Through outpatient and inpatient training, as well as through procedure-focused training, the fellows develop a comprehensive understanding of indications, contraindications, limitations, techniques, complications and interpretation of procedures that are required of diagnosis and management of patients with disorders of endocrinology and metabolism.

This understanding includes informing the patient about the above aspects of specific procedures and obtaining informed consent. Fine needle aspirations (FNA) biopsy of the thyroid, under ultra-sound guidance, will be taught and then supervised by faculty in an outpatient care settings. Trainees will maintain logbooks that list each procedure and copies will be maintained in the program director's files. Each entry includes name of patients, identifying numbers, clinical problem, procedure, indication of complications, results of test. The program director will determine, on the basis of faculty input and analysis of logbook entrees, when the trainee has achieved proficiency in a specific procedures. 

All procedures are carried out in accord with universal precautions and protection of healthcare workers, as defined by Occupational Safety and Health Administration (OSHA).