective)
• Mitochondrial disease group

Procedural

• Continuous glucose monitor interpretation and reporting
• Initiation of insulin pump ± continuous glucose monitor
• Placement of Implantable continuous glucose monitor

Observation/meeting or similar non-clinic experiences with non-diabetes specialists managing diabetes

• Bariatric program
• Pancreas transplantation clinic
• Pancreas disease program in gastroenterology
• Pancreas radiology including localization of pancreas abnormalities
• Clinical Laboratory Medicine (pertaining to endocrine assays as organized by clinical lab medicine consultants)

Clinical rotations

• Transgender and Intersex Specialty Care Clinic (TISCC) endocrinology shared calendar (Chair TISCC practice)
• Individual endocrinology calendar (consultants and APP providers)
• Pediatric endocrinology TISCC
• Behavioral health rotation social work and psychology/psychiatry
• Independent TISCC calendar with supervision as needed (toward the end of clinical rotation)
• Potential rotation to Florida/Arizona TISCC

Rotations pertaining to TISCC conducted outside of endocrinology

• Shadow Surgical TISCC team members – Plastic Surgery, Urology, GYN surgery
• Post-operative visits in the hospital

Observation/meeting electives

• Vocal therapy
• Pelvic floor physical therapy
• Nursing (for example, injection instruction education)
• Co-lead Patient and Family Advisory Council

By the end of the year, you are expected to master the required procedures of your specific area of training (for example, FNAs for thyroid AF; interpretation of CGM and insulin pump downloads for diabetes and metabolism AF, etc.).

The program director will review competency-based evaluations, procedure logs, participation and attendance in didactic sessions, and satisfactory delivery of safe, effective, and compassionate patient care to ensure successful completion at the end of the fellowship. You are expected to gain an understanding of research methodology, including how to design and interpret research as it applies to the disciplines of Endocrinology. In order to accomplish this, you are expected to work with a research mentor to complete an independent research project under the supervision of a mentor.

The following conferences take place between 12:30-1:30 p.m. each day as follows.

Mondays

• Fellows townhall meeting (in February, May, August, and November) on the first Monday of the month
• Education Committee meeting on the second Monday of the month
• Journal Club on the fourth Monday of the month

Tuesdays

• Endocrine Research Seminar on the first, second, fourth, and fifth Tuesdays of the month

Wednesdays

• Endocrine Grand Rounds on the second to fifth Wednesdays of the month between 7:30-8:30 a.m.
• Quality Improvement (QI) meeting on the fourth Wednesday of the month between 12:30-1:30 p.m.

Thursdays

• Tumor Board between 7-8 a.m.
• Fellows conference between 12:30-1:30 p.m.

Fridays

• Endocrine Grand Rounds on the first Friday of the month between 7:30-8:30 a.m.
• Core curriculum lectures (dictated by subspecialty staff) on the second to fifth Fridays of the month at 12 p.m.

Moonlighting

Scope

Advanced Endocrinology Fellows in Rochester who wish to moonlight at any point during the training program.

Purpose

To communicate program specific policies that supplement MCSGME moonlighting policy.

Policy

• Advanced Endocrinology fellows are permitted to moonlight.
• Advanced Endocrinology fellows who wish to moonlight will review their eligibility and general requirements to moonlight outlined in the MCSGME moonlighting policy.
• Subsequent to this review, the Advanced Endocrinology advanced fellow (AF) will schedule a meeting with the program director to jointly complete the MCSGME Moonlighting Approval Form and review relevant policies and performance expectations.
• AFs may schedule moonlighting shifts on weekends (Friday evening through Sunday evening) that are free of program activities without program director approval. Program responsibilities include laboratory procedures that may occur on weekends(for example, consenting or admitting study subjects to the CRU).
• AFs may not moonlight Sunday evening through Thursday evening under any circumstances if they have clinical responsibilities the following day.
• AFs are not allowed to leave clinical duty early (before 5 p.m.) on Friday to report to a moonlighting shift.
• AFs are not allowed to moonlight on any home call rotation (pager call on DCS being the main consideration).
• The program director has the ability to retract moonlighting privileges at any time based on clinical or academic performance (for example, poor rotation evaluation or research productivity).

Facilities and locations

All training for the Advance Endocrinology Fellowship will take place in the outpatient clinics located on the 18th floor of the Mayo Building (East and West sides).

For inpatient rotations, training will take place at Saint Marys Hospital and/or Methodist Hospital.

Fellows will have assigned desks to work in the Endocrine Fellows Room located on 18th floor of the Mayo Building.

The Division of Endocrinology is composed of 38 faculty members, each specializing in a specific area within the field. These members are grouped into specialty or “core groups” based on their expertise. There are several core groups including:

• Thyroid core group
• Diabetes, lipids, and metabolism core group
• Calcium and bone metabolism core group
• Obesity and nutrition core group
• Pituitary-gonadal-adrenal core group

Each core group includes four to eight members who are deeply passionate and highly knowledgeable in their respective fields. This structure provides trainees with the unique opportunity to rotate through various specialty areas, gaining invaluable insights from the most experienced leaders in each field.

• Juan Brito Campana, M.B.B.S.
• M. Regina Castro, M.D. (Program Director)
• Diana Dean, M.D.
• Hossein Gharib, M.D.
• Julie Hallanger Johnson, M.D.
• Mabel Ryder, M.D.
• Marius Stan, M.D. (Chair)

• Chris Adams, M.D., Ph.D.
• Aoife Egan, M.B., B.Ch., Ph.D.
• Yogish Kudva, M.B.B.S. (Chair)
• Victor Montori, M.D.
• K. Sreekumaran Nair, M.D., Ph.D.
• Pankaj Shah, M.D.
• Vinaya Simha, M.B.B.S., M.D.
• Adrian Vella, M.D.

• Bart Clarke, M.D.
• Daniel Hurley, M.D.
• Kurt Kennel, M.D.
• Sundeep Khosla, M.D.
• Jad Sfeir M.D., M.S. (Chair)
• Robert Wermers, M.D.

• Irina Bancos, M.D., M.S.
• Caroline Davidge-Pitts, M.B., B.Ch.
• Diane Donegan, M.D.
• Dana Erickson M.D.
• Lucinda Gruber, M.D.
• Neena Natt, M.D. (Chair)
• William Young Jr., M.D.

• Haitham Abu-Lebdeh, M.D.
• Maria Collazo-Clavell, M.D.
• Daniel Hurley, M.D.
• Donald Hensrud, M.D., M.S.
• Kurt Kennel, M.D.
• Manpreet Mundi, M.D.
• Kalpana Muthusamy, M.B.B.S., M.D.
• Meera Shah, M.B., Ch.B. (Chair, Associate Program Director)