Course/Rotation Title:
ENDOCRINOLOGY
Date of Last Review/Update
3/07
Course/Rotation Director: Bruce Shickmanter / Anna Kozupa
Location of clinical encounters
Inpatient % time = <5%
(Check all that apply)
[X]
Wards
[X]
ICU
[ ]
ED
Outpatient% time = >95%
(Check all that apply)
[X]
Clinic
[ ]
Home
Course/Rotation description with educational purpose/value
The goal of this rotation is to prepare future general internists with the skills and knowledge to
appropriately evaluate, treat, and refer in a timely fashion patients with Endocrine disease.
Because the majority of Residents are exposed to acute Endocrine issues as part of their Ward
Rotation and because the majority of Endocrine consults occur in the outpatient setting this
rotation has been designed to be almost exclusively outpatient.
Types of Clinical Encounters
Outpatient Endocrine consults
Outpatient Endocrine follow up visits
Occasional ED consult
Occasional Inpatient consults or follow up (if case offers significant learning opportunity)
Types of Patients
[X]
[X]
[X]
Adults of all ages
Male
Female
Mix of Diseases: (PLEASE SPECIFY ANY ADDITIONAL DISEASES
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Insulin-dependent, non-insulin-dependent diabetic patients
Gestational diabetes mellitus
Hypo- and Hypercalcemia
Primary/Secondary Amenorrhea
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Hirsutism
Impotence
Abnormal sexual maturation
Adrenal Insufficiency
Cushing’s Syndrome
Pituitary Tumor/Water Imbalance/Hypopituitarism
Hypo/Hyperthyroidism
Secondary Hypertension
Types of Procedures
None
Describe the level of supervision by faculty
[X]
[X]
[X]
[ ]
Attending staff will supervise and precept all patient care activity directly or indirectly.
Attending staff will provide mid rotation feedback
Attending staff will provide end-of-rotation feedback
Other (please specify)
Competency Based Objectives/Expectations. Please see Roman Numeral II with additional
items specific to this rotation as below:
Patient Care
 How to evaluate and treat patients with insulin-dependent, non-insulin-dependent, and
gestational diabetes mellitus, and common complications. (This also falls under
competency of medical knowledge).
 Initiate appropriate diagnostic studies and therapeutic measures for thyroid problems and
know when to involve an endocrinologist. (This also falls under competencies of systembased practices and interpersonal communication skills).
 Be able to manage hypo- and hypercalcemia and order appropriate diagnostic studies.
(This also falls under competency of medical knowledge).
 Initiate evaluation for primary or secondary amenorrhea, hirsutism, impotence, and
abnormal sexual maturation. (This also falls under competency of medical knowledge).
 Evaluation of patients for adrenal insufficiency and Cushing’s syndrome. (This also falls
under competency of medical knowledge).
 Critically evaluate studies useful for the diagnosis of pituitary tumor/water
imbalance/hypopituitarism. (This also falls under competency of medical knowledge).
 Palpation of thyroid and assessment of signs of hypo- and hyperthyroidism.
 Physical examination of the diabetic patient.
 Interpret endocrine function testing/thyroid scans/bone densitometry. (This also falls
under competency of medical knowledge).
 Review all pathology specimens and x-ray studies on their patients, interpretation of bone
density studies
 See office patients Participate in outpatient endocrine assessment
 Perform inpatient consults Inpatient assessment and follow-ups
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Medical Knowledge
 Know when to order thyroid scans/RAIU, refer for fine needle aspiration, order bone
densitometry. (This also falls under competency of system-based practices).
 Attend departmental conferences
 See above under patient caree
Practice-Based Learning
 Present at Endocrine conference (This also falls under competency of practice-based
learning and improvement).
 See Roman Numeral II
Interpersonal and Communication Skills
 Diabetic Education session with Candace Lusa and patient. (This also falls under
competency of system-based practices).
 See Roman Numeral II
Professionalism
 See Roman Numeral II
System-Based Practice
 See Roman Numeral II
Check Any Methods Used For Teaching and Assessment:
[ ] Ambulatory Clinic (feedback written & verbal)
[ ] Annual In-service Exam (feedback written)
[ ] Attending Rounds (feedback written & verbal)
[ ] Board Review (feedback written examination)
[ ] Cancer Conference
[ ] Case Management Evaluation (360 degree written evaluation)
[x] Chart Stimulated Recall & Feedback (feedback verbal)
[x] Direct Observation and Feedback (feedback written & verbal)
[x] GME Core Curriculum
[ ] Interns Report (feedback written & verbal)
[ ] Journal Club (feedback written & verbal)
[x] Medical Record Review (feedback written & verbal)
[ ] Mentor Feedback (feedback written & verbal)
[x] Monthly End of Elective Exam (feedback written)
[x] Monthly Mini CEX (feedback written & verbal)
[x] Monthly Competency Based Written Evaluation
[ ] Morning Report (feedback written & verbal)
[ ] Multidisciplinary Rounds Feedback (feedback verbal)
[ ] Nursing Evaluation (360 degree written evaluation)
[ ] Patient Evaluation (360 degree written evaluation)
[ ] Patient Management Discussions (feedback written & verbal)
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[x] Procedure Logs
[ ] Performance improvement Multidisciplinary Morbidity and Mortality
(feedback written & verbal)
[ ] Semi Annual Program Director Feedback (feedback written & verbal)
[ ] Student Evaluation (feedback written & verbal)
[ ] Supervised Sign In Rounds (feedback written & verbal)
[ ] Supervised Sign-Out Rounds (feedback verbal)
[ ] Other _______________________________
[ ] Other _______________________________
[ ] Other _______________________________
[ ] Other _______________________________
Other Policies:
The Course Director recognizes that the trainee is accountable to all BMC Residency and GME
Personnel Policies and Procedures. The Course Director recognizes that the residents are
expected to attend all continuity clinics and mandatory educational conferences unless excused
by the Program Director or Chief Medical Resident with advanced notice.
Check The Educational Materials Used (beyond direct patient care):
[ ] Reading List (Please Specify):
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P. Felig, Textbook of Endocrinology and Metabolism.
L. DeGroot, Endocrinology.
C. Bardin, Current Therapy in Endocrinology & Metabolism.
Syllabus of Endocrine Review Course at MGH.
MKSAP, Endocrine section.
R. Sherwin and J. Olefsky, Diabetes Mellitus Management and Complications.
Braverman, The Thyroid.
[X] Review of Appropriate Radiology Images (Please Specify):
 Thyroid scans
 Bone desitometry
[X] Review of Appropriate Pathology (Please Specify):
 Thyroid biopsies
 Other biopsy material obtained during the roatation
[X] Review of Appropriate Laboratory Data (Please Specify):
 As appropriate to the care of patients
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