The Pediatric Endocrinology and Diabetes Fellowship at NYU Grossman School of Medicine is a three-year program accredited by the Accreditation Council for Graduate Medical Education (ACGME) that prepares trainees for careers in academic pediatric endocrinology, clinical pediatric endocrinology, and both basic science and clinical research. Fellows gain comprehensive experience in the clinical treatment of a wide variety of patients. As a benefit of training at a top-tier academic and clinical center in the heart of a busy metropolitan area, trainees have the opportunity to treat a broad array of pediatric endocrine disorders, in addition to caring for patients in varied clinical settings.

Fellows in the program learn how to care for children, adolescents, and young adults with endocrine disorders and develop the skills and knowledge necessary to become an expert in the field. Outpatient training takes place at the Fink Children’s Ambulatory Care Center, the Pediatric Diabetes Center, and the Children’s Health Clinic at NYC Health + Hospitals/Bellevue. Inpatient training occurs at Hassenfeld Children’s Hospital at NYU Langone and at Bellevue.

In addition to treating patients in the general pediatric endocrine and diabetes clinics, fellows participate in the subspecialty endocrine clinics, housed within the Fink Children’s Ambulatory Care Center. Doctors at the Pediatric Bone Health Program care for patients with metabolic bone disease, and the program is a registered site for pediatric patients with osteogenesis imperfecta. Doctors at the Pediatric Lipid Clinic care for patients with lipid abnormalities, including inherited lipid disorders. The Healthy Weight Program cares for patients with weight gain and utilizes a multidisciplinary team approach, including doctors, nurses, social work, psychology, exercise physiology, and other support members. The Transgender Youth Health Program provides gender-affirming care, which can include medical, surgical, psychology, therapy, reproductive endocrinology services, and voice therapy for transgender and gender-expansive children, adolescents, and young adults.

Fellows also develop both clinical and laboratory research skills across a wide spectrum of endocrine disorders, including diabetes, in children, adolescents, and young adults. The faculty consists of both clinical and basic science researchers who help novice investigators feel comfortable and help experienced researchers further their goals in the field. The division is active in ongoing national research projects.

Fellowship Clinical Training

During the clinical training, fellows learn about the physiology of hormone secretion and action, including hormone receptors and molecular mechanisms underlying endocrine disorders. The following are pediatric endocrine disorders and treatments in which you receive training:

• abnormalities of anterior and posterior pituitary function, including postoperative complications affecting fluid and electrolyte balance such as diabetes insipidus and syndrome of inappropriate antidiuretic hormone secretion
• bone mineralization disorders such as osteogenesis imperfecta
• carbohydrate metabolism disorders such as diabetes mellitus and hypoglycemia
• disorders of adrenal gland physiology, including congenital adrenal hyperplasia
• disorders of androgen and estrogen metabolism, including adolescent reproductive endocrinology
• disorders of calcium, phosphorus, and vitamin D metabolism such as rickets
• disorders of hypothalamic hormonal regulation
• endocrine neoplasia
• growth disorders, including short and tall stature, with and without dysmorphic or disproportionate features, as well as constitutional delay of growth and puberty
• growth hormone therapy in children, adolescents, and those with postadolescent growth hormone deficiency
• issues related to transgender, gender-affirming, and gender-expansive care
• late endocrine effects of cancer treatment
• lipoproteins and lipid disorders
• nutrition disorders, including obesity, particularly as they affect growth and development
• ovarian hyperandrogenic states such as insulin-resistance syndromes
• polyglandular autoimmune diseases
• pubertal development and sexual differentiation disorders
• thyroid and parathyroid disorders

Fellows care for inpatients alongside pediatric faculty and residents. They also interact with experts from other fields and subspecialties, including pediatric neurosurgery, pediatric surgery, urology, genetics, child psychiatry, obstetrics and gynecology, and radiology.

Fellows will become physician educators during their fellowship training as they give lectures to medical students and residents during their academic sessions on various endocrine topics. Fellows will take an active role in teaching upcoming physicians through these lectures and case-based learning sessions.

Fellowship Research Training

Fellows are required to undergo substantial training in research, including laboratory techniques, basic principles of competitive hormone assays, the performance of radioimmunoassay of hormones in blood and other fluids, and the interpretation of laboratory results. By the completion of fellowship, fellows will be able to demonstrate knowledge of biostatistics, clinical and laboratory research methodology, study design, preparation of applications for funding and/or approval of clinical research protocols, critical literature review, principles of evidence-based medicine, ethical principles involving clinical research, and teaching methods. Depending on their interests, training in laboratory techniques can be expanded to include more advanced methodologies, such as high-performance liquid chromatography, receptor assays, and other chromatographic techniques.

Fellows are expected to participate in quality improvement initiatives and, at the start of fellowship, may begin their research endeavors with case reports/case studies and/or QI projects. As fellowship continues, fellows are expected to design and execute a research project that results in a manuscript that is ready to submit for publication. Because clinical research projects are an integral part of the fellowship experience, protected time for the pursuit of scholarly activity and research is provided. Fellows help prepare proposals for grant applications and for review by the institutional review board. First-year fellows work closely with the program director and other faculty members to determine a research topic that interests them, identify a mentor, and design their research project. Fellows also learn about ethical principles in research, biostatistics, epidemiology, outcomes analysis, and legal considerations. In addition, fellows gain experience in performing literature searches, teaching, and administration.

For those fellows who are interested in exploring, participating in, and/or developing laboratory research projects, the program will assist in making connections to our basic science colleagues, supporting laboratory investigation, experimental design, and bench work.

Recent fellow case reports include:

• Severe DKA in adolescent at onset of type 2 diabetes and COVID-19
• Primary ovarian failure in an adolescent due to a homozygous pathogenic variant in the mitochondrial poly-a-polymerase gene
• Case of skeletal dysplasia in post-menarchal pediatric patient due to novel mutation of CSGALNACT1
• Exogenous Cushing's Syndrome, hypogonadism, and diabetes secondary to megestrol acetate
• Incidental MODY3 diagnosis in a pediatric patient with resected hepatocellular adenoma

Recent fellow quality improvement projects include:

• Family Impact Module (FIM) in type 1 diabetes mellitus
• Cautionary tale to investigate low gonadotropin levels in Turner Syndrome
• Contraception use in adolescents with type 1 diabetes mellitus
• Safe binding practices for transgender youth

Recent fellow research projects include:

• The role of the IGF-1 receptor signaling in the closure of the anterior fontanelle
• Impacts of the COVID-19 pandemic on the diagnosis of idiopathic central precocious puberty in pediatric females in New York City
• Testosterone induced ovarian changes in transgender patients

Pediatric Endocrinology Fellows

Third-Year Fellow

Simrat Veera, DO
Hometown: Toronto, Ontario, Canada
Residency: Goryeb Children's Hospital, Morristown, NJ
Favorite thing to do in New York City: Ending up in new neighborhoods and discovering new cuisines!

Second-Year Fellow

Jessy Epstein MD
Hometown: Manhattan, NYC
Residency: NYU Long Island school of medicine
Favorite thing to do in NYC: Ride the East River ferry in the summertime, eat amazing food in Flushing

First-Year Fellow

Alexandra Altamura, MD
Hometown: Wood-Ridge, NJ
Residency: Pediatrics at Jersey Shore University Medical Center
Favorite thing to do in NYC: Catching a concert, Broadway show or comedy show with friends.

Fellowship Application and Selection Process

The fellowship program participates in the National Resident Matching Program (NRMP) Pediatric Specialties Fall Match. Applications are accepted through the Electronic Residency Application Service (ERAS). Interviews take place between August and November, and fellows are matched in December.

For more information about the application process, including requirements, please contact Dhurata Baci, MPH, program manager, at Dhurata.Baci@NYULangone.org, or Jason A. Klein, MD, fellowship director, at Jason.Klein@NYULangone.org. The division accepts one fellow each year.