VCU Internal Medicine Training Program
Endocrinology & Metabolism Curriculum
Revision Date: September 19, 2007
Revised by: David F. Gardner, MD
Purpose
Learning Objectives
How Learning Objectives are Met
Required Reading/Resources
Expectations
Evaluation
Contact
Resident Schedule
Printable version of the curriculum (pdf)
Purpose:
- To provide internal medicine residents with a basic foundation in the evaluation and treatment of patients with endocrine disorders in the outpatient and inpatient settings
- To understand the use of screening tests in the evaluation and diagnosis of endocrine disorders
- To understand the basic pathophysiology of common endocrine disorders
- To understand appropriate management of inpatients and outpatients with diabetes
Learning Objectives
At the end of the rotation, residents will be able to:
- Patient Care:
- Obtain a thorough, targeted endocrine history and physical exam
- Convey history and physical exam findings in a written and verbal format
- Have a basic knowledge of the typical history and physical findings encountered in the evaluation of suspected endocrine disorders
- Understand and utilize appropriate screening tests in the initial evaluation of patients with suspected endocrine disorders
- Understand and utilize appropriately definitive diagnostic studies to confirm an endocrine disorder
- Develop a basic treatment plan for common endocrine disorders
- Medical Knowledge:
- Understand the basic pathophysiology of common endocrine disorders
- Develop a thorough differential diagnosis of common endocrine symptoms
- Understand the basic clinical manifestations of the spectrum of endocrine disorders seen in clinical practice:
- Adrenal disorders
- Cushing's syndrome
- Addison's disease
- pheochromocytoma
- Diabetes mellitus
- Type 1 and 2 diabetes
- diabetic ketoacidosis
- diabetic complications
- Hypoglycemic disorders
- Lipid disorders
- Metabolic bone disease/calcium disorders
- osteoporosis
- Paget's disease
- hypercalcemia
- hypocalcemia
- Pituitary disorders
- pituitary tumors (prolactinomas, acromegaly, hypopituitarism, diabetes insipidus)
- Reproductive/gonadal disorders
- galactorrhea
- gynecomastia
- hirsutism and virilization
- polycystic ovary disease
- male hypogonadism
- Thyroid disorders
- hyperthyroidism
- hypothyroidism
- thyroid enlargement (goiters and nodules)
- Adrenal disorders
- Practice-Based Learning and Improvement:
- Use available electronic and library resources to direct timely and appropriate
diagnostic evaluations and treatment plans - Evaluate and target areas for self-improvement
- Interview and examine patients in a timely manner
- Interpersonal and Communication Skills:
- Communicate effectively and respectfully with referring physicians, patients, families, staff, and colleagues using both written and verbal formats
- Contact fellow and/or attending physician in a timely fashion and summarize appropriate information
- Professionalism:
- Demonstrate compassion and respect towards patients and their families and all members of the health care system
- Maintain the professional code of conduct
- Provide informed consent as appropriate for procedures
- Maintain patient confidentiality at all times
- Systems-Based Practice:
- Understand available medical resources to effectively manage patients and provide continuity of care
- Understand the practice of endocrinology in both inpatient and outpatient settings
- Learn to work in a complex environment with multiple clinicians providing care for individual patients
- Appreciate the appropriate role of a consultant in the inpatient and outpatient settings
How Learning Objectives are met:
- Participate in four Veterans Administration Hospital Clinics and two MCVH Clinic per week Attendance at these clinics is mandatory unless precluded by resident's primary care clinic or vacation.
- See "Resident Schedule"
- Participate on inpatient endocrine consult rounds every afternoon at MCVH. This will be primarily an educational experience rather than a service obligation, as it is unlikely that residents will have the opportunity to primarily evaluate patients because of morning outpatient clinic responsibilities.
- Each month, for ONE week only, one of the residents on the Endocrine Consult Service will be designated as the "consult resident" and will work closely with the MCV fellow in the evaluation and management of inpatients with endocrine disorders.
- The resident assigned this responsibility will be notified by the MCV consult fellow regarding this responsibility and will not attend the morning VA Clinics for that week.
- It is anticipated that this inpatient consult experience will enhance the resident's ability to manage inpatients with diabetes, although consultations will not be limited to diabetic patients.
- Attend case-based conferences at the VA Hospital and MCVH following clinic sessions and Endocrine Grand Rounds Thursday afternoons
Required Reading/Resources:
- Larsen: Williams Textbook of Endocrinology, 10th ed, 2003. (11th edition to be published in November, 2007).
- UpToDate - Provides excellent overviews of most clinical endocrine topics.
Expectations:
- Attendance at all clinics and daily inpatient consultation rounds
- Attendance at all conferences summarized above
- Attendance at core Internal Medicine Conferences
- Literature searches and textbook reading (including UpToDate) on selected cases
- Professional behavior towards patients, staff, students and physician colleagues
Evaluation:
- Residents will be evaluated by the supervising medical admitting attendings on www.newinnov.com
- Residents will evaluate supervising attendings on www.newinnov.com
Contact:
On first day of rotation, contact one of the Endocrine fellow on call for orientation as to location and timing of various clinics.
- Contact Endocrine Office, 828-9696, to identify fellow assigned for the month
- Dr. David Gardner, 828-9696, pager 3105
Resident schedule:
- Endocrinology Clinics
Day/Time Clinic Monday AM VA Lipid Clinic (Dr. Zieve) Tuesday AM VA General Endocrine Clinic Wednesday AM MCV Endocrine/Diabetes Clinic Thursday AM VA Diabetes Clinic (Dr. Zieve) Thursday PM MCV Inmate Endocrine Clinic
(1st and 3rd Thursday of each month)Friday AM VA Metabolic Bone Disease Clinic
-
Endocrine Consult Rounds
- Conferences
- Following each clinic sessions at the VA and MCV, there is a case-based conference attended by students, residents, fellows, and faculty. Attendance at these conferences is required.
- Prior to the Wednesday morning MCV Endocrine/Diabetes Clinic there is a half-hour conference on general endocrine topics for M-III students. Residents are welcome to attend this conference, although it is understood that it may conflict with Morning Report, so attendance is not mandatory.
- Endocrine Grand Rounds - Thursday afternoons at 4:30pm at MCV, except for the last Thursday of each month when the conference is held at the VA. This conference is suspended for the summer months and restarts after Labor Day.
