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ROTATION AND ELECTIVE
Curriculum: Goals
and Objectives
Department of
Medicine
Harbor-UCLA
Medical Center
ENDOCRINOLOGY AND
METABOLISM (R2, R3)
Rotation and
Elective
A. The PURPOSE of
this rotation is to provide clinical experience with patients having
endocrine and metabolic problems in both the outpatient and inpatient
settings. At the conclusion of this rotation, residents will have gained
insight into the pathophysiology, diagnosis, natural history and management
of many common
endocrine and metabolic diseases. Aside from the general rotation described
below, the elective may be modified to accommodate: 1) residents who choose
to have a focused interest in one area of endocrinology; 2) wish to have a
tailored or individualized rotation content; and 3) with to have clinical or
basic research experiences. Specific areas of clinical research and basic
research in the Division include:
1) study of male
infertility and contraception;
2) study of
reproductive aging;
3) androgen
replacement therapy;
4) GH replacement
therapy;
5) inborn errors
of metabolism;
6) blood glucose
regulation;
7) lipid
disorders;
8) immune basis
of Grave’s ophthalopathy;
9) studies of
insulin secretory dysfunction;
10) genetics of
type II diabetes;
11) studies of
non diabetic hypoglycemia;
12) genetic basis
of diabetic nephropathy;
13) Pituitary dysfunction after
head trauma;
14) Kleinfelter syndrome;
15) regulations of
Spermatogenesis;
16) adult stem cell
transplantation into the testis.
This can be done
through discussion of specific goals with the Chief of Endocrinology or one
of the members of the Education Committee (Drs. Gianoukakis or Mao).
Both R2 and R3
residents may be assigned to the rotation. The Department of Medicine does
not distinguish R2 and R3 resident assignments on this rotation; both have
identical levels of responsibility for patient care, teaching, and medical
record documentation. There are no differences in patient assignment.
However, R3
residents are expected to display a greater degree of independence in
decision-making (under the supervision of the Attending Physician) than R2
residents.
B. GOALS AND
OBJECTIVES
1. Increased
understanding of common endocrine, reproductive, and metabolic disorders,
including recent advances at the molecular level.
2. Ability to
plan a comprehensive evaluation of an endocrine problems in a rapid, cost
efficient manner.
3. Ability to
accurately examine and describe normal and abnormal thyroid glands.
4. Increased
experience in the diagnosis and management of endocrine emergencies
including myxedema coma, thyroid storm, adrenal crisis, hyper- and
hypocalcemia, and DKA.
C. The CLINICAL
EXPERIENCE may include patients having:
1. Thyrotoxicosis
2. Thyroid
nodules, thyroid cancer
3. Hypothyroidism
4. Diabetes
mellitus
5. Hypocalcemia
and hypercalcemia
6. Hypoglycemia
7. Management of
morbid obesity
8. Differential
diagnosis of Cushing’s
9. Pituitary
tumors
10. Post
menopausal management including osteoporosis
11. Endocrine
causes of hypertension
12. Abnormalities
of salt and water metabolism
13. Reproductive
disorders: amennorhea, hypogonadism, erectile dysfunction, male factor
infertility, hirsutism, gynecomastia
D. The CLINICAL
SKILLS to be developed include:
1. Systematic
approach to thinking about endocrine problems.
2. Ability to
interpret the results of measurements of hormones in the blood and urine and
the responses to stimulation and suppression of the glands.
3. Appropriate
format for writing subspecialty consultations.
Curriculum: Goals
and Objectives Department of Medicine
Harbor-UCLA
Medical Center
E. Exposure to
the following endocrine PROCEDURES:
1. Interpretation
of thyroid function tests
2. Fine needle
thyroid aspiration and interpetation of the cytology
3. Nuclear
medicine diagnostic and therapeutic modalities as related to endocrine
disorders
4. Appropriate
use of intravenous insulin (insulin drip), rational use of the newer oral
antidiabetic agents
5. Performance
and interpretation of common endocrine tests including cotrosyn stimulation,
glucagon stimulation, and pituitary stimulation testing
F. EDUCATIONAL
RESOURCES available during this rotation include:
1. Daily work
rounds with fellow
2. Attending
rounds 4x/week
3. Weekly core
endocrine curriulum sessions
4. Weekly general
endocrinology clinic
5. Weekly
diabetes clinic which includes interaction with diabetes nurses educators,
ophthalmology, psychiatry, nephrology, and nutrition staff part of the
multidisciplinary approach to the management of diabetes in weekly diabetes
clinic
6. Bi-monthly
interdisciplinary pituitary clinic. Here, patients with pituitary/hypothlamic
tumors are evaluated from both the medical (endocrine) and surgical
perspectives
G. SUPERVISION
will be provided by:
1. Endocrinology
Fellow
2. Attending
physician of consult service
3. Full time
endocrine faculty in all clinics. Volunteer endocrine clinical faculty in
endocrine and diabetes clinics
(Endocrine and neurosurgical faculty in pituitary clinic).
H. EVALUATION of
performance will be provided by written evaluation by the Attending
Physician of the consult service. This evaluation takes into account
feedback from fellows and nursing staff. Residents in turn evaluate the
experience as a whole and the individual physicians they interact with in
both the consult service and outpatient clinics.
I. WHO might
ELECT this rotation
1. Residents who
appreciate an intellectual challenge and have an appreciation for the
importance of mechanism of disease.
2. Residents who
are interested in pursuing a career in primary care and who would like to
have a better handle on the intricacies of managing diabetes and thyroid
diseases (two very common endocrine diseases).
3. Residents who
want to explore the possibility of a career in this exciting, intellectually
gratifying yet undersubscribed field of Endocrinology and Metabolism.
revised
Endocrinology 10/98, revised 4/00
http://www.medsch.ucla.edu/som/ddo/harbor_med/endo.pdf
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