Endocrinology, Diabetes, and Metabolism Fellowship. SECTION 16 Subsection 2 of urgent and emergency problems in endocrinology and diabetes. 2nd year …
University of Pennsylvania Medical Center
Endocrinology, Diabetes, and Metabolism Fellowship
SECTION 16 - Subsection 2
SUBJECT: Roles and Responsibilities for Endocrinology Residents SSR1 and
SSR2
At HUP, the Presbyterian Medical Center PMC, and the Veterans
Administration Medical Center VAMC
POLICY
Each endocrinology fellow is expected to care for his/her own patients
during all inpatient rotations consult services in endocrinology and
diabetes In addition, fellows accrue a substantial panel of their own
patients, which they follow in their mentored continuity outpatient clinic
for 24 months of their fellowship They also follow patients in outpatient
ambulatory rotations for between 4-12 months
PURPOSE
The purpose of this policy is to insure that endocrinology fellows have
adequate exposure to both inpatients and outpatients, and that they have
incremental responsibility in these settings over the two consecutive years
of fellowship training
SCOPE
This policy applies to all fellows in the Endocrinology,
Diabetes, and
Metabolism Fellowship Training Program within the Department of Medicine at
the University of Pennsylvania Medical Center
IMPLEMENTATION
Implementation of this policy is the responsibility of the Director of the
Endocrinology, Diabetes, and Metabolism Fellowship Training Program, the
Associate Program Director at the VAMC, and the clinic preceptors Lipid
Clinic and Metabolic/Obesity Clinic at PMC
PROCEDURE
Consultation and New Patient Evaluation, In-patient Endocrine and Diabetes
Consult services at HUP and the VAMC; Out-patients clinics at HUP, PMC, and
the VAMC
Each fellow will have the following responsibilities:
Perform complete history and physical examinations on all new patients
for whom consults are requested at each of the hospital training sites
and outpatients in their practices
Examine all primary and secondary data including lab tests and procedures
related to management of their patients
Synthesize all available results and data gathering to generate
differential diagnoses and subsequent diagnostic and therapeutic
management strategies
Communicate the above information in both oral and
written form to the
endocrine or diabetes attending, the housestaff team, the consulting
service and the referring doctor and
Be responsible for all consultation service requests and follow-up of all
tests and procedures ordered for each patient on their service or in
discussion with a faculty attending
Perform adequate documentation of all patients encountered including
discharge summaries when applicable
Provide verbal, and as required, written feedback to interns, residents
and faculty with whom they worked on each and every rotation regarding
their clinical performance
Insure that all the above rotations meet the duty or requirements at all
times
Develop a comprehensive approach to self-directed learning based on their
own perception of deficiencies in their fund of knowledge, in addition to
the results of external assessments
Participate in the educational conferences of the Division of
Endocrinology, Diabetes, and Metabolism and the Quality Assurance
activities and at all times serving as mentors for younger colleagues,
residents and medical students
Complete scholarly
requirements starting in the first year with
identification of a clinical and a project mentor and resulting in
abstracts presented at national subspecialty meetings, publications and
the writing of grant proposals and other publications
SPECIFIC PROFICIENCIES-ALL YEARS
Perform histories and physical examinations that are expert in their
evaluation of symptoms and signs of endocrine disorders
Performance and cytologic interpretation of fine-needle aspiration
biopsies of the thyroid documented in the first year
Interpretation of laboratory tests of hormone levels and electrolytes and
other endocrine related immunoassays
Interpretation of the radionuclide, ultrasound, radiologic, and other
imaging studies for the diagnosis and treatment of endocrine and
metabolic disease
Indication and interpretation of quantitative digital radiography and
other tests used in the management of osteoporosis and other metabolic
bone diseases
Performance of thyroid ultrasound as a diagnostic technique
Multidisciplinary and mulimodality management of patients with diabetes
mellitus, including insulin
delivery systems, diet and exercise programs,
podiatric and ophthalmologic evaluation
Performance and interpretation of dynamic hormone testing, eg CRH and
ACTH stimulation
Correlation of clinical information with cytology, histology, molecular,
genetic, and imaging techniques
The management of urgent and emergency problems in endocrinology and
diabetes
2nd year
Endocrinology Fellows will have increasing responsibility for mentored
patient management choosing diagnostic studies, developing comprehensive
management plans, caring for patients across the trajectories of their
illnesses
Endocrinology Fellows will have ever increasing responsibilities for the
design, writing and implementation of research projects and will write up
work for presentation at national meeting and for publication
They will mentor 1st year fellows in clinical care and research
methodology
Ambulatory Clinics including Continuity Clinics
After_______________All Hematology-Oncology Fellows 1st through 2nd years
Perform history and physical examinations
Collaboratively practice with nurse colleagues
Follow-up on all primary and
secondary data related to management of
their patients
Prioritize attention in the delivery of care in an outpatient
settingCoordination of emergency care to critically ill patients
Maintain appropriate records and data gathering
Answer telephone and other inquiries from their own patients
Communicate with referring and attending faculty supervisor in the
clinics
Maintain records of continuing patient care
