MEDU-4009 - Clinical Endocrinology and Metabolism

MEDU-4009 - Clinical Endocrinology and Metabolism

Elective Title: Clinical Endocrinology and Metabolism
Course Number: MEDU-4009
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 3
Additional Requirements: A C-Form signed by Dr. McKinney or Dr. Belalcazar must be submitted to Enrollment Services 30 days in advance of the course.
Responsible Faculty Director: Kevin McKinney, MD or Maria Belalcazar, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Victoria Garcia & Kiki Baldwin Other Faculty: Wendy Pan, MD; Nisarg Shah, MD
Location to Report on First Day:
9C Team Room, Jennie Sealy Hospital

It is anticipated that the student will become familiar with all aspects (diagnostic and therapeutic) of common endocrine disorders. These include specifically diabetes mellitus, hyperthyroidism, hypothyroidism, thyroid nodule, pituitary tumor, hypercalcemia, osteoporosis, adrenal insufficiency and lipid disorders. Patient discussions and conferences will encourage critical evaluation of the medical literature.

1. The student will be able to elicit and evaluate history and physical examination findings of most common endocrinologic syndromes.
2. In particular, the student will be able to perform management of diabetes mellitus. The student will become familiar with the complications of diabetes including renal, neurologic, ophthalmologic, cardiovascular and other complications.

Description of course activities
1. Students will evaluate patients for endocrine consults. Fellows or residents will supervise them, and the cases will be seen and discussed by endocrine faculty.
2. Students will see patients in several of UTMB's Endocrinology clinics in the Primary Care Pavilion. Each case will be presented to and discussed with faculty.
3. Students are invited to attend a weekly endocrine conference presented by a faculty member or outside speaker, as well as a weekly endocrine clinical conference, in which interesting cases are discussed.

The clinical schedule information:
Students will be assigned to both inpatient and outpatient services in Galveston and at the Victory Lakes Town Center.

Type of students who would benefit from the course
Endocrinology is a subspecialty which deals with broad internal medicine problems. An endocrine rotation would be useful to any student entering a primary care specialty.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday Inpatient (9C- Jennie Sealy) Endo Clinic (PCP)
Tuesday Inpatient (9C-Jennie Sealy) Inpatient (9C-Jennie Sealy)
Wednesday Outpatient (VL) Outpatient (VL)
Thursday Endocrine Didactics Endo Clinic (PCP)
Friday Inpatient (9C-Jennie Sealy) Inpatient (9C-Jennie Sealy)
Saturday n/a n/a
Sunday n/a n/a

 Average number of patients seen per week: 10-15
 Call Schedule: No

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Nine half-days/week
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty, Fellows, Residents, other students
  B. Frequency / Duration of Presentation(s)?
    each patient encounter, and occasional special 10-minute topics
  C. Format - What guidelines are set for the student's presentation?
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Each patient encounter (daily notes, H&P's)
  B. Format - What guidelines are set for the student's written work?
    Standardized forms
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    To be punctual and attentive.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.
    The attending staff evaluates with advice from the fellows and residents.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.