Pediatric Adolescent Medicine Fellowship Curriculum

Organization

The Adolescent Medicine Fellowship prepares fellows for a career in adolescent medicine in a variety of clinical and academic settings. The fellowship program is applicable for those interested in a career in academic medicine or in clinical practice. Successful completion qualifies the candidate for subspecialty board certification in adolescent medicine. The Adolescent Medicine fellowship is a three-year program; the length of the program provides fellows with sufficient time for acquisition of clinical skills (in both the inpatient and outpatient setting) as well as time to pursue scholarly and research activities. The fellowship curriculum follows Accreditation Council on Graduate Medical Education (ACGME) guidelines and requirements, with a predominantly clinical first year followed by an increased focus on scholarly activity, teaching and academic professional development in years two and three.

  • The first year of fellowship training will focus on developing a foundation of clinical expertise that will help guide further training. Fellows will provide primary care, inpatient care and consultation services for self- or physician-referred adolescents and young adults aged 12-22 years. We are a major referral center for the evaluation and medical management of eating disorders in adolescents in the mid-south region. In addition, we provide comprehensive health services and consultations for adolescents with chronic illnesses, which allows our fellows to participate in caring for teenagers with developmental disabilities, asthma, sickle cell anemia, cancer, renal disease, organ transplants, rheumatologic diseases, diabetes mellitus, and others. Fellows will participate in divisional, departmental, institutional, regional, and national educational conferences focused on Adolescent Medicine.

  • The second year of fellowship will focus on the trainee’s primary research/scholarly project, which will have been identified by the end of their first year. The fellow’s clinical responsibilities are reduced to allow ample time to focus on their project. The upper-level fellow will also take on a graduated teaching role, educating residents and medical students. They will continue to participate in educational conferences throughout the year.

  • The third year of fellowship is structured like year 2. The third-year fellow will focus on the completion of the scholarly project and developing the skills necessary to successfully "launch" into a career in adolescent medicine. The third-year fellow will also be expected to continue to attend educational conferences. Clinical activities during the third year will be associated with increased autonomy and discussions that will prepare the fellow for independent practice.

Clinical Settings

Vanderbilt Health One Hundred Oaks

Outpatient primary care clinic: The Adolescent and Young Adult Health (AYAH) Clinic at Vanderbilt located at One Hundred Oaks (OHO) provides primary and specialty care for adolescents and young adults. It is an off-campus site that averages 8,000 clinical visits/year. This location will serve as the main base of operations for adolescent medicine fellows. Fellows will serve as the primary medical provider in the ambulatory setting for all three years of training, providing longitudinal care that is directly supervised by faculty. They will develop a continuity clinic experience at this site, conducting new patient visits, follow-up visits, and outpatient consults. The fellow will assume primary responsibility for their panel of patients and see their own patients with supervision by the attending. As they gain experience, fellows will develop teaching skills by precepting residents and medical students in this clinical setting.

Fellows will be trained to provide long-acting reversible contraception, including intrauterine device and implant insertions and removals in outpatient setting. The Division of Adolescent Medicine also provides expert reproductive health care for healthy adolescents as well as those with complex medical issues through our programs which provide consultative care for girls needing contraception and menstrual management.

Outpatient referral clinics: The fellow will also evaluate and treat patients in the AYAH referral clinic, which is a tertiary care clinic for adolescents with feeding and eating disorders, mental health issues, sexual and reproductive health concerns, or menstrual disorders. These patients are often referred from their primary care providers in the greater Middle Tennessee area (including neighboring states) for a dedicated adolescent medicine-related issue. The fellow will gain experience as an adolescent medicine consultant to adolescents and their families in this referral clinic setting.

The Eating Disorder Program at Vanderbilt is a collaborative multidisciplinary effort, encompassing nutrition, psychiatry, and medical management of adolescents and young adults with eating disorders. The goal is to provide family-based specialized eating disorder treatment both in the outpatient and inpatient settings, as well as facilitate transfers to higher levels of care if needed. Fellows learn the medical management of eating disorders by caring for patients in our outpatient clinic and on the inpatient service, as well as by participating in weekly multidisciplinary rounds.

The HIV Comprehensive Care Transition Clinic provides primary care for young people with HIV infection or AIDS and counseling and testing services for those at risk for this infection, including the provision of pre-exposure prophylaxis. This multidisciplinary clinic is housed at OHO with experts in adolescent medicine, infectious diseases, social work, health care navigation/case management, and nursing.

Fellows will also have longitudinal clinical experience at a community-based setting within the Department of Pediatrics at Meharry Medical Center.

Elective experiences are available in sports medicine, psychiatry, college health, and other disciplines (depending on fellow interest).

Inpatient service: The inpatient experience at the Monroe Carell Jr. Children's Hospital at Vanderbilt provides care for adolescents and young adults with diverse acute and chronic medical, surgical, gynecological, and psychosocial problems. Fellows will serve as consultant to the inpatient general pediatrics medical service with faculty mentoring and supervision. For consults initiated by the emergency department and inpatient hospital medicine teams, the fellow will be expected to be the initial point of contact during their inpatient service blocks in collaboration with the on-call attending physician. Treatment plans will be developed for the setting, including arranging outpatient follow-up with the adolescent medicine team if needed. Clinical fellows will spend four to six weeks each year on the inpatient team, serving as the junior attending physician for adolescents admitted to the Adolescent Medicine Service. This service primarily provides inpatient care for adolescents and families affected by an eating disorder.