Endocrine Fellowship Pediatric Rotation
Time
8:00 – 9:00 am
Monday
Morning Report
Clinics
8:00 – 12:00
Peds Endo Clinic
Tuesday
Endocrine Core
Conference
7:30 – 8:30
Endocrine Fellow
Clinic
12:00 – 1:00 pm
1:00 – 5:00
High Risk Pediatric
Diabetes Clinic
95th Street Clinic
Wednesday
IM Grand Rounds
Thursday
Morning Report
Friday
Pediatric Grand
Rounds
Type 2 DM Peds
Endo clinic
Type 1 DM Peds
Endo Clinic
Pediatric Endo
Conference
9:15-10:30
Diabetes Care
Committee 1st Wed
of the Month
Clinical Case Conf
2nd Wed of the
Month
Journal Club
3rd Wed of the
Month
3:00 – 4:00
Peds Endo Teaching
conference
Research
Conference
Weekly
“Healthy Hawk”
Peds Obesity Clinic
Endocrinology Fellowship Pediatric Rotation
Rotation Director:
James Lynn Casey, MD
Faculty:
James Lynn Casey, MD
Department of Pediatrics
University of Kansas
Leland Graves, III, MD
Leigh Eck, MD
Raj Bhattacharya, MD
David Robins, MD
Rudruidee Karnchanasorn, MD
Candice Rose, MD
Wayne Fowler, MD, PhD
Fellowship Coordinator:
Lanie Draper (913)-588-6841
Location:
University of Kansas Hospital Department of Pediatrics
University of Kansas Department of Internal Medicine
Duration:
1 month rotation during year one or year two.
Educational Goals:
1.
2.
3.
4.
5.
6.
To provide a comprehensive experience with the clinical features, diagnosis,
natural history, prevention and treatment of a broad range of pediatric
endocrine diseases in both the inpatient and outpatient setting.
Acquisition of a knowledge-base and cognitive skills to be an effective
consultant and practitioner of the discipline of Endocrinology
To acquire/maintain a professional demeanor, ethical standards and
humanistic qualities required to be an effective, respected physician
To provide education to others and develop life-long learning skills
Maintain skills in general internal medicine, learn skills that are unique to the
practice of pediatric medicine.
To produce a graduate who is competent, compassionate, and certifiable by
the ABIM in Endocrinology, Diabetes and Metabolism
Objectives:
1.
2.
3.
4.
5.
6.
Hands-on experience with history taking and examination of a large number
of cases representative of the specialty of Pediatric. Endocrinology and
Diabetes.
Analysis of the clinical clues and laboratory data to arrive at a differential
diagnosis.
Providing a plan for further evaluation and/or therapy.
Utilizing diagnostic and therapeutic modalities in the most cost-effective
manner.
Learn the pathogenesis, pathophysiology of a broad array of Pediatric
Endocrine diseases.
Understand the usefulness and limitations of diagnostic and therapeutic
modalities.
Methods:
1.
2.
3.
4.
5.
6.
Case based, small group interactive discussions
Problem-oriented reading
Role modeling by experienced faculty
Interactions with other housestaff and faculty
Case base conferences
Didactic lectures
Principle Teaching/learning Activities
Conferences
Endocrinology Journal Club (JC): The third Wednesday of each month, located in the
Cray Diabetes Center Conference room in the Endocrinology outpatient clinic. 12:001:00 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 (ERT): 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. Fellow are encouraged
to attend. Dinner is served. This conference is held 4-6 times per year.
Clinical Case Conference (CCC): This conference takes place on the first 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 (ECC): This conference occurs weekly with the
residents, students and endocrinology fellows. ECC is held on Tuesday mornings 7:30 –
8:30 am 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 Type 1 clinic, Diabetes Type 2 clinic, Healthy Hawk obesity
Clinic, High Risk Diabetes Clinic (EC): The fellow will actively participate in
outpatient clinics in pediatric endocrinology. These include type 1 diabetes clinic, type 2
diabetes clinic, high risk diabetes clinic, Endocrinology clinic and “Healthy Hawk”
obesity clinic. The times are listed on the pediatric endocrine calendar.
Endocrinology consultation Service (ECS): The fellow is expected to participate in inhospital 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 (OCS) patient phone calls are discussed. Issues of
diagnosis and management are reviewed with the resident.
There is no in hospital night or weekend call. The Endocrine fellow will participate in
weekend consultation rounds. When on call the fellow may be required to return to the
hospital to provide consultation. This occurs rarely. Fellows will be given and average
of one day off of all responsibilities per week. Home beeper call will not be counted
towards total duty hours (not to exceed 80 yours per week).
Educational Goals, Learning Activities and Evaluation Tools by Competency
Legend for learning activities: EC-Endocrinology outpatient clinics. ECSEndocrinology in-patient consultation service. ECC-endocrinology core curriculum.
CCC-clinical case conference. ERT- endocrine round table. EJ-endocrinology journal
club.
Legend for evaluation techniques: VE-verbal evaluation and mid and end rotation; miniCEX-mini Clinical Evaluation Exercise; SE-self-evaluation, WE-written examination.
NCE- Nurse Clinician Evaluation
1st Year Fellow
CORE COMPETENCY: PATIENT CARE
Goal: Develop and demonstrate expertise in consultation and assessment care management of
endocrinology pediatric patients.
Objectives:
Learning
Evaluation
Activities
Tools
Perform efficient, focused interview and physical
EC, ECS
VE, miniexamination
CEX
Diagnosed and initiate treatment
EC, ECS, OPC, CCC,
VE, mini-
Provide appropriate follow-up
ERT, JC,
EC, ECS,
CEX
VE
CORE COMPETENCY: MEDICAL KNOWLEDGE
Goal: : Demonstrate knowledge and competency in understanding disease process, diagnosing
treating various common endocrine diseases
Objectives:
Learning
Evaluation
Activities
Tools
Beginning competency to diagnose and treat the
EC, ECS, JC, CCC,
VE, WE
follow diseases:
ERT, OCS
Diabetes Mellitus
 Classification
 Pathogenesis
 Acute and Chronic Complications.
Management
 Type 1 diabetes in pediatric population
 Type 2 diabetes in the pediatric population
 Insulin pump management in pediatrics
Nutritional disorders in Pediatrics
 Anorexia
 Bulimia
 Obesity
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
 Growth hormone deficiency
Disorders of Short Stature
Adrenal Disorders
 Hyperaldosteronism
 Adrenal Cushing’s
 CAH
 Adrenal insufficiency
 Adrenal Incidentaloma
Gonadal Disorders
 Testicular dysfunction
 Ovararian failure
 PCOD
 Gonadal dysgenesis.
 Precocious Puberty
 Delayed Puberty
Neuroendocrine tumors
 Carcinoid tumor
 MEN Syndrome

CORE COMPETENCY: PRACTICE BASED LEARNING AND IMPROVEMENT
Goal:
Learn to investigate and evaluate personal patient care practices, appraise and assimilate
scientific evidence related to endocrinology, and improve personal patient care practices.
Objectives:
Identify gaps in knowledge
Develop evidence-based strategies for filling in
knowledge gaps
Learning
Activities
EC, ECS, CCC,
EC, ECS, JC,
Evaluation
Methods
VE, WE, SE
VE, WE, SE
CORE COMPETENCY: INTERPERSONAL AND COMMUNICATION SKILLS
Goal:
Demonstrate interpersonal and communication skills in medical practice that develop and
maintain effective information exchange and collaboration with endocrinology pediatric
patients and family members as well as other professional associates
Objectives:
Learning
Evaluation
Activities
Methods
Exhibits compassion towards patients
EC, ECS
VE, mini-CEX, SE
Listens well to patients and family
Explains treatment plans, rationale, and risks and
benefits to patients in understandable language
Concludes patient visits by asking if the patient or
family has any questions
Facilitates effective patient care by communicating
patient issues and treatment recommendations to
colleagues, nursing, and ancillary staff
Writes notes and signs name legibly.
CORE COMPETENCY: PROFESSIONALISM
Goal:
Demonstrate commitment to carrying out professional responsibilities, adherence to ethical
principles, and sensitivity to a diverse endocrinology pediatric patient population
Objectives:
Learning
Evaluation
Activities
Methods
Behave professionally toward patients, families,
EC, ECR,
VE, SE, NCE
colleagues and all members of the healthcare team
CORE COMPETENCY: SYSTEM BASED PRACTICE
Goal:
Demonstrate an awareness of and responsiveness to the larger context and system of health
care and the ability to effectively call on system resources to provide care in that is of optimal
value to their endocrinology patients.
Objectives:
Learning
Evaluation
Activities
Methods
Understanding the team approach to comprehensive
EC, ECS, CCC,
VE, WE
diabetes management
JC
Participation in
 Certified Diabetes Educator
Diabetes Care
 Dietician
Committee
 Social Service
 Economic Burden and available assistance..
Understanding how to utilize computer tools to assure
quality health care goals across the practice
(Areas in Bold have special emphasis in the pediatric rotation)
2nd Year Fellow
CORE COMPETENCY: PATIENT CARE
Goal: Demonstrate continued and proficient expertise in consultation and assessment care
management of endocrinology pediatric patients.
Objectives:
Learning
Evaluation
Activities
Tools
Perform efficient, focused interview and physical
EC, ECS
VE, miniexamination
CEX
Diagnosed and initiate treatment
EC, ECS, OPC, CCC,
VE, miniERT, JC,
CEX
Provide appropriate follow-up
EC, ECS,
VE
CORE COMPETENCY: MEDICAL KNOWLEDGE
Goal: : Demonstrate continued knowledge and competency in understanding and teaching
disease process, diagnosis and treatment of various common endocrine diseases
Objectives:
Learning
Evaluation
Activities
Tools
Continued competency to diagnose and treat the
EC, ECS, JC, CCC,
VE, WE
follow diseases:
ERT, OCS
Diabetes Mellitus
 Classification
 Pathogenesis
 Acute and Chronic Complications.
Management
 Type 1 diabetes in pediatric population
 Type 2 diabetes in the pediatric population
 Insulin pump management in pediatrics
Nutritional disorders in Pediatrics
 Anorexia
 Bulimia
 Obesity
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
 Growth hormone deficiency
Disorders of Short Stature
Adrenal Disorders
 Hyperaldosteronism
 Adrenal Cushing’s
 CAH
 Adrenal insufficiency
 Adrenal Incidentaloma
Gonadal Disorders
 Testicular dysfunction
 Ovararian failure
 PCOD
 Gonadal dysgenesis.
 Precocious Puberty
 Delayed Puberty
Neuroendocrine tumors
 Carcinoid tumor
 MEN Syndrome
CORE COMPETENCY: PRACTICE BASED LEARNING AND IMPROVEMENT
Goal:
Demonstrate competency in ability to investigate and evaluate personal patient care practices,
appraise and assimilate scientific evidence related to endocrinology, and improve personal
patient care practices.
Objectives:
Identify gaps in knowledge
Develop evidence-based strategies for filling in
knowledge gaps
Learning
Activities
EC, ECS, CCC,
EC, ECS, JC,
Evaluation
Methods
VE, WE, SE
VE, WE, SE
CORE COMPETENCY: INTERPERSONAL AND COMMUNICATION SKILLS
Goal:
Demonstrate continued competent interpersonal and communication skills in medical practice
that develop and maintain effective information exchange and collaboration with endocrinology
pediatric patients and family members as well as other professional associates
Objectives:
Learning
Evaluation
Activities
Methods
Exhibits compassion towards patients
EC, ECS
VE, miniCEX, SE
Listens well to patients and family
Explains treatment plans, rationale, and risks and
benefits to patients in understandable language
Concludes patient visits by asking if the patient or
family has any questions
Facilitates effective patient care by communicating
patient issues and treatment recommendations to
colleagues, nursing, and ancillary staff
Writes notes and signs name legibly.
CORE COMPETENCY: PROFESSIONALISM
Goal:
Demonstrate commitment to carrying out and teach professional responsibilities, adherence to
ethical principles, and sensitivity to a diverse endocrinology pediatric patient population
Objectives:
Learning
Evaluation
Activities
Methods
Behave professionally toward patients, families,
EC, ECR,
VE, SE,
colleagues and all members of the healthcare team
NCE
CORE COMPETENCY: SYSTEM BASED PRACTICE
Goal:
Demonstrate continued competent ability and teaching approach to increase an awareness of
and responsiveness to the larger context and system of health care and the ability to effectively
call on system resources to provide care in that is of optimal value to their endocrinology
patients.
Objectives:
Learning
Evaluation
Activities
Methods
Understanding the team approach to comprehensive
EC, ECS, CCC, JC
VE, WE
diabetes management including:
Participation in
Diabetes Care
 Certified Diabetes Educator
Committee
 Dietician
 Social Service
 Economic Burden and available assistance..
Understanding how to utilize computer tools to assure
quality health care goals across the practice
(Areas in Bold have special emphasis in the pediatric rotation)
Resources:
Up-to Date: Provided by the University of Kansas Medical Center, On Line
William’s Text book of Endocrinology: Provided by the Endocrine division
Important Endocrine Journals available on line to the Fellows:
Journal of Clinical Endocrinology and Metabolism
Diabetes
Diabetes CARE
Journal of Bone and Mineral Research
New England Journal of Medicine
JAMA
Evaluation:
The fellow will receive verbal and written evaluation by the faculty responsible for the
consultative service at the completion of each month. The faculty responsible for the
evaluation will utilize input from all faculty involved in the rotation that month.