Gynecologic Endocrinology and Infertility Rotation Schedule
Time
8:00 – 9:00 am
Monday
Morning Report
Clinics
8:00 – 12:00
GYN Endo Clinic
12:00 – 1:00 pm
Diabetes Care
Committee 3rd Wed
of the Month
1:00 pm – 5:00 pm
OB-High Risk
Tuesday
IM Grand Rounds
Clinical Case Conf
4th Wed of the
Month
Journal Club
3rd Wed of the
Month
Endocrine Fellow
Clinic
Wednesday
IM Grand Rounds
Thyroid Tumor
Board 2nd Wed 7:00
AM
GYN Endo Clinic
Thursday
Morning Report
GYN Endo Clinic
Endocrine Fellow
Core Lecture Series
GYN Endo Clinic
Friday
Morning Report
GYN Endocrinology and Infertility Rotation
Rotation Director:
Linda Nelson, MD
Associate Professor of Obstetrics and Gynecology
University of Kansas, School of Medicine
Faculty:
Department of OB-GYN KU Medical Center
Leland Graves, III, MD
Leigh Eck, MD
Rajib Bhattacharya, MD
David Robins, MD
Rudruidee Karnchanasorn, MD
Candice Rose, MD
Wayne Fowler, MD, PhD
Fellowship Coordinator:
Location:
Lanie Draper (913)-588-6841
University of Kansas Hospital
Department of OB-GYN
University of Kansas Department of Internal Medicine
Duration:
One month block rotation in year one or two or the Endocrine Fellowship
Educational Goals:
1.
To provide a comprehensive experience with the clinical features, diagnosis,
natural history, prevention and treatment of disorders of reproduction.
2. Acquisition of a knowledge-base and cognitive skills to be an effective
consultant and practitioner of the discipline of Endocrinology
3. To acquire/maintain a professional demeanor, ethical standards and
humanistic qualities required to be an effective, respected physician
4. To provide education to others and develop life-long learning skills
5. Maintain skills in general internal medicine
6. To produce a graduate who is competent, compassionate, and certifiable by
the ABIM in Endocrinology, Diabetes and Metabolism
Objectives:
1.
2.
Hands-on experience with history taking and examination of a large number
of cases representative of the specialty GYN Endocrinology and Infertility as
well as general endocrinology.
Analysis of the clinical clues and laboratory data to arrive at a differential
diagnosis.
3.
4.
5.
6.
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 d diseases of
reproduction and reproductive health.
Understand the usefulness and limitations of diagnostic and therapeutic
modalities.
Methods:
1.
2.
3.
4.
5.
6.
7.
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
Patient management with supervision of faculty
Principle Teaching/learning Activities
Conferences
Endocrinology Journal Club (JC): The third Tuesday 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 last 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.
GYN Endocrine and Reproductive Clinics (GYN ENDO): These clinics will take
place under the direction and supervision of Dr. Linda Nelson in department of OB-GYN
at KU Medical Center. They will occur Tuesday mornings, Wed. mornings and all day
Thursday. Patient in seen in these clinics will include patients with menstrual
abnormalities, polycystic ovarian syndrome, and infertility disorders.
High Risk Obstetric clinic HROB: The fellow will participate in high risk obstetric
clinic with the emphasis on gestational diabetes recognition and management as well as
the management of pregnancy in the patient with previously diagnosed diabetes type 1 or
type 2. This clinic is a multidisciplinary clinic involving physicians, nurse educators, and
dieticians.
Outpatient Phone Consultation (OCS) patient phone calls are discussed. Issues of
diagnosis and management are reviewed with the fellow.
There is no in hospital night 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 patients.
Objectives:
Learning
Evaluation
Activities
Tools
Perform efficient, focused interview and physical
EC, ECS
VE
examination
Diagnosed and initiate treatment
EC, ECS, OPC, CCC,
VE,
ERT, JC,
Provide appropriate patient follow-up
EC, ECS,
VE
CORE COMPETENCY: MEDICAL KNOWLEDGE
Goal: : Demonstrate knowledge and competency in understanding disease process, diagnosing
treating various common endocrine diseases
Objectives:
Beginning competency to diagnose and treat the
follow diseases:
Thyroid Diseases
 Hyper and hypothyroid disorders
 Nodular thyroid disease
 Thyroid Cancer
 Goiter
Pituitary disorders
 Prolactinoma
 Non-functioning adenoma
 Hypopituitarism
Adrenal Disorders
 Hyperaldosteronism
 CAH
 Hirsuitism
Gonadal Disorders
 Testicular dysfunction
 Ovararian failure
 PCOD
 Gonadal dysgenesis.
 Primary and Secondary Amenorrhea
 Infertility
 Menopause
 Dysfunctional uterine bleeding
 Hirsuitism and virilization
 Male infertility
 Male hypogonadism
 Gynecomastia
Screening for Endocrinologic causes of infertility
 Use of semen analysis
 Testicular biopsy
 Anatomic evaluation of the female
reproductive tract.
Experience in
 Ovulation indection with clomiphene
 Gonadotropins
 GnRH
Review of the the techniques of
 Artificial insemination
 GIFT
 IVF
Learning
Activities
EC, ECS, JC, CCC,
ERT, OCS, GYN
ENDO
Evaluation
Tools
VE, WE
Diabetes in Pregnancy
 Diagnosis and management of gestational
diabetes
 Management of the patient with type 1
diabetes during pregnancy
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, ECR,
EC, ECR,
Evaluation
Methods
VE, SE, NCE
VE, SE, NCE
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 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
Explains treatment plans, rationale, and risks and
benefits to patients in understandable language
Concludes patient visits by asking if the patient 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 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 will be an emphasis of this rotation)
2nd Year Fellow
CORE COMPETENCY: PATIENT CARE
Goal: Demonstrate continued and proficient expertise in consultation and assessment care
management of endocrinology patients.
Objectives:
Learning
Evaluation
Activities
Tools
Perform efficient, focused interview and physical
EC, ECS
VE
examination
Diagnosed and initiate treatment
EC, ECS, OPC, CCC,
VE,
ERT, JC,
Provide appropriate patient 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, GYN
ENDO
Thyroid Diseases
 Hyper and hypothyroid disorders
 Nodular thyroid disease
 Thyroid Cancer
 Goiter
Pituitary disorders
 Prolactinoma
 Non-functioning adenoma
 Hypopituitarism
Adrenal Disorders
 Hyperaldosteronism
 CAH
 Hirsuitism
Gonadal Disorders
 Testicular dysfunction
 Ovararian failure
 PCOD
 Gonadal dysgenesis.
 Primary and Secondary Amenorrhea
 Infertility
 Menopause
 Dysfunctional uterine bleeding
 Hirsuitism and virilization
 Male infertility
 Male hypogonadism
 Gynecomastia
Screening for Endocrinologic causes of infertility
 Use of semen analysis
 Testicular biopsy
 Anatomic evaluation of the female
reproductive tract.
Experience in
 Ovulation indection with clomiphene
 Gonadotropins
 GnRH
Review of the the techniques of
 Artificial insemination
 GIFT
 IVF
Diabetes in Pregnancy
 Diagnosis and management of gestational
diabetes
 Management of the patient with type 1
diabetes during pregnancy
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, ECR,
EC, ECR,
Evaluation
Methods
VE, SE,
NCE
VE, SE,
NCE
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
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
Explains treatment plans, rationale, and risks and
benefits to patients in understandable language
Concludes patient visits by asking if the patient 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 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 will be an emphasis of this 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 receive input from all faculty involved in the rotation that month.