Primary Care Fellowship in Diabetes: An Innovative Program in Postgraduate Diabetes Education

Abstract

Background: To address the need of caring for the growing number of patients with diabetes, East Carolina University implemented a 1-year fellowship in diabetes. Most of the region has been designated as Health Professional Shortage Areas. Description: The objective of the fellowship is to educate primary care physicians to serve as regional specialists in diabetes. The program is administered by physicians, educators, and representatives of the university's affiliated teaching hospital. The curriculum includes clinical, didactic, and experiential learning strategies in outpatient and inpatient settings. Adult and pediatric endocrinologists, obstetricians, and generalists mentor and evaluate the fellows. Evaluation: This innovative training program has improved the availability of high-quality diabetes care for underserved patients in the region. Mean glycemic control in fellows' patients improved and other clinical endpoints were also met. Conclusions: A 1-year diabetes fellowship is a replicable solution to address the need for diabetes care specialists.

The Duke Endowment, University Health Systems and East Carolina University provided support for the Diabetes Fellowship Program. Pitt County Memorial Hospital: Diane Poole, Roger Robertson, and Sandra Young, BSN, MSN. The Duke Endowment: Mary L. Piepenbring, Director, Health Care Division. Eastern Area Health Education Center: Stephen Willis, MD, and David Kennedy. Brody School of Medicine at East Carolina University: Department of Internal Medicine: A, J. Drake, III, MD, Bruce Johnson, MD, Sangnya Patel, MD, Sylvester Odeke, MD, Fiona Cook, MD, Nancy Leggett-Frazier, RN, MSN, CDE, Susan Houston, RN, Mindy Saenz, RD, LDN, CDE, Cathy Rademacher, RN, Amy Long, BA, and Roy Carlton, MBA. Department of Pediatrics: Glenn Harris, MD, Dale Newton, MD, Pam Hardy, FNP, and Susan Holiday, PNP. Department of Family Medicine: David Weismiller, MD. Department of Obstetrics and Gynecology: Edward Newton, MD, James deVente, MD, and Christy Isler, MD. Office of the Vice Chancellor: John Lehman, PhD, and Terri Workman, JD.

Notes

^a Entering endocrinology fellowship in 2007.

^b Although Cumberland is not a Health Professional Shortage Area (HPSA) county, it is surrounded by HSPA counties.

^c J-1 Visa.

^d Fellow 4 was originally scheduled to work in a rural medicine clinic in Greene County, NC, that serves an uninsured primarily Hispanic population. However, because of a delay in obtaining a contract in NC, she elected to go out of state for a J-1 waivered position. She is doing diabetes and primary care in a rural community of 10,000 mostly comprised of Mexican American farm workers.