Endocrinology  Core Competency Curriculum

 

 

Program:                        Internal Medicine, Sinai-Grace

                                          Detroit Medical Center/Wayne State University

 

Program Director:        Mohamed S. Siddique M.D. 

 

Specialty / Course:      Endocrinology Rotation PGY 2/3

 

Curriculum Coordinators:     1. Gary W Edelsen, MD

                                                      2. Opada Al-Zohaili, MD

 

Date:                                April 2007

 

 

 

 

Competency

 

Objectives

Specific

 

Educational Experiences

Knowledge/ Skills

Integration/Application

 

 

Assessment

Tools

 

 

Patient Care

That is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

 

  1. Learner based and not teacher based education.
  2. Learners should be able to examine patients efficiently and accurately
  3. Learner should learn how to evaluate, work-up and treat common endocrinological problems under supervision of board certified endocrinologists.

 

 

  1. Ambulatory Endocrinology clinic training
  2. In-patient endocrinology consultations

 

 

  1. Mid & End of rotation evaluation by attending
  2. Mini-CEX (ABIM)#
  3. Evaluation by attending of residents knowledge & clinical skills during rotation

 

 

 

 

 

 

 

Medical Knowledge

About established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care

 

  1. Learn patho-physiology, clinical presentation, lab & radiographic evaluation and management of important endocrinological problems.
  2. Commitment to continuous learning
  3. Demonstrate analytical thinking
  4. Learn management of endocrinological emergencies.

 

  1. Topic based didactic lectures.
  2. Case based discussions to include endocrinological disorders.

 

 

  1. Pre and post test on endocrinology.
  2. Attending’s evaluation of residents knowledge during rotation

 

 

 

 

 

 

Interpersonal and Communication Skills

That result in effective information exchange and teaming with patients, their families, and other health professionals

 

  1. Communicate effectively with attending faculty
  2. Demonstrate effective patient/family interviewing skills
  3. Establish excellent relationships with patients/families
  4. Able to educate and counsel patient/families
  5. Improve listening skills
  6. Able to maintain comprehensive, timely, legible medical records
  7. Prepare and present effective medical presentations to peers

 

  1. Ambulatory case discussions with attending.
  2. Peer-group discussion
  3. Interaction & communication with other health care personnel involved in patient care e.g. radiologist, pathologist, dietitian and social worker.

 

  1. Rounders evaluation thru direct observation and feedback by patients & ancillary staff.
  2. Mini-CEX (ABIM)

 

 

 

 

 

 

Professionalism

As manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

 

  1. Treat patient and families with respect and consideration
  2. Treat nursing and other health care professional with respect
  3. Understand issues of race, religion, sexual orientation, disability, age, culture, gender etc. in patients and other health care providers
  4. Always respect patients’ autonomy
  5. Serve the interest of the patients
  6. Maintain trust by managing conflicts of interest
  7. Always be honest with patients
  8. Always maintain patients’ confidentiality
  9. Strive to improve patients’ quality of care
  10. Maintain appropriate relations with patients

 

  1. Daily interaction with health care professionals
  2. Peer-group discussion
  3. Faculty Role modeling

 

 

  1. Rotation evaluation by rounder.
  2. ABIM Praise Cards and Early warning Cards
  3. Mini-CEX (ABIM)#

 

 

 

 

 

 

 

Practice-Based Learning and Improvement

That involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care

 

  1. Self directed learning to keep up with new developments in the management & changes in practice guidelines.
  2. Learn and demonstrate knowledge of scientific study design and statistical methods
  3. Learn to accept feedback from others
  4. Regularly self-assess
  5. Use information technology to manage information
  6. Facilitate learning of others

 

  1. Book: Users’ guides to the Medical Literature (JAMA)
  2. Self-directed inquiry
  3. Interactive computer programs

 

 

 

  1. Rotation evaluation by rounder

 

 

 

 

 

Systems-Based Practice

As manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value

 

  1. Practice cost-effective care
  2. Learn to minimize patient care errors
  3. Understand various types of health insurances and how it impacts patient care in both in-patient/out-patient settings i.e. LOS, UR and prescriptions
  4. Advocate for patients within the health care system

 

 

1. Ambulatory case discussions with attending.

 

 

  1. Rotation evaluation by attending

 

 

                                                                               

 


Common Clinical Endocrinological Diseases To be Covered During Rotation:


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.

 

 

Endocrine Emergencies:


Diabetic ketoacidosis
Hyponatremia
Hypernatremia
Hyperosmolar coma
Adrenal crisis
Thyroid storm
Hypoglycemia

 

Resource Materials

 

Recommended Books:

 

1. Wiiliams Textbook of Endocrinology.

2. AMA Guidelines on Management of Diabetic Complications

3. Harrison’s textbook of Internal Medicine

4. MKSAP 12

 

Relevant Practice Guidelines: Available at www.guidelines.gov

 

1.     Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002 Jan;25(Suppl 1):S50-60. [7 references]

2.     New Zealand Guidelines Group. Primary care guidelines for the management of core aspects of diabetes care. Wellington (NZ): New Zealand Guidelines Group (NZGG); 2000 Jun. 19 p. [41 references]

3.     Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2002 Jan;25(Suppl 1):S5-20. [143 references]

4.     Preconception care of women with diabetes. Diabetes Care 2003 Jan;26 Suppl 1:S91-3. [2 references]

5.     Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, Wall BM. Hyperglycemic crises in patients with diabetes mellitus. Diabetes Care 2003 Jan;26 Suppl 1:S109-17. [38 references]

6.     Diabetic nephropathy. Diabetes Care 2002 Jan;25(Suppl 1):S85-S89. [15 references]

7.     Diabetic retinopathy. Diabetes Care 2002 Jan;25(Suppl 1):S90-3. [1 reference]

8.     Management of dyslipidemia in adults with diabetes. Diabetes Care 2002 Jan;25(Suppl 1):S74-S77. [12 references]

9.     AACE Thyroid Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract 2002 Nov-Dec;8(6):457-69. [46 references]

10. National Academy of Clinical Biochemistry (NACB). NACB: laboratory support for the diagnosis and monitoring of thyroid disease. Washington (DC): National Academy of Clinical Biochemistry (NACB); 2002. 125 p. [495 references]

11. AACE Hypogonadism Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hypogonadism in adult male patients--2002 update. Endocr Pract 2002 Nov-Dec;8(6):439-56. [77 references]

12. Brigham and Women's Hospital. Osteoporosis. Guide to prevention, diagnosis, and treatment. Boston (MA): Brigham and Women's Hospital; 2001. 11 p. [13 references]

13. American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE). AACE/ACE position statement on the prevention, diagnosis and treatment of obesity (1998 revision). Jacksonville (FL): American Association of Clinical Endocrinologists; 1998. 35 p. [270 references]

 

Web Based Resources:

American Association of Endocrinology: www.aace.com

American Diabetes Association: www.diabetes.org

American Thyroid Association: www.thyroid.org

Diabetes & Endocrinology practice guidelines: www.medscape.com/pages/editorial/public/ pguidelines/index-diabetes –