MPEU-4036 - Endocrinology MED/PEDS

MPEU-4036 - Endocrinology MED/PEDS

Elective Title: Endocrinology MED/PEDS
Course Number: MPEU-4036
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: Successful completion of Intl Med & Pediatric Clerkships; Please contact the Course Director 30 days in advance of the course to discuss scheduling. C-form is required
Responsible Faculty Director: Phillip Lee, MD & Kevin H. McKinney, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Other Faculty:
Location to Report on First Day:
Student should check with pediatric endocrinology office (Children's Hosp 3.270, x23365) prior to first day to confirm reporting location. See schedule info

Acquire knowledge and experience with diagnosis and management of common endocrine disorders in infants, children, adolescents and adults. Such conditions include diabetes mellitus (all types), hyper- and hypo-hyroidism, thyroid nodules, pituitary disorders, vitamin D and calcium disorders, adrenal disorders, and disorders of growth and pubertal development.

By the end of the elective period, the student should: 1. Be able to evaluate, diagnose and develop basic management plans for common endocrine disorders. 2. Be aware of similarities and differences between pediatric and adult patients with specific endocrine conditions in terms of diagnosis, management and documentation of care. 3. Recognize the importance of transitioning patients from pediatric to adult endocrine care.

Description of course activities
Students will attend pediatric or adult endocrinology and diabetes clinics each day according to a predetermined schedule. Patients will be independently evaluated and presented to the attending faculty and appropriate documentation will be generated and reviewed by the faculty. Students will also follow endocrine inpatients and consults as available with residents and fellows and discuss the cases with the faculty.Students will attend Grand Rounds and endocrinology conferences.

Type of students who would benefit from the course
Students planning on a Med-Peds residency and interested in gaining an understanding of endocrine disorders affecting pediatric and adult populations.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 8:00 5:00
Tuesday 8:00 5:00
Wednesday 8:00 5:00
Thursday 8:00 5:00
Friday 8:00 5:00

 Average number of patients seen per week: 35
 Call Schedule: N/A

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, endocrinology fellows.
  B. Frequency / Duration of Presentation(s)?
    10 to 20 minutes per patient, at least 2 patients per half-day clinic.
  C. Format - What guidelines are set for the student's presentation?
    Students are expected to present a complete history, physical exam, pertinent lab/study results and propose a management plan.
  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)?
    Students will record the history, physical, assessment, and treatment plan for each patient seen.
  B. Format - What guidelines are set for the student's written work?
    SOAP format is acceptable. H&P templates and other instructional materials may be provided.
  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?
    For selected cases, if relevant to the diagnosis and/or management plan and assigned by the faculty.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Faculty selected, case-relevant.
  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)?
    The student is expected to be present at 8am each morning and attend both morning and afternoon clinic sessions. Attendance is encouraged at endocrine educational conferences held on campus. The student is also encouraged to attend morning report, Grand Rounds, and noon conferences.

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 faculty in both pediatrics and internal medicine will complete standard evaluation forms, which will be compiled into one final evaluation form by the course director, Dr. Phillip Lee.

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.