Date Issued: 06/05/2002
Prior Revision Date: 03/02/2009
Date Reviewed and Revised: 07/27/2010
Department: Internal Medicine
Faculty Coordinator: Richard Sachson, M.D.
Hospital: Texas Health Presbyterian Hospital Dallas
Periods offered: All
Length: 4 weeks
Max no. of residents: 2
First Day Contact: Dr. Sachson - (214) 363-5535
First DayTime: 9:00 a.m.
First Day Place: 10260 N. Central Expressway, Suite 100, Dallas, TX 75231
Requirements: Monday through Friday 9:00 am to 5:00 pm
I. Course Description:
Residents will be working with an Endocrinologist. They will participate in seeing inpatient
consults. However, the primary focus of this rotation is an outpatient clinic
where the resident will gain skills in the recognition, evaluation, and management
of metabolic disease states.
II. Course Goals
and Objectives: (based on ACGME competencies for resident
Residents are expected to provide care that
is compassionate, appropriate and effective for the promotion of health, prevention
of illness, treatment of disease and at the end of life.
- Gather accurate, essential information from
all sources, including medical interviews, physical examinations, medical
records and diagnostic/therapeutic procedures. Examples: Resident will learn the skills of taking a complete,
system-focused history and physical exam in the patient with an endocrine
related illness; Resident will learn cost effective, evidence-based diagnostic
evaluation of the patient with endocrine disease.
- Make informed recommendations about preventives,
diagnostic and therapeutic options and interventions that are based on clinical
judgement, scientific evidence, and patient preference. Examples:
Resident will be able to inform the patient with diabetes mellitus or a thyroid
nodule about the appropriate interventions for their disease state; Resident
will educate the at-risk patient about evidence-based interventions to prevent
diabetes mellitus and osteoporosis.
- Develop, negotiate and implement effective
patient management plans and integration of patient care. Examples: Resident will learn the skill of working with a multidisciplinary
team in the education, evaluation, and management of the patient with diabetes
mellitus, obesity, and infertility.
- Perform competently the diagnostic and therapeutic
procedures considered essential to the practice of internal medicine. Examples:
Resident will observe the technique
of a thyroid nodule biopsy.
Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and the education of others.
- Apply an open-minded, analytical approach
to acquiring new knowledge. Examples: Resident will demonstrate a desire to pursue knowledge
by reading about patients seen in the office, bringing literature pertaining
to the area of interest in Endocrinology to the attending, actively listening
and asking appropriate questions of the attending.
- Access and critically evaluate current medical
information and scientific evidence. Examples: By participating in journal club, the resident will
learn the art and science of evaluating medical literature. He/she will apply
this to the field of Endocrinology.
- Develop clinically applicable knowledge of
the basic and clinical sciences that underlie the practice of internal medicine.
Examples: Resident will read,
understand and apply the biochemistry and physiology of the endocrine system
to the common metabolic diseases such as diabetes mellitus, hyperlipidemia,
Cushing's syndrome, and hypertension.
- Apply this knowledge to clinical problem-solving,
clinical decision-making, and critical thinking. Examples: See above.
Residents are expected to be able to use scientific evidence
and methods to investigate, evaluate, and improve patient care practices.
- Identify areas for improvement
and implement strategies to enhance knowledge, skills, attitudes and processes
of care. Examples: Resident will,
with the help of the attending, recognize his/her knowledge deficits and read text books, review articles and original research to improve
- Analyze and evaluate practice
experiences and implement strategies to continually improve the quality of patient
practice. Examples: Gaining experience
in a well-run Endocrine Clinic, the resident will develop skills to improve
the care of his/her Internal Medicine Clinic patients with diabetes mellitus,
osteoporosis, hyperlipidemia, etc.
- Develop and maintain a willingness
to learn from errors and use errors to improve the system or processes of care.
Examples: Resident will have an
open-minded approach to realizing his/her errors and working with the attending
to correct those errors.
- Use information technology or
other available methodologies to access and manage information, support patient
care decisions and enhance both patient and physician education. Example:
Resident will be skilled at accessing current literature
through the Internet.
Interpersonal and Communication
Residents are expected to demonstrate
interpersonal and communication skills that enable them to establish and maintain
professional relationships with patients, families and other members of health
- Provide effective and professional consultation
to other physicians and health care professionals and sustain therapeutic
and ethically sound professional relationships with patients, their families,
and colleagues. Examples: Resident
will be skilled in his/her role as consulting endocrinologist and work with
the referring physician to manage and educate the patient. He/she will demonstrate
professional behavior when interacting with patients and staff.
- Use effective listening, nonverbal,
questioning, and narrative skills to communicate the patients. Examples: Resident will be able to obtain an accurate
history by using the above skills. He/she will also demonstrate the skill
of informing and educating the patient.
- Interact with consultants in a respectful,
appropriate manner. Examples: See above.
- Maintain comprehensive, timely, and legible
medical records. Examples: Resident will be responsible for entering timely, written or dictated
consultations and progress notes in the inpatient and outpatient setting.
Residents are expected to demonstrate behaviors that reflect
a commitment to continuous professional development, ethical practice, an understanding
and sensitivity to diversity and a responsible attitude toward their patients,
their profession, and society.
- Demonstrate respect, compassion, integrity,
and altruism in relationships with patients, families, and colleagues.
- Demonstrate sensitivity and responsiveness
to the gender, age, culture, religion, sexual preference, socioeconomic status,
beliefs, behaviors and disabilities of patients and professional colleagues.
- Adhere to principles of confidentiality,
scientific/academic integrity, and informed consent.
- Recognize and identify deficiencies in peer
Residents are expected to demonstrate
both an understanding of the contexts and systems in which health care is provided,
and the ability to apply this knowledge to improve and optimize health care.
- Understand, access and utilize
the resources, providers and systems necessary to provide optimal care. Examples:
Resident will work with the dietician, nurse, and
diabetic educator in managing the patient with diabetes mellitus. He/she wil learn how to access the
governmental resources available to patients with diabetes.
- Understand the limitations and
opportunities inherent in various practice types and delivery systems, and develop
strategies to optimize care for the individual patient. Examples: While working in a private practice setting, the resident
will work to optimize the care of the patient with limited financial resources
by utilizing services offered by the hospital, county, and state such as diabetic
education, cholesterol screening and education, osteoporosis screening.
- Apply evidence-based, cost-conscious
strategies to prevention, diagnosis, and disease management. Examples: See above.
- Collaborate with other members
of the health care team to assist patients in dealing effectively with complex
systems and to improve systematic processes of care. Examples: See above.
III. Methods of instruction:
- Didactic (schedule, topic, faculty)
Daily residents conference 12:00-1:00 p.m. - IM Training Room
Wednesday mornings 7:30-8:00 a.m. - Clinical Ground Rounds -
IM Training Room
Wednesday afternoons 12:15-1:00 p.m. - Internal Medicine Update - Haggar
Friday mornings 7:30 - 8:00 a.m. - Coffee with Cardiology - IM Training
Attend clinic from 9:00 a.m. to 5:00 p.m., seeing and assessing patients, writing notes in the charts, discussing cases one on one with the attending. See inpatient consults.