The Division of Endocrinology and Metabolism is based at the Children’s Hospital of Eastern Ontario (CHEO). It has grown from three faculty members in 1995 to our current complement of eight full-time and three part-time faculty.

The clinical programs are supported by 16 allied health professionals including nurses, dietitians, social workers, clinical psychologists and an exercise specialist. The team also includes 12 research personnel. 

Our clinical programs include roughly 8,000 patient visits per year and are structured to provide care in the following areas:

  • Diabetes
  • General endocrinology
  • Obesity
  • Bone health
  • Neuro-oncology
  • Transgendered youth

Our team’s mission isto provide comprehensive, evidence-based, family-centered, interdisciplinary, team-based care for children and youth with diabetes and other endocrine disorders. We also focus on educating and empowering patients, parents and the community to be active participants in the achievement of optimal health outcomes.

We also strive to educate current health care professionals in pediatric endocrinology and diabetes as well as train future leaders in the field to be at the forefront of research in pediatric endocrinology and to translate this research into improved clinical care.

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Clinical programs

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)

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 

Laboratory and diagnostic programs

  • Advanced bone diagnostic and monitoring techniques such as bone biopsies
  • Trainees are exposed to endocrine tests through the biochemistry laboratory at The Ottawa Hospital, dynamic endocrine testing at CHEO and the Newborn Screening Laboratory.

Research

Members of the Division of Endocrinology hold over $15 million in grants covering many aspects of pediatric endocrinology. This includes strong research programs particularly in the areas of bone health, Type 1 diabetes, pediatric obesity, and transgender youth.  Dr. Ward leads local, national and global research initiatives in the study of mechanisms, epidemiology and treatment of bone disorders in children, with an emphasis on osteoporosis in children with serious chronic illnesses. As director of the JDRF-CCTN Centre for Type 1 diabetes Research, Dr. Lawson is developing and participating in multi-centre pediatric clinical trials. She is also involved in international diabetes prevention studies such as TRIGR and Trialnet, and is Co-Principal Investigator of the CIHR funded Trans Youth Can! - a prospective pan Canadian study assessing health, social and family outcomes amongst transgender youth and their parents. Dr. Hadjiyannakis’ group is examining the interplay between behavioural/psychosocial, genetic and intrauterine factors in predicting risk for obesity related co-morbidities. Dr. Ahmet is leading initiatives to provide more evidence-based guidelines on the management of adrenal suppression. 

Predominant areas of research:

  • Type 1 Diabetes
  • Pediatric bone health
  • Adrenal suppression
  • Obesity and lipid disorders
  • Transgender youth
  • Shared decision making
  • Medical education
  • Global health

Faculty

Training programs

Undergraduate training opportunities

Endocrinology is an important area of pediatric education for medical students. Diabetes is one of the most common chronic illnesses in pediatrics. Assessment of growth is fundamental to pediatric medicine and interplays with each and every system of the body.

Drs. Ahmet and Lawrence lecture as part of the pediatric week of the endocrine block and each of the faculty have contributed to workshops and as CBL tutors. Several faculty also participate in regular sessions with the clerks rotating through pediatrics as well as OSCE examinations.

There is almost always a medical student on a selective or elective rotation in Endocrinology, which consists primarily of attending outpatient clinics. They also have the opportunity to do inpatient consults and rounds with the residents and fellows on inpatients either admitted or consulted to endocrinology. This provides a broad exposure to both acute and chronic care in endocrinology.

Each week of the rotation, time is dedicated for sit down teaching with the on-service endocrinologist as well as with the fellows and residents on service. The topic is typically chosen in advance by the learners and is predominantly case-based discussion and learning.

A unique opportunity for medical students is the chance to attend diabetes camp for up to two weeks in August. This is a wonderful opportunity to learn about diabetes by spending time with 86 children and youth, experiencing how they manage their condition and making hundreds of insulin adjustment decisions. 

Postgraduate training program 

The Division of Endocrinology offers a comprehensive clinical and academic fellowship program in pediatric endocrinology. This training will enable residents to practice in this subspecialty with a high level of skill. 

Through 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.

On 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 the research skills required to perform independent research. 

Additional postgraduate training

Members of the Division of Endocrinology provide postgraduate training to interested trainees, both as an integral part of general pediatric residency training as well as to interested applicants as part of their available electives. Specific areas covered during these rotations include but are not limited to:

  • Type 1 Diabetes
  • General endocrinology
  • Pediatric bone health
  • Obesity and lipid disorders
  • Neuro-oncology
  • Gender diversity

Division members regularly contribute to grand rounds presentations as well as academic half day for pediatrics as well as a number of subspecialty programs, particularly emergency medicine, pediatric critical care and neonatal and perinatal medicine