Endocrine Residency Learning Objectives
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 microalbumin. Dietary management and pharmacological therapy to include intensive insulin programs. Patient recommendations for "sick days" and hypoglycemia. Management of commonly associated disorders (hyperlipidemia and hypertension) and their interaction with diabetic therapy. Appropriate and timely referrals to ophthalmology, podiatry, dietary and the diabetes education program.
- Thyroid disease. Diagnostic evaluation and management of the functional thyroid disorders (hypothyroidism and hyperthyroidism). Treatment options for 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 intensive care setting.
- Lipid disorders. NCEP guidelines. Secondary hyperlipidemia, Dietary and pharmacologic management of dyslipidemias.
- Metabolic bone diseases. Diagnostic evaluation and treatment options of osteoporosis. 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.
- Pituitary 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 (SIADH and diabetes insipidus).
- Gonadal dysfunction. Diagnostic evaluation of gynecomastia, hirsutism, amenorrhea and impotence. Androgen and estrogen replacement therapy.