This training will enable residents to practice in this subspecialty with a high level of skill.

In coordination with the Faculty of Medicine at the University of Ottawa, this program has full accreditation from the Royal College of Physicians and Surgeons of Canada. All Canadian trainees satisfactorily completing the program are eligible candidates for the Royal College Pediatric Endocrinology examination.

Residents must have completed three years of core pediatrics in an approved institution to be eligible for this program.

Upon completion of the core two-year Pediatric Endocrinology Fellowship program, trainees will have the clinical skills necessary to diagnose and manage endocrinologic diseases in children, be knowledgeable to teach at both the undergraduate and postgraduate levels, and have the basic skills required to conduct clinical and/or laboratory research. Our training program also provides academic consultants in pediatric endocrinology.

Residents may choose a third year of training to allow for further development of research skills required to perform independent research.

Related links

• CaRMS University of Ottawa Pediatric Endocrinology
• Royal College of Physicians and Surgeons of Canada
• Professional Association of Residents of Ontario (PARO)

A core two-year program has been designed to provide the trainee with the appropriate skills to maintain a consultative practice in pediatric endocrinology and metabolism. The first year of the program is primarily clinical and the trainee will be exposed to a broad spectrum of pediatric endocrinology conditions through both a variety of outpatient clinics and inpatient consultations.

The second year of the program will be tailored to the resident’s learning needs and future career goals with an increased emphasis on research, if desired. Continuity clinics in both endocrine and diabetes are established in the first year and continue until the completion of training. Residents will have a staff supervisor for these clinics and have graded levels of responsibility.

Opportunities for a third year of training with an academic focus are available and encouraged.

This pediatric endocrinology program provides two core years of training in pediatric endocrinology and metabolism. The overall goal of the program is to produce an endocrinologist who has the:

• Clinical competence in the broad field of pediatric endocrinology and metabolism, with a sound background in the appropriate basic sciences and laboratory procedures. He or she will be able to:
  • Manage endocrine/metabolic disorders in hospitalized and ambulatory patients
  • Serve as a consultant to general practitioners and pediatricians, as well as other specialists, on endocrine/metabolic disorders
  • Arrange for, supervise and interpret complex diagnostic procedures being developed in the specialty (e.g. various stimulation and suppression tests)
  • Address issues of gender, sexual orientation, age, culture, ethnicity and ethics in a professional manner
  • Demonstrate skills and attitudes required for effective patient-centered care
• Ability to develop and carry out research projects, clinical or basic science, in the broad field of endocrinology and metabolism. It is not expected that the trainee will have the skills to conduct independent sophisticated research upon completion of the two-year program. Residents are encouraged to complete a third year of training to focus on academic endeavors including, but not limited to, further development of research skills required to perform independent research.
• Interest and ability to teach endocrinology and metabolism to undergraduates, postgraduates and colleagues.

A comprehensive Academic Half Day curriculum has been designed to cover all major topics within endocrinology and metabolism including both adult and pediatric topics. A weekly teaching session about specific pediatric endocrinology topics occurs for all house staff. Weekly pediatric endocrinology rounds include discussion of interesting inpatients and outpatients and teaching through a journal club or an evidence-based review. An additional monthly teaching session for pediatric endocrinology residents ensures coverage of objectives not addressed in the weekly teaching sessions.

Teaching of non-medical expert CanMEDS roles is provided with workshops within the Academic Half Day curriculum and during pediatric subspecialty resident retreats. Residents are encouraged to attend summer research methodology seminars hosted by the CHEO Emergency Medicine Program. Ottawa city-wide Endocrinology Grand Rounds are held weekly. 

A number of clinical and educational activities have been designed to develop the necessary skills to maintain a consultative practice in pediatric endocrinology and metabolism. These include, but are not limited to:

• Clinicsin pediatric diabetes, general pediatric endocrinology, bone, growth, obesity, transgender, metabolics, pediatric gynecology and neuro-oncology
• Inpatient endocrinology service
• Resident’s Longitudinal Clinic in both general endocrinology and diabetes. Residents have the opportunity to follow their own patients with a staff supervisor. This experience begins during the first year and continues for the duration of training.
• Insulin pumps - residents get hands-on experience with both pump starts and continued care of patients using the insulin pump
• Research rotation(s)
• Lab rotation
• Adult endocrinology rotation
• Bone rotation
• Electives

The training program in endocrinology and diabetes includes experience in the following clinical programs. 

Inpatient care

Endocrinology consults on approximately 200 in-patients per year. There are no dedicated endocrinology beds, although there is capacity to admit patients to endocrinology on the clinical teaching units. 

Outpatient care (approximately 8,000 visits annually)

• Diabetes (3,400 visits annually)
  • Individual and group-based diabetes education
  • Insulin pump and continuous glucose monitoring program
  • Type 2 diabetes clinic
  • Transition to adult care program
  • Diabetes camp (Camp Banting)
  • Outreach clinics including North Bay and Pembroke
  • Two-hour emergency hotline for 900 patients and families with diabetes 

•  Endocrinology (3,000 visits annually)
  • General pediatric endocrinology
  • Disorders of sex development team (combined with urology, gynecology, genetics, psychology, neonatology and medical ethics)
  • Diversity clinic/transgender health team (together with adolescent medicine)
  • Growth hormone clinic
  • Neuro-Oncology clinic (with oncology, neurology, neurosurgery, radiation oncology)
  • Adrenal suppression surveillance
  • Newborn screening (congenital adrenal hyperplasia, congenital hypothyroidism) 

• Bone Health (500 visits annually)
  • General bone health and endocrinology health clinic
  • Osteoporosis clinic
  • Intravenous bisphosphonate treatment program
  • Advanced bone diagnostic and monitoring techniques such as bone biopsies
  • Internationally recognized for clinical expertise and excellence 

• Centre for Healthy Active Living (CHAL) (1,100 visits annually)
  • Pediatric regional assessment and treatment centre for severe complex obesity

Clinical problems and diseases evaluated and followed

Diabetes

• Type 1, Type 2
• Cystic fibrosis related diabetes
• Monogenic diabetes
• Diabetes secondary to medication

General endocrinology

• Assessment of growth and puberty
• Thyroid conditions
• Disorders of the adrenal gland
• Pituitary disorders
• Childhood cancer survivors at risk of hormone deficiencies
• Transgender youth
• Disorders of sex development / ambiguous genitalia
• Disorders of calcium regulation
• Rickets
• Polycystic ovarian disease
• Metabolic syndrome
• Dyslipidemia
• Bone health assessments for children and teens with osteoporosis due to chronic diseases and their treatment
• Genetic bone conditions
• Skeletal dysplasias
• Disorders of calcium regulation
• Severe complex obesity with co-morbidities 

Related links

• Canadian Bioethics Society
• Canadian Paediatric Society
• Canadian Tri-council core skills tutorial for research ethics

The fellowship is based primarily at the Children’s Hospital of Eastern Ontario (CHEO). The training site for adult rotation/lab rotation is The Ottawa Hospital.

Trainees are expected to produce a minimum of one manuscript during their core pediatric endocrinology training. All residents have mentorship for research through the division with many opportunities to be involved in ongoing or new projects. Basic research training is provided through workshops and mentorship at the CHEO Research Institute, through the University of Ottawa and in the summer research methodology seminars hosted by the CHEO Emergency Medicine Program.

Applications are accepted through the CaRMS pediatric subspecialty match. Requirements for application through CaRMS include:

• Completing core pediatric R3/R4 in an accredited core pediatric program in a Canadian or U.S. university
• Canadian citizen or permanent resident
• International medical graduates enrolled in pediatric residency programs in Canadian medical schools are eligible to apply
• Sponsored residents (foreign governments) are not eligible to apply through the CaRMS residency matching service

Consideration of foreign applicants who do not meet the above criteria will be based on position availability. To enquire about this process, please visit the uOttawa Faculty of Medicine’s PGME section for foreign applicants.