Program Requirements for Residency Education in Pediatric ...
1 Program Requirements for Residency Education in Pediatric Endocrinology
4 A. Scope of Training
5 1. Pediatric endocrinology programs must provide fellows with the ability
6 background to diagnose and manage endocrine diseases and to understand
7 the physiology of hormonal regulation in infancy, childhood, adolescence,
8 and young adulthood.
9 2. The program must emphasize fundamentals of clinical diagnosis, with
10 special emphasis on history taking, physical examination, and
11 interpretation of pertinent laboratory data.
12 VIII. Program Personnel and Resources
13 A. Faculty
14 1. Pediatric Endocrinology Specialists
15 A program must have at least two qualified pediatric endocrinologists,
16 inclusive of the program director. and ensure access to the full range of
17 pediatric subspecialists.
18 2. Other Physician Teaching and Consultant Faculty
19 In addition, The following physician faculty from other disciplines
20 appropriate consultant faculty and staff must be available: in related
21 disciplines, including surgery, obstetrics/gynecology, internal medicine,
22 child and adolescent psychiatry, nephrology, child neurology, as well as
23 the following physician faculty with significant experience in pediatrics:
24 surgery, neurosurgery, radiology, nuclear medicine, ophthalmology,
25 urology, and genetics. and diabetes education.
26 B. Facilities Resources
27 1. Outpatient and Inpatient Facilities
28 Facilities should include space in an ambulatory setting for optimal
29 evaluation and care of outpatients and an inpatient area with a full array of
30 pediatric and related services staffed by pediatric residents and faculty.
31 2. Laboratory/Support Services
32 Modern Facilities and services, including inpatient, ambulatory care, and
33 laboratory and comprehensive diagnostic imaging resources, must be
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34 available and functioning. Specifically, a complete chemistry laboratory;
35 facilities for radioimmunoassay and karyotyping; nuclear, ultrasonic, and
36 radiologic imaging services that can conduct studies for all types of
37 endocrine disease; There must be a diabetes education service; a
38 nutrition/dietary education service; mental health services; endocrine
39 surgical services; and a pathology laboratory for the interpretations of
40 surgical and cytologic specimens, including immunohistologic studies. In
41 addition, there should be a close working relationship with dietary and/or
42 nutrition services. There must be the capacity for specialized hormone
43 measurements and genetic testing relevant to endocrine disorders either on
44 site or through established commercial laboratories.
45 3. Patient Population
46 There must be an adequate number of patients with endocrine disorders,
47 including diabetes, who range in age from newborn through young
48 adulthood, must be available to the training program to ensure that each
49 fellow achieves competence in patient care.
50 IX. Educational Program
51 A. Patient Care
52 1. Fellows must have a sufficiently diversified and complex endocrine
53 outpatient experience and adequate experience with inpatient
54 management. In particular, the pediatric endocrinology fellows must have
55 continuing responsibility for longitudinal care of patients with diabetes
56 mellitus and other chronic endocrine disorders.
57 2. Fellows must learn through patient care about normal and abnormal
58 hormonal regulation. The interaction of endocrine pathology and
59 psychosocial problems must be addressed.
60 3. The clinical experience must include, but not be limited to, the following:
61 a) Short stature, including constitutional delay Disorders of growth
62 b) Disorders of anterior pituitary hormone physiology, including
63 growth hormone deficiency
64 c) Disorders of posterior pituitary hormone physiology, including
65 diabetes insipidus
66 d) Disorders of hypothalamic hormonal regulation
67 e) Disorders of thyroid hormone physiology
68 f) Diagnosis and management of Endocrine neoplasia
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69 g) Disorders of the adrenal gland physiology
70 h) Disorders of androgen and estrogen physiology metabolism,
71 including adolescent reproductive endocrinology
72 i) Disorders of sexual differentiation and development
73 j) Disorders of parathyroid gland physiology
74 k) Disorders of calcium, phosphorus, and vitamin D
75 l) Disorders of bone physiology metabolism
76 m) Disorders of fluid and electrolyte balance
77 n) Disorders of carbohydrate metabolism, including diabetes mellitus
78 and hypoglycemia
79 o) Disorders of nutrition, including eating disorders
80 p) Obesity including obesity related endocrine disorders (e.g.
81 polycystic ovarian syndrome, impaired glucose tolerance,
82 metabolic syndrome and type 2 diabetes)
83 4. Laboratory Experience
84 The residents must be instructed in the proper use of laboratory techniques
85 for measurement of hormones in body fluids. They must be taught to
86 recognize the limitations and pitfalls of interpretation of laboratory results.
87 All residents should be instructed in proper interpretation of endocrine
88 stimulation and suppression tests, including the normal variations that
89 occur in laboratory results at different ages and times of day. Residents
90 should be provided with a background that will enable them to utilize
91 current diagnostic procedures of endocrinology that involve radiology,
92 including ultrasonography, CT scanning and MRI, and nuclear medicine.
93 B. Medical Knowledge
94 1. Fellows must have instruction in: related clinical and basic sciences. These
95 include endocrine physiology, pathology, immunology, and biochemistry,
96 pharmacology; and embryology of endocrine and related systems
97 including with emphasis on sexual differentiation; genetics, including
98 laboratory methods, cytogenetics, and enzymology; and aspects of
99 immunology pertinent to understanding endocrine disease and the use of
101 2. The fellows must understand the principles of laboratory techniques for
102 measurements of hormones. Fellows must be instructed in interpreting
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103 endocrine laboratory results including stimulation and suppression tests.
104 Fellows should be provided with a background that will enable them to
105 choose the most appropriate imaging procedure(s) for a given endocrine
107 3. In addition, regular conferences reviewing patient management must be
108 scheduled and attendance required of the subspecialty residents.
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