Adult Endocrinology and Metabolism — Core of Discipline

C2 Assessing and managing patients with complex and/or atypical presentations

Key Features:
- This EPA includes all aspects of a consultation: gathering information from the history, physical exam, and other sources, working effectively with other members of the interprofessional team (as well as with the referring service if relevant), and developing a management plan which may include treatment as well as further investigation.
- This may require scholarly review of treatment options and/or multidisciplinary collaboration or consultation with external experts.
- This EPA may be observed in any care setting (e.g., clinic, hospital, emergency department), including virtual care.
- At this stage, this EPA includes the full range of endocrine conditions and presentations that are complex or atypical due to patient factors (e.g., pregnancy, other medical conditions, peri-operative timing) or complicated by management challenges, including those due to social determinants of health and geographic and/or cultural variability.

Assessment Plan:
Direct and/or indirect observation by supervisor
Use Form 1. Form collects information on:
- Presentation (write in):
Collect 4 observations of achievement
- At least 3 different presentations
- At least 2 different observers

Form

F1: Observation

Milestones

• ME 1.4. Perform a clinical assessment that addresses all relevant issues

• ME 2.2. Integrate the clinical data to establish the diagnosis and, if relevant, stage and/or severity of the condition

• S 3.4. Integrate best evidence and clinical expertise into decision-making

• ME 2.4. Develop and implement a management plan

• ME 2.2. Identify whether the case warrants discussion at multidisciplinary case conference

• ME 4.1. Determine the need and timing of referral to another physician

• L 2.1. Consider costs and resource availability when selecting diagnostic or treatment options

• COL 1.2. Work effectively with members of the interprofessional team to implement a management plan

Context Variables

• Presentation (free-text)

Requirements

• Collect 4 observations of achievement (minimum 4)
• At least 3 different presentations (minimum 3)
• At least 2 different observers (minimum 2)
  • Counted once per distinct Assessor