ENDOCRINOLOGY CURRICULUM

 

          To ensure that at the end of the residency training, each resident has had exposure to a wide variety of endocrine disorders through direct patient encounters and/or through didactic sessions.

 

Objectives:

 

Become familiar with the most common clinical endocrinology diseases, clinical emergencies in endocrinology & investigation issues current in clinical endocrinology.


Components of Familiarity:


Understand the pathophysiology, natural history & therapeutic interventions for common & uncommon endocrinology diseases.
Understanding of longitudinal clinical and laboratory evaluation &
understanding questions and issues that needs to be resolved.
Having access to appropriate text and serial literature

 

Specific Common Clinical Endocrinology Diseases:


Diabetes mellitus
Obesity
Thyroid disorders
Parathyroid disorders
Pituitary disorders of all trophic hormones
Hypothalamic disorders
Gonadal disorders
Impotence
Infertility
Genetic diseases
Metabolic bone disease
 Lipoprotein disorders
Adrenal disorders
Disorders of Calcium Metabolism

Paraneoplastic Endocrine Syndromes

PCOS

 

 

Endocrine Emergencies:


Diabetic ketoacidosis
Hyponatremia
Hypernatremia
Hyperosmolar coma
Adrenal crisis
Thyroid storm
Hypoglycemia

 

Skills:

Residents are expected to acquire following skills during their 4 week rotation:

1.    Clinical and communication skills - history including sexual and reproductive history. Examination of the endocrine system including recognition of the features of Cushing's syndrome, acromegaly, hypogonadism and hypopituitarism, hyper/hypothyroidism.

2.    Interpretation of basic endocrine function tests: thyroid function tests; bone profile; pituitary function tests; adrenal function tests; sex steroids.
Recognition of the importance of timing of the investigations (diurnal changes, phase of the
menstrual cycle).
Critical evaluation of data.

3.    Interpretation of imaging investigations:
   Pituitary
MRI / CT scan showing large pituitary tumours.
   DEXA scan interpretation  

4.    X rays showing osteopaenia, Paget's disease
  Abdominal CT
demonstration of adrenal pathology

Endocrinology Rotation Expectations:

 

1.    All patients assessed by the resident on the inpatient and outpatient services will be seen and discussed by the attending physician.

2.    The treatment plan should be outlined by the resident and discussed with and approved by the attending physician.

3.    Case discussions will include review of pertinent history and physical findings, appropriate laboratory investigations, health risk assessments and interactions between various disease states.

4.    Didactic lectures will be presented on a regular basis covering common and uncommon clinical endocrine problems.

5.    The resident is expected to read independently, reviewing basic physiology from medical and endocrinology texts and specific articles from journals, some of these being suggested by the attending.

 

Reference Books:

 

1. Williams Textbook of Endocrinology.

2. Harrison’s textbook of Internal Medicine, endocrine section, current edition

3. MKSAP, endocrine booklet, current edition

 

Articles and guidelines to read are suggested by the rotation coordinator Dr. Alzohaili based on current evidence. In addition, Dr. Alzohaili has developed easily understandable tables for various endocrine topics such as thyroid disorders, laboratory evaluation of thyroid disorders, amenorrhea, hirsutism, etc.

 

 

Rotation Schedule:

 

Residents can do the rotation with Dr. Alzohaili for the whole month, or the resident can do the rotation with Dr. Edelson and his group for 2 weeks, and Dr. Alzohaili for 2 weeks.

Residents generally do the rotation with Dr. Alzohaili only, if there is only one resident that month. If there are 2 residents, then the rotation is split between Drs. Alzohaili and Edelson, so there is only one resident in each location at any given time.

 

Endocrine with Dr. Alzohaili:

 

Monday: Consults, discussion and rounds and office hours.

 

Tuesday: Consults, discussion and rounds and office hours.

 

Wednesday: Endocrine grand rounds, University health centre endocrine clinic.

 

Thursday: Board review and office hours.

 

Friday: Consults, discussion and rounds and office hours.

 

Residents are also required to do their Primary Care Continuity Clinic one half day per week, according to schedule.

 

Endocrine with Dr. Edelson and associates:

Monday: Office hours with Dr. Edelson

 

Tuesday: Office hours with Dr. Edelson

 

Wednesday: Office hours with Dr. Schmeltz

 

Thursday: Board Review and office hours with Dr. Kaplan

Friday: Office hours with Dr. Edelson

 

Residents are also required to do their Primary Care Continuity Clinic per schedule.