IM Endocrine Rotations Curriculum
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IM Endocrine Rotations Curriculum

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  • 1. Rotation: Endocrinology, Diabetes and Metabolism Curriculum University of Kansas School of Medicine and Hospital Revised 12/2006 The Residency Review Committee requires that the resident and attending have a face-to-face meeting at the beginning of the rotation to review the learning objectives. Director: Leland Graves, III, MD Faculty: Leland Graves, III, MD Joseph Kyner, MD Barbara Lukert, MD Deana Paramore, MD Neil Schimke, MD Rajib Bhattacharya, MD David Robbins, MD Administrative Office: 4022 Wescoe Mail Stop 2024 Kansas University Medical Center 3901 Rainbow Blvd. Kansas City, KS 66160 (913) 588-6022 FAX: (913) 588-4060 Division Coordinator: Beth Lucasey, RN (913) 588-6022 Administrative Assistant: Connie Bennett, 913-588-6022 Endocrine/Diabetes/Osteoporosis/Genetics Clinics: Internal Medicine Clinic, 1st Floor University of Kansas Hospital Clinic Phone: (913) 588-3979 Educational Purpose: To understand the principles of evaluation and management of endocrine problems arising in both the outpatient and inpatient setting. This goal will be accomplished through a combination of faculty directed patient care activities and didactic learning experiences. Residents will gain experience in the spectrum of diabetes care from acute inpatient management to chronic preventive care, as well as the diagnosis and management of less common endocrine disorders. Teaching Methods: Conferences
  • 2. Endocrinology Journal Club: The third Wednesday of each month, located in the Cray Diabetes Center Conference room in the Endocrinology outpatient clinic. 12:00-1:00 pm. Articles are present for critical review by faculty and residents. Each resident will present one article during his or her rotation. The resident will receive assistance from a faculty member in choosing an appropriate article. Endocrinology Round Table: This conference includes the faculty of the University of Kansas School of Medicine and the University of Missouri-Kansas City School of Medicine as well as the Endocrinologist of the greater Kansas City area. Invited speakers present topics of significance in Endocrinology. Residents are encouraged to attend. Dinner is served. Clinical Case Conference: This conference takes place on the last Wednesday of each month in the Cray Diabetes Conference room, 12:00-1:00. The staff with discussion of diagnostic and management issues presents unusual and difficult cases. Endocrinology Core Curriculum: This conference occurs weekly with the residents, students and endocrinology fellows. Tuesday noon in the clinic conference room. Clinical cases are presented by the faculty in the various areas of Endocrinology. Discussion of diagnostic and management of various endocrinological areas are discussed. Endocrinology/Diabetes/Osteoporosis/Genetics Clinics: Endocrinology is primarily and outpatient subspecialty. There are clinics in each of these areas ongoing each morning and afternoon with the exception of Friday afternoon. The resident is expected to attend outpatient clinic each morning. Endocrinology consultation Service: The resident is expected to participate in in-hospital consultation rounds each afternoon. In general the resident will see the new consultation and then present the new consultation to the faculty. A discussion of the diagnostic and management issues regarding each case will follow. Outpatient Phone Consultation patient phone calls are discussed. Issues of diagnosis and management are reviewed with the resident. Clinical Responsibilities and Level of Resident Supervision: Residents are expected to participate in the teaching/learning experiences outlined below which include outpatient clinics, inpatient consultation service and didactic conferences. Residents are supervised by the attending physician, including discussion of the diagnosis and care plan for each patient evaluated by the resident, both in the inpatient and outpatient settings.
  • 3. Residents do not have in-hospital call responsibilities while on the Endocrinology service. Residents will be expected to participate in outpatient “beeper call” while on this service. Endocrinology is primarily an outpatient service. Learning the skill of assessment and management of patients calling by phone is a very important. These are primarily patients with diabetes mellitus. The number of calls is relatively minimal and unobtrusive. Residents are encouraged to review the calls and management with the faculty each day. The resident will be expected to round with the attending physician on the weekends with at least one day off of clinical responsibilities per week. Competency-Based Educational Goals and Objectives by Level of Training and Evaluation Methods: Medical Knowledge: PGY-1: • Use written and electronic reference and literature sources to learn about patients' endocrine disorders. • Be able to apply knowledge to patient care to begin to formulate a care plan. • Become familiar with the following areas of endocrinology: Diabetes Mellitus • Classification • Pathogenesis • Acute and Chronic Complications. • Management Thyroid Diseases • Hyper and hypothyroid disorders • Nodular thyroid disease • Thyroid Cancer • Goiter Pituitary disorders • Acromegaly • Cushing’s Disease • Prolactinoma • Non-functioning adenoma • Hypopituitarism • Diabetes Insipidus Adrenal Disorders • Hyperaldosteronism • Adrenal Cushing’s • CAH
  • 4. • Adrenal insufficiency • Adrenal Incidentaloma • Hirsuitism Gonadal Disorders • Testicular dysfunction • Ovararian failure • PCOD • Gonadal dysgenesis. Osteoprosis and metabolic bone diseases. • Interpretation of bone density testing • Evaluation for secondary causes of osteoporosis. • Treatment of osteoporosis. • Hyperparathyroidism • Diagnosis and treatment of Paget’s desease Neuroendocrine tumors • Insulinoma • Carcinoid tumor • MEN Syndrome PGY-2: All of the above, and: • Show increasing understanding of the above areas of endocrinology • Be aware of indications, contraindications and risks of commonly used medications in endocrinology. • Demonstrate knowledge of epidemiologic and social-behavioral sciences. • Apply the basic, clinical, epidemiologic and social behavioral science knowledge to the care of the patient • Successfully complete the required Internet-based training module for the rotation. PGY-3: All of the above, and: • Demonstrate advanced understanding of the above areas of endocrinology. • Demonstrate an investigatory and analytic approach to clinical situations. Evaluation Methods: Attending evaluation, Internet-based training module, chart-stimulated recall Patient Care: PGY-1: • Recognize limits in clinical experience and know when to ask for help. • Understand and weigh alternatives for diagnosis and treatment of common endocrine conditions. • Obtain a complete history. • Elicit common findings on physical examination. • Contribute to development and completion of management plans.
  • 5. PGY-2: All of the above, and: • Understand and weigh alternatives for diagnosis and treatment of less common endocrine conditions. • Use diagnostic procedures and therapies appropriately. • Elicit subtle findings on physical examination. • Obtain a precise, logical and efficient history. • Interpret results of procedures properly. • Be able to manage multiple problems at once. • Develop and carry out management plans. PGY-3: All of the above, and: • Reason well in ambiguous situations. • Spend time appropriate to the complexity of the problem. Evaluation Methods: Attending evaluation, mini-CEX, chart-stimulated recall Professionalism: PGY-1: • Establish trust with patients and staff. • Be honest, reliable, cooperative and accept responsibility. • Demonstrate respect, compassion and integrity. • Demonstrate sensitivity to patient culture, gender, age, preferences and disabilities. • Acknowledge errors and work to minimize them. PGY-2: All of the above, and: • Display initiative and leadership. • Be able to delegate responsibility to others. • Demonstrate commitment to ethical principles pertaining to the provision or withholding of care, patient confidentiality, informed consent and business practices. PGY-3: All of the above, and: • Demonstrate commitment to on-going professional development. Evaluation Methods: Attending evaluation with solicited feedback from other members of the care team, mini-CEX Systems-Based Practice: PGY-1: • Advocate for high quality patient care and assists vulnerable patients in dealing with system complexity.
  • 6. • Demonstrate ability to adapt to change. PGY-2: All of the above, and: • Apply knowledge of how to partner with health care team members, consultants, and primary care physicians to assess, coordinate and improve patient care. • Use systematic approaches to reduce errors. • Participate in developing ways to improve systems of practice and health management. PGY-3: All of the above, and: • Provide cost effective care. • Understand how individual practices affect other health care professionals, organizations and society. • Demonstrate knowledge of types of medical practice and delivery systems. • Practice effective allocation of health care resources that does not compromise the quality of care. Evaluation Methods: Attending evaluation Practice-Based Learning and Improvement: PGY-1: • Understand personal limitations of knowledge. • Show willingness to learn from mistakes. • Be self- motivated to acquire knowledge. • Accept feedback and develop self-improvement plans. • Understand the team approach to comprehensive diabetes management: o Certified Diabetes Educator o Dietician o Social Service o Economic Burden and available assistance PGY-2: All of the above, and: • Undertake self-evaluation with insight and initiative. • Facilitate the learning of students and other health care professionals. • Be able to access and apply multiple sources of information to practice evidence-based patient care. • Understand how to utilize computer tools to assure quality health care goals across the practice PGY-3: All of the above, and: • Analyze personal practice patterns systematically, and look for areas to improve.
  • 7. Evaluation Methods: Attending evaluation, performance on journal club presentation Interpersonal and Communication Skills: PGY-1: • Write pertinent and organized progress notes. • Use effective listening, narrative and non-verbal skills to elicit and provide information. • Work effectively as a member of the health care team. • Create and sustain therapeutic and ethically sound relationships with patients and families. PGY-2: All of the above, and: • Provide education and counseling to patients, families and colleagues. PGY-3: All of the above, and: • Be able to communicate with consultants and referring physicians with confidence and clarity. Evaluation Methods: Attending evaluation with solicited feedback from other members of the care team, mini-CEX, performance on journal club presentation Resources Up-to Date: provided by University of Kansas Medical Center William Textbook of Endocrinology –provided in Endocrinology Clinic Journal of Clinical Endocrinology –provided on line by KU Library Diabetes CARE: Provided on line by KU Library Literature search using Pub Med via KU Library for specific literature regarding patient related problems.
  • 8. Review of Goals and Objectives with Resident Block ______ Rotation_________________________________ Resident statement: The above goals and objectives were reviewed with me at the beginning of my rotation, and I understand the expectations for the rotation and how I will be evaluated. Resident Signature: ______________________________________________________ Printed Name: ______________________________________________________ Date: ______________________________________________________ Staff Signature: ______________________________________________________ I have discussed with my staff my need for a Mini-CEX during this block. 