MEDU-4043 - Clinical Endocrinology and Metabolism-Year 3

MEDU-4043 - Clinical Endocrinology and Metabolism-Year 3

Elective Title: Clinical Endocrinology and Metabolism-Year 3
Course Number: MEDU-4043
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: C-Form needed to enroll, send form to Kiki Baldwin.
Responsible Faculty Director: Kevin McKinney and Maria Belalcazar Periods Offered: 1-13 including holiday period 8 
Coordinator: Kiki Baldwin Other Faculty: Isra Ali, Wentong Pan, MD; Nisarg Shah, MD; Reba Varughese
Location to Report on First Day:
Jennie Sealy 10A, Victory Lakes, Stark Diabetes Center or other as instructed

To provide the third year medical students with the basic tools necessary for the diagnosis and management of common endocrine diseases.

1. To understand the basic physiopathology of common endocrine diseases
2. To learn how to perform an endocrine-focused history and physical exam
3. To become familiar with the differential diagnosis of major endocrine syndromes
4. To contribute to the diagnostic and therapeutic plan of a patient with endocrine disease

Description of course activities
1. Students will join the endocrinology consultation team and have the opportunity of eliciting a history and performing an endocrine-focused exam on patients admitted to the hospital with common endocrine diseases.
2. Students will participate in the discussion of cases seen in the consult service, with an opportunity to review the physiopathology, differential diagnosis and treatment plan for each of these cases.
3. Students will participate in the evaluation and follow-up of patients with common endocrinological diseases presenting to the outpatient clinic.
4. Students will attend weekly endocrine conferences during their rotation, including diabetes-related presentations sponsored by the Stark Diabetes Center, small group sessions by faculty members in the division and a combined journal club with pediatric endocrinology.

Type of students who would benefit from the course
The rotation will be particularly valuable to third year medical students with an interest in a primary care specialty. It will provide important medical concepts in the area of endocrinology to any interested student.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
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: 10-40 ( inpatient team based numbers for latter)
 Call Schedule: none

Research / Other Course 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?
  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
  B. Frequency / Duration of Presentation(s)?
  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)?
    One written H&P per week
  B. Format - What guidelines are set for the student's written work?
    Given at start of rotation
  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)?

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.
    Attending faculty will complete standard evaluation based on student's participation in the clinical and academic activities during the rotation.

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.