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CuRe Endocrinology and Metabolism Carmen Hurd UGME Course Leader May 14, 2013 Committee • • • • • • • • • • • Course Leader: Carmen Hurd Educational Coordinator: Suzanne Doyle Content expert: Pam Katz Diabetes education: Lori Berard Pediatrics: Brandy Wicklow/Liz Sellars Anatomy: Maria Vrontakis Physiology: ? Pathology: Michael Curtis Generalism: ? Residents/Students: Janice Ho (PGY 4) Longitudinal course leaders Current Endocrine Course • Strengths – Super awesome area of medicine! – Bone and calcium curriculum – Fits nicely with reproduction course – Good pediatric representation, sessions with allied health professionals, patients/families • Challenges – Some sessions outdated – Tutorial cases need work – Repetition/overlap – Too much anatomy/pathology, not enough physiology and clinical material – Lipids!!! How to teach? Who to teach? Where to teach (cardiology vs. endo) – Missing key topics: PCOS, obesity Endocrine: Essential skills, longitudinal and theme courses CP4 Skills Diabetes - Obesity Insulin Adjustment Basic dietary/exercise advice Longitudinal/Theme - Indigenous Health Community Health Interprofessional education Clinical Skills ?Pediatrics (effects of chronic illness, transition issues) - Interview for behavioral change - Psychology Clinical Skills Community Health Lipids - Interpret lipid profiles Risk stratification - Community Health (Biostats) Hirsutism/Growth - Tanner staging - Pediatrics Foot Ulcers - Diabetes foot exam - Clinical Skills Thyroid Mass - Examine thyroid - Diagnostic Imaging Thyroid disorders - Interpret TFTs Adrenal/Pituitary Osteoporosis - Diagnostic Imaging - Calculate fracture risk - Geriatrics (falls?), Community Health Endocrinology: Global UGME Objectives/CanMeds competencies • Medical expert – Yes • Communication – Motivational interviewing/lifestyle counseling, cultural safety • Collaborator – Session with diabetes educators • Advocate – Determinants of health, health promotion and disease prevention • Scholar – Can be incorporated depending on session format • Professional - ? • Manager - ? (longitudinal course involvement) Endocrine M1 • Shared with reproduction, 4 weeks (minus 2 for evaluation, minus 1 for stat day) • Strong focus on physiology • Basic anatomy should incorporate radiology • Proposed topic for clinical reasoning: Amenorrhea M1 Endocrine: Proposed topics CP4 Topic Hours Intro Intro lecture/hormones 2 Diabetes Anatomy/Histology of Pancreas Physiology of Glucose Metabolism 1 5 Obesity Epidemiology/Adipose endocrinology 2 Pituitary Gross anatomy, microanatomy, basic function 2 Thyroid Anatomy/hormone synthesis/drugs Hormone action, feedback Pregnancy/newborn 1 1 1 Adrenal Anatomy, basic histology Hormone action and feedback Steroid pharmacology 1 1 1 Hirsutism/Growth Growth and Puberty Sexual development and differentiation 1 1 Lipids Epidemiology of lipids Pathways and Mechanisms of drugs 1 2 Calcium Physiology of calcium metabolism 1 Osteoporosis Histology of Bone and Parathyroid Bone Physiology 1 1 Menses Menstrual cycle Prolactin 2 1 Endocrine M2: Proposed topics • • • • • • • • Introduction (1 hrs) Pituitary (4 hrs): Review, masses and hypofunctioning, diabetes incipidus, hyperfunctioning Thyroid (6 hrs): Review/drugs, hyperthyroidism, pregnancy and the newborn, hypothyroidism, thyroid nodules, thyroid function test interpretation Adrenal (4 hrs): Cushings/adrenal insufficiency, incidentaloma/hyperaldosteronism, pheochromocytoma Hirsutism/Growth (2 hrs): Ambiguous genitalia, short /tall stature Calcium (2 hrs): Clinical disorders of calcium metabolism Osteoporosis (2 hrs): Review/drugs, metabolic bone disease Menses (3 hrs): Prolactinemia, PCOS , male hypogonadism Endocrine M2: Proposed topics • • • Diabetes (13 hours): – Review of physiology/diagnosis/epidemiology (1) – Microvascular and macrovascular complications (2) – Diabetes in pregnancy (including newborn) (1) – Oral agents (2), Insulin (2), Insulin adjustments (2) – Comprehensive management of the diabetes patient (2) – Diabetes emergencies: DKA (1) – Clinical skills: Diabetes education, foot ulcer Obesity (2 hours) – Epidemiology and health effects. Pediatric obesity? – Diabetes prevention trials, weight loss management – Clinical skills: Motivational interviewing Lipids (3 hours) – Cardiovascular risk stratification and targets (1 hour) – Review of pathways and drug therapy (2 hours) Endocrine Course: Discussion