committed to training effective clinicians who are imbued with respect
for patients and colleagues; who practice medicine with unquestionable
professionalism; who appreciate honest communication; and who possess an
innate curiosity to know more and a desire to pursue answers."
Hal Atkinson, MD, Director, Internal Medicine Residency Program
hallmark of our program is the emphasis placed on training residents to
be effective clinicians. Wake Forest Baptist Medical Center is an
exceptional hospital, drawing patients from a nineteen-county region of
North Carolina as well as from surrounding states. Residents are
intimately involved in patient care and have significant autonomy in
decision-making. While nearly all rotations occur at the medical
school/medical center, the Department also has a large community-based
ambulatory health center. New initiatives are increasing residents
interface with community-based generalists and subspecialists. They
spend time in underserved areas of the Winston-Salem community, giving
them insight into the challenges faced by patients and providers.
mentors and formal initiatives like the Tinsley Harrison Translational
Research Program promote and support resident research. Our house
staff’s impressive research productivity is reflected by published
manuscripts, abstracts, and presentations at local, regional and
Wake Forest is a
national leader in evidence-based medicine (EBM). Residents are taught
to be leaders in EBM and learn to critically appraise and apply the best
evidence from the medical literature at the bedside and in clinic.
Upper level residents assume an important role in teaching EBM to
medical students and junior house officers. Residents also receive a
solid foundation in medical systems. In 2006/2007 residents played an
active role in implementing an electronic medical record system for
ambulatory and inpatient services, a highly successful project.
The educational goals of the Endocrine Elective are for house
officers to develop the ability to independently evaluate, treat
and monitor common endocrine disorders (diabetes, thyroid
dysfunction, lipid abnormalities, metabolic bone disease, and
calcium disorders) and to be familiar enough with the less common
endocrinopathies (adrenal disease, pituitary disease and gonadal
dysfunction) to recognize the abnormality and initiate evaluation
prior to sub-specialty consultation.
- Diabetes mellitus.
Differences between Type 1 and Type 2 diabetes. Natural
course of diabetes and its complications. Appropriate monitoring
methodologies to include home glucose monitoring, glycated proteins
and urine protein excretion. Dietary management and pharmacological
therapy to include intensive insulin programs, non-insulin injectables, oral hypoglycemic medications. Patient
recommendations for "sick days" and hypoglycemia. Management of
commonly associated disorders (hyperlipidemia and hypertension) and
their interaction with diabetes management. Appropriate and
timely referrals to ophthalmology, podiatry, dietary and the
diabetes education program.
disease. Diagnostic evaluation and management of the
functional thyroid disorders ( hypothyroidism and hyperthyroidism).
Treatment options for hypothyroidism and hyperthyroidism. Evaluation of anatomic
thyroid abnormalities (simple goiter, multinodular goiter and
solitary thyroid nodule) to include use of nuclear medicine
procedures, ultrasound studies and fine needle aspiration.
Evaluation of thyroid function tests in the hospital and intensive care
disorders. NCEP guidelines. Secondary hyperlipidemia,
dietary and pharmalcologic management of dislipidemias.
- Metabolic bone
diseases. Diagnostic evaluation and treatment options of
osteoporosis and osteopenia. Risk factors for osteoporosis. The use of bone
densitometry. Osteomalacia, Paget's disease.
- Calcium disorders.
Diagnosis and management of hypercalcemia and
hypocalcemia. Management of hyperparathyroidism (medical vs.
surgical). Management of critical hypocalcemia and hypercalcemia.
Diagnosis and management of vitamin D deficiency.
- Adrenal disease.
Diagnosis and management of Cushing's syndromes, adrenal failure
and pheochromocytoma. Diagnosis and management of adrenal
emergencies (Addisonian or pheochromocytoma crisis). Evaluations of
the incidental adrenal mass.
disease. Diagnostic evaluation of pituitary tumors to
include the incidental pituitary mass. The role of surgery,
radiation therapy and medical management. Diagnosis and management
of pituitary apoplexy. Empty sella syndrome. Diagnosis and
evaluation of posterior pituitary dysfunction, such as DI and SIADH.
Dysfunction. Diagnostic evaluation of gynecomastia,
hirsutism, amenorrhea and impotence. Androgen and estrogen