Endocrinology (Peds/Medi 412)

DUTIES OF THE MEDICAL STUDENT ON THE ENDOCRINOLOGY ROTATION

The purpose of this rotation is to expose the medical student to patients with endocrine disease and the pathophysiologic problems of endocrine function.

A maximum of 1 student can rotate through Endocrinology per 4-week block (with the exception of February, when the rotation is not offered). Each student will spend 2 weeks on the Pediatric portion and 2 weeks on Medicine portion. The student will require a car or other reliable form of transportation, as part of the rotation takes place on the UNC campus in Chapel Hill, and part takes place at the Medical Endocrinology clinics in Durham. The students will rotate according to the following schedule.

Week 1

Pediatric Endocrinology

Week 2

Pediatric Endocrinology

Week 3

Medicine Endocrinology

Week 4

Medicine Endocrinology

FIRST DAY INFORMATION FOR PEDIATRICS

Please contact Dr. Ali Calikoglu (ali_calikoglu@med.unc.edu) prior to the first day to confirm schedule.

Pediatric Endocrine Clinic

The Pediatric Endocrine Clinic meets at 8:00 AM for a full day every Tuesday and Wednesday, and for a half day every Friday morning in the Pediatric Subspecialty Clinic near the Outpatient Center II area on the ground floor of the Children’s Hospital. On Tuesday, there is a full-day fellow clinic, in which the pediatric endocrine fellows are assigned a list of patients and are supervised by an attending.

Clinical Activities: In the clinic the student will be assigned both new and return patients. Before the student enters the room to see assigned patients, he/she should discuss an approach to the patient given the nature of the referral. He/she is to take a complete history or the appropriate interval history, and do a physical examination. He/she is then to meet with the attending preceptor, present the patient, and review the findings. He/she will then assist in executing the plan for care for the patient. The student should record detailed notes to be used for a medical student note or for dictation either by the student or the attending. As soon as possible after the clinic, the student should collect all laboratory data on the patients he/she has seen. X-rays should be reviewed with the attending that saw the patient. The post-clinic conference is held for selected patients on Thursday at 1:15 PM in room 3311 MBRB. The purpose of this conference is to review the important aspects of selected patients. The pediatric endocrine fellows, pediatric residents, and students are primarily responsible for summation of the case histories on these patients.

On certain Wednesdays, Dr. Marsha Davenport has a Turner syndrome clinic. This clinic also meets at 8 a.m. and is at the same location on the ground floor of the Children’s Hospital. There is also a pediatric Bone Clinic on certain Wednesdays.

Pediatric Diabetes Clinic

These Clinics meet at 8:00 AM for a full day each Monday in the same location at the Pediatric Endocrine Clinic (Pediatric Subspecialty Clinic near Outpatient Center II, ground floor, Children’s Hospital). Students on the endocrine rotation are required to attend these clinics. Currently, there is a half day diabetes clinic every other Thurs. morning. Starting in 10/11, there will instead be either individual or group diabetes education sessions on Thurs. mornings.

Pediatric Endocrine Clinic at Rex Hospital (Raleigh)

This Clinic meets at 9:00 a.m. on Wednesdays at 4414 Lake Boone Trail, Suite 505, in Raleigh (please see attached map). Students have the option of attending this clinic. They should contact Dr. Nina Jain for additional details.

PEDIATRIC ENDOCRINE SCHEDULE

 

 

Monday

Tuesday

Wednesday

Thursday

Friday

Week 1

am

Diabetes

Clinic

Fellow Endo

Clinic

Attending Endo

Clinic (Chapel Hill/ Raleigh)

Student Teaching

Seminar/ half day diabetes clinic

Attending Endo

Clinic

 

pm

Diabetes

Clinic

Fellow Endo

Clinic

Attending Endo

Clinic (Chapel Hill/ Raleigh)

Fellow and Joint

Ped/Med conference

 

Week 2

am

Diabetes

Clinic

Fellow Endo

Clinic

Attending Endo

Clinic (Chapel Hill/ Raleigh)

Student Teaching

Seminar

Attending Endo

Clinic

 

pm

Diabetes

Clinic

Fellow Endo

Clinic

Attending Endo

Clinic (Chapel Hill/ Raleigh)

Fellow and Joint

Ped/Med conference

 

 

FIRST DAY INFORMATION FOR MEDICINE

STUDENTS ARE TO CONTACT THE MEDICINE ENDOCRINE COURSE DIRECTOR, Dr. Deepa Kirk, email dkirk@med.unc.edu, PRIOR TO THE FIRST DAY OF THE MEDICINE PORTION OF THE ROTATION, to confirm the schedule for the upcoming week.

Medicine Clinics

The Medicine Endocrine and Diabetes clinics meet in the Highgate Medical Center on Highway 54. For directions, please call the clinic at 484-1015 or the Endocrine Division secretary at 966-0134. We have multiple types of providers in our clinic, and emphasize a team-based approach to patient care. This includes endocrine faculty, endocrine fellows, certified diabetes educators, a physician assistant, a nurse practitioner, and a full-time clinical pharmacist. A variety of endocrine tests are performed on-site, including A1c testing, phlebotomy, DEXA scans, thyroid ultrasound and thyroid nodule biopsies, and insulin pump and continuous glucose sensor initiation and adjustments. The 2nd floor of the building is an active diabetes clinical trials unit.

The student will be assigned to an individual attending or to fellows’ clinic, for several morning and afternoon sessions. The specific attending or fellow schedule will be provided to the student on the first day of clinic. The attending physicians have individual areas of interest, and thus we recommend rotating among them to optimize your exposure to endocrine disorders. Morning clinics normally begin at 8:00 a.m. Early in the rotation students may be asked to “shadow” the preceptor, but later on, students should aim to interview, examine, and present 1-2 patients per half-day session. At times, the student may be asked to write or dictate a note, which will be countersigned by the attending. It will be the responsibility of the attending physician to write letters to the referring physician and follow up with laboratory tests.

MEDICINE ENDOCRINE SCHEDULE

 

 

Monday

Tuesday

Wednesday

Thursday

Friday

Week 1

am

Endo/DM

Clinic

Endo/DM

Clinic

Endo/DM

Clinic

Fellow Endo/DM

Clinic

Endo/DM

Clinic

 

pm

Endo/DM

Clinic

Inpatient

Rounds

Inpatient

Rounds

Fellow and Joint

Ped/Med conference

 

Week 2

am

Endo/DM

Clinic

Endo/DM

Clinic

Endo/DM

Clinic

Fellow Endo/DM

Clinic

Endo/DM

Clinic

 

pm

Endo/DM

Clinic

Inpatient

Rounds

Inpatient

Rounds

Fellow and Joint

Ped/Med conference

 

Inpatient Consultations

Pediatrics: The student should keep the pediatric endocrine resident or fellow informed through the week as to his/her whereabouts. In this way he/she can be called upon to assist in consultation on hospitalized pediatric patients with endocrine problems. The role of the student on each of these patients will be determined by the pediatric endocrine resident, fellow, or attending. Students may participate on inpatient rounds, which are held daily at 11 a.m. in the 6th floor conference room of the Children's Hospital. During these rounds, service patients are discussed and there are brief teaching sessions on pediatric endocrine topics.

Medicine: The Endocrine division has an active inpatient consultation service, which conducts rounds each afternoon. The inpatient service typically consists of an Endocrine fellow, nurse practitioner, and attending; medicine residents also rotate through the service. Students participate in inpatient rounds several times per week. Depending on individual interests, we are can arrange for students to spend additional time working on the inpatient service.

Case Write Ups

Medicine and Pediatrics: A total of 6 more formal Case Write Ups should be completed and discussed with the course directors or designated fellows. Three of these should occur during the Pediatrics portion of the rotation and three should occur during the Medicine Portion of the rotation. The purpose is to crystallize thinking on the topics of discussion; to address misconceptions or areas of confusion; and to provide the student with one-on-one discussion time with an expert in endocrinology.

The student is expected to prepare for these sessions so that the discussion can be at a relatively high level. A schedule of the meeting time, place, and assigned instructor for each session will be provided by Dr. Calikoglu (at the start of the Peds portion of the rotation) and by Dr. Kirk (at the start of the Medicine portion of the rotation). The form and instructions for completing the case write-ups will be provided at prior to the start of the rotation.

Conferences

Medicine and Pediatrics: All students should attend the Endocrinology Fellows Didactic Conference at 3:00 PM and the joint Pediatric-Medicine Endocrine Conference at 3:45 PM every Thursday in Bondurant Hall, room 2020. If there is a room change, the student will be notified.