Endocrinology (MPED 402)

The purpose of this rotation is to expose the medical student to patients with endocrine disease and the pathophysiologic problems that can occur in the endocrine system.

A maximum of 1 student can rotate through Endocrinology per 4-week block. Each student will spend 2 weeks on the Pediatric portion and 2 weeks on the Medicine portion. The student will require a car or other reliable form of transportation, as the rotation will require students to travel to the UNC campus in Chapel Hill, the Pediatric Subspecialty Clinic in Raleigh (2801 Blue Ridge Road) and the Medical Endocrinology Clinics in Eastowne in Chapel Hill. 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. Sara Duffus (sara_duffus@med.unc.edu) prior to the first day to confirm the schedule.

Pediatric Endocrine Clinic

The Pediatric Endocrine Clinic meets at 8:30 AM for a full day every Monday, Tuesday, Wednesday, and Friday. Students will work closely with attendings, fellows, and medical staff.

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, they should discuss an approach to the patient given the nature of the referral, take a complete history or the appropriate interval history, and do a physical examination. The student will then meet with the attending preceptor or fellow, present the patient, and review the findings. They will assist in developing a differential diagnosis and executing a plan of care for the patient. The student should document the visit in the electronic medical record (EPIC) to be reviewed and signed by the attending.

On certain days, there are subspecialty clinics focusing on patients with Turner Syndrome, Prader Willi Syndrome, and gender dysphoria. The student will be instructed to attend these clinics during orientation for the rotation.

Inpatient Pediatric Endocrine Experience

On various days, the student will be instructed to work with the on-call inpatient pediatric endocrine team. During this time, the student will round on patients on the endocrine service and on patients requiring endocrine consultation. The student will work closely with the on-call fellow to review the patients’ charts, to obtain initial or interval history, to assess findings from physical examinations, laboratory results and/or imagining, and to develop recommendations for further evaluation and/or treatment. The student will be expected to write the consult or progress note, and continue to follow the patient’s clinical course during the rotation.

Pediatric Endocrine Conferences

Students will be expected to attend the pediatric endocrine conferences on Thursdays. The day begins with Pediatric Grand Rounds in the Old Clinical Auditorium at 8:00am. After Grand Rounds, the student will meet with the on-call pediatric endocrine team to round on inpatients. The student will then attend the division sign-out, conferences and board review as instructed.

During the student’s two week rotation in Pediatric Endocrinology, they will be expected to give a brief presentation on a topic related to a patient case at the division conference. Further instructions about the presentation will be provided at orientation for the rotation.

 

FIRST DAY INFORMATION FOR MEDICINE

Students should contact the medicine endocrine course director, Dr. Deepa Kirk at 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 at 100 Eastowne Drive, Chapel Hill, NC, 27514. For directions, please call the clinic at 984-974-2950. 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 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 by the first day of clinic.  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.

Inpatient Adult Endocrine Experience

The Endocrine division has an active inpatient consultation service, which conducts rounds every morning and afternoon. The inpatient service typically consists of an Endocrine fellow, several advanced practice providers, and an attending; medicine residents also rotate through the service. Medical students will work on the inpatient service ~2 days each week. Students will be assigned patients to see and present on rounds. Students will be given instructions about documentation and notes.

Adult Endocrine Conferences

Adult Endocrine Conferences occur on Thursday afternoons. Students should attend the Endocrinology Fellows Didactic Conference which begins at 2:00 or 2:30 PM and the general Endocrine Division Conferences from 3:30 – 5:00 PM. These are currently virtual, or in-person with a virtual option.