Download CuRe Endocrinology and Metabolism Carmen Hurd UGME Course Leader

CuRe Endocrinology and
Metabolism
Carmen Hurd
UGME Course Leader
May 14, 2013
Committee
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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
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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
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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– Some sessions outdated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
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Obesity
Insulin Adjustment
Basic dietary/exercise advice
Longitudinal/Theme
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Indigenous Health
Community Health
Interprofessional education
Clinical Skills
?Pediatrics (effects of chronic illness,
transition issues)
- Interview for behavioral change
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Psychology
Clinical Skills
Community Health
Lipids
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Interpret lipid profiles
Risk stratification
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Community Health (Biostats)
Hirsutism/Growth
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Tanner staging
- Pediatrics
Foot Ulcers
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Diabetes foot exam
- Clinical Skills
Thyroid Mass
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Examine thyroid
- Diagnostic Imaging
Thyroid disorders
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Interpret TFTs
Adrenal/Pituitary
Osteoporosis
- Diagnostic Imaging
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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
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5
Obesity
Epidemiology/Adipose endocrinology
2
Pituitary
Gross anatomy, microanatomy, basic function
2
Thyroid
Anatomy/hormone synthesis/drugs
Hormone action, feedback
Pregnancy/newborn
1
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Adrenal
Anatomy, basic histology
Hormone action and feedback
Steroid pharmacology
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Hirsutism/Growth
Growth and Puberty
Sexual development and differentiation
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Lipids
Epidemiology of lipids
Pathways and Mechanisms of drugs
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2
Calcium
Physiology of calcium metabolism
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Osteoporosis
Histology of Bone and Parathyroid
Bone Physiology
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Menses
Menstrual cycle
Prolactin
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Endocrine M2: Proposed topics
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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
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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