Clinical clerkship in endocrinology, diabetes, & metabolism

Geisinger offers a four-week elective rotation in endocrinology, diabetes and metabolism that focuses on adult patients with diabetes mellitus and other endocrine and metabolic disorders. The department provides comprehensive, team-centered care at three clinical sites for patients that live within the 40 counties of central, northern and northeastern Pennsylvania.

Our team of physicians, nurse practitioners, certified diabetes educators, registered dieticians and certified insulin pump trainers manage Type1 and Type 2 diabetes mellitus and obesity and insulin resistance syndromes. We provide diabetes and nutrition education, analysis of glycemic control through the use of continuous glucose monitoring and intensive insulin management with insulin pump therapy in both inpatient and outpatient settings.

We also provide comprehensive management of thyroid disease--including diagnostic ultrasonography, radioiodine ablative therapy and ultrasound guided thyroid fine needle aspiration--and advanced multidisciplinary treatment of thyroid carcinoma. For patients with metabolic bone diseases, we perform and interpret DXA scanning and provide infusion therapy for osteoporosis. Finally, we perform dynamic endocrine testing to evaluate and treat patients with functional and nonfunctional pituitary and adrenal diseases.

The rotating medical student is integrated into our services through active involvement in the daily care of our patients, beside teaching and didactic instruction. Students see new patients in both inpatient and outpatient settings, and patient follow up is done at the discretion of the supervising attending physician. Faculty guided observation presents opportunities for students to experience thyroid ultrasonography, ultrasound guided fine needle thyroid nodule aspiration and DXA scan interpretation. To broaden the educational experience, students attend weekly endocrine and other department grand rounds and participate in discussions, case presentations and literature review. Students are expected to give short presentations summarizing interesting clinical topics determined by service patient mixture and the attending endocrinologist.

Goals & objectives

The overall goal of this medical student elective is to teach evidence-based, high quality care for patients who have diabetes mellitus, thyroid, metabolic bone, pituitary and adrenal disease. Specific educational objectives are based on the six core clinical competencies of the Accreditation Council for Graduate Medical Education and adapted to the level expected of a medical student, as follows:

• Patient care: Provide supervised patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness and treatment of disease. At all times, the student should act as the patient’s advocate
• Medical knowledge: Demonstrate knowledge of and an interest in learning established and evolving biomedical, clinical and social sciences
• Interpersonal skills and communication: Demonstrate interpersonal and communication skills that enable students to establish and maintain professional relationships with patients, families and other members of health care teams.
• Professionalism: Demonstrate behaviors reflecting a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity, and a responsible fiduciary attitude towards their patients, their profession and society.
• Systems-based practice: Develop a basic understanding of the contexts and systems in which health care is provided, and demonstrate the ability to apply this knowledge to improve and optimize health care.