Detailed Curriculum Map

Transition to Discipline

Required 1. Clinical training experiences:
	1.1. Endocrinology and metabolism clinical service
		1.1.1. Clinic and/or consultation service to the emergency department and inpatient services, including critical care
Required 2. Other training experiences:
	2.1. Orientation to the post-graduate medical education office and program, including structure, policies, portfolio, resources, and expectations
	2.2. Orientation to the hospital(s), including policies and procedures, information systems, and electronic medical records
	2.3. Orientation to the interprofessional team and their roles, particularly with regard to diabetes management
Recommended 3. Clinical training experiences:
	3.1. After-hours coverage of the endocrinology and metabolism service
	3.2. Diabetes camp (for pediatric stream)
Optional 4. Clinical training experiences:
	4.1. Endocrinology and metabolism longitudinal clinic
	4.2. Diabetes camp (for adult stream)

Foundation of Discipline

Required 1. Clinical training experiences:
	1.1. Endocrinology and metabolism clinical service
		1.1.1. Clinic or consultation service to intensive care settings, emergency department, and wards, or both
		1.1.2. Longitudinal clinic
		1.1.3. Diabetes or other endocrinology interprofessional clinic
		1.1.4. After-hours coverage
Required 2. Other training experiences:
	2.1. Formal instruction in the basic and clinical sciences of endocrinology and metabolism, including
		2.1.1. Endocrine physiology
	2.2. Endocrine emergencies
	2.3. Critical appraisal activities, such as journal club
	2.4. Identification of a supervisor and initiation of a scholarly project
	2.5. Participation in divisional educational activities, such as rounds and case discussions
Recommended 3. Clinical training experiences:
	3.1. Endocrinology and metabolism clinical service
		3.1.1. Virtual care
	3.2. Specialized clinics
Recommended 4. Other training experiences:
	4.1. Attendance at annual scientific meeting of the Canadian Society of Endocrinology and Metabolism or Diabetes Canada, or both (for adult stream)
Optional 5. Clinical training experiences:
	5.1. Performance of ultrasound guided thyroid fine needle aspiration (for adult stream)

Core of Discipline

Required 1. Clinical training experiences:
	1.1. Breadth of endocrinology and metabolism in different settings to include
		1.1.1. Consultation to the emergency department, intensive care settings, and inpatient services
		1.1.2. Clinic
		1.1.3. Longitudinal clinic
		1.1.4. Diabetes or other endocrinology interprofessional clinic
		1.1.5. Pediatric endocrinology and metabolism consultation service or clinic (for adult stream)
		1.1.6. Adult endocrinology and metabolism consultation service or clinic (for pediatric stream)
		1.1.7. After-hours coverage
		1.1.8. Participation in multidisciplinary care rounds, such as tumour board or case rounds
Required 2. Other training experiences:
	2.1. Formal instruction in the basic and clinical sciences of endocrinology and metabolism
	2.2. Formal instruction in
		2.2.1. The Truth and Reconciliation Commission of Canada’s Calls to Action in health
		2.2.2. Patient safety and quality improvement
		2.2.3. Resource stewardship
	2.3. Ongoing participation in scholarly activity (i.e., scholarly project)
	2.4. Critical appraisal activities, such as journal club
	2.5. Presentation at or participation in divisional educational activities, such as rounds and case discussions
	2.6. Provision of informal and/or clinical teaching for junior learners
	2.7. Resident wellness activities
Recommended 3. Clinical training experiences:
	3.1. Endocrinology and metabolism
		3.1.1. Virtual care
		3.1.2. Community setting (for adult stream)
	3.2. Reproductive endocrinology (for adult stream)
	3.3. Gender-affirming care
	3.4. Clinical chemistry, including endocrine assays
	3.5. Pathology (for adult stream)
	3.6. Radiology (for adult stream)
	3.7. Nuclear medicine (for adult stream)
Recommended 4. Other training experiences:
	4.1. Formal instruction in
		4.1.1. Research methodology
		4.1.2. Disclosure of medical error and adverse events
		4.1.3. Conflict resolution
		4.1.4. Ethics and professionalism, including
			4.1.4.1. Consent
			4.1.4.2. Interactions with industry
	4.2. Participation in a quality improvement project
	4.3. Attendance and/or presentation of project at a local, national, or international scientific meeting relevant to endocrinology and metabolism
Optional 5. Clinical training experiences:
	5.1. Endocrinology and metabolism
		5.1.1. Specialized clinics, including those that provide services such as (for adult stream)
			5.1.1.1. Fertility
			5.1.1.2. Diabetic foot care
			5.1.1.3. Retinopathy
		5.1.2. Care for vulnerable populations (for adult stream)
		5.1.3. Community setting
	5.2. Observation of common endocrine-related surgery (for adult stream)
	5.3. Nuclear medicine (for pediatric stream)
Optional 6. Other training experiences:
	6.1. Teaching junior learners
	6.2. Participation in the administrative duties of the program and/or service (e.g., scheduling, triaging referrals)
	6.3. Completion of an advocacy project

Transition to Practice

Required 1. Clinical training experiences:
	1.1. Endocrinology and metabolism in the role of junior attending
		1.1.1. Service providing consultation to the emergency department, intensive care settings, and inpatient services
		1.1.2. Clinic
		1.1.3. Longitudinal clinic
		1.1.4. After-hours coverage
Required 2. Other training experiences:
	2.1. Formal instruction in practice management
	2.2. Participation in the administrative duties of the program and/or service (e.g., scheduling, triaging referrals)
	2.3. Completion of a scholarly project

Transition to Discipline

TTD1. Assessing patients with a known endocrine condition

Foundation of Discipline

F1. Assessing and managing individuals with an uncomplicated presentation of an endocrine condition
F2. Providing ongoing care for individuals with an uncomplicated presentation of an endocrine condition
F3. Performing endocrine focused physical examinations
F4. Counselling patients and families for the purposes of patient education, disease prevention, and/or health promotion

Core of Discipline

C1. Managing patients presenting with an emergency related to an endocrine condition or its treatment
C2. Assessing and managing patients with complex and/or atypical presentations
C3. Providing ongoing care
C4. Interpreting investigations
C5. Managing diabetes with insulin therapy and the use of diabetes technologies
C6. Documenting patient encounters
C7. Providing indirect patient management recommendations to other health care professionals
C8. Providing unplanned advice to patients
C9. Supporting adolescents/young adults with endocrine conditions in the transition from the pediatric to adult care setting
C10. Leading patient care on an inpatient consultation service

Transition to Practice

TTP1. Managing an endocrinology practice
TTP2. Developing a plan for continuing professional development

Medical Expert

1. Practise medicine within their defined scope of practice and expertise
	1.1. Demonstrate a commitment to high-quality care of their patients							C: 10 TTP: 1
	1.2. Integrate the CanMEDS Intrinsic Roles into their practice of Endocrinology and Metabolism
	1.3. Apply knowledge of the clinical, socio-behavioural, and fundamental biomedical sciences relevant to Endocrinology and Metabolism, including							C: 4 · 5
	1.4. Perform appropriately timed clinical assessments with recommendations that are presented in an organized manner							F: 2 C: 1 · 2 · 3
	1.5. Carry out professional duties in the face of multiple competing demands							C: 10
	1.6. Recognize and respond to the complexity, uncertainty, and ambiguity inherent in Endocrinology and Metabolism practice
2. Perform a patient-centred clinical assessment and establish a management plan
	2.1. Prioritize issues to be addressed in a patient encounter							C: 1 · 7
	2.2. Elicit a history, perform a physical exam, select appropriate investigations, and interpret their results for the purpose of diagnosis and management, disease prevention, and health promotion							TTD: 1 · 1 · 1 F: 1 · 1 · 1 · 1 · 2 · 2 · 2 · 3 · 3 · 3 C: 1 · 1 · 2 · 2 · 3 · 3 · 4 · 4 · 4 · 5 · 6 · 7 · 8 · 8 · 9 · 9 · 9
	2.3. Establish goals of care in collaboration with patients and their families, which may include slowing disease progression, treating symptoms, achieving cure, improving function, and palliation							C: 3
	2.4. Establish a patient-centred management plan							F: 1 C: 1 · 1 · 2 · 7 · 7 · 7 · 8 · 8 · 8 · 9 · 10 TTP: 1
3. Plan and perform procedures and therapies for the purpose of assessment and/or management
	3.1. Determine the most appropriate procedures or therapies
	3.2. Obtain and document informed consent, explaining the risks and benefits of, and the rationale for, a proposed procedure or therapy
	3.3. Prioritize procedures or therapies, taking into account clinical urgency and available resources
	3.4. Perform procedures and provide therapies in a skilful and safe manner, adapting to unanticipated findings or changing clinical circumstances, including							C: 5 · 5
4. Establish plans for ongoing care and, when appropriate, timely consultation
	4.1. Implement a patient-centred care plan that supports ongoing care, follow-up on investigations, response to treatment, and further consultation							F: 2 C: 2 · 3 · 5 · 9
5. Actively contribute, as an individual and as a member of a team providing care, to the continuous improvement of health care quality and patient safety
	5.1. Recognize and respond to harm from health care delivery, including patient safety incidents
	5.2. Adopt strategies that promote patient safety and address human and system factors

Communicator

1. Establish professional therapeutic relationships with patients and their families
	1.1. Communicate using a patient-centred approach that encourages patient trust and autonomy and is characterized by empathy, respect, and compassion							F: 4 · 4
	1.2. Optimize the physical environment for patient comfort, dignity, privacy, engagement, and safety							TTD: 1 F: 3
	1.3. Recognize when the perspectives, values, or biases of patients, patients’ families, physicians, or other health care professionals may have an impact on the quality of care, and modify the approach to the patient accordingly
	1.4. Respond to a patient’s non-verbal behaviours to enhance communication
	1.5. Manage disagreements and emotionally charged conversations
	1.6. Adapt to the unique needs and preferences of each patient and to the patient’s clinical condition and circumstances
2. Elicit and synthesize accurate and relevant information, incorporating the perspectives of patients and their families
	2.1. Use patient-centred interviewing skills to effectively gather relevant biomedical and psychosocial information							TTD: 1
	2.2. Provide a clear structure for and manage the flow of an entire patient encounter
	2.3. Seek and synthesize relevant information from other sources, including the patient’s family, with the patient’s consent							TTD: 1 C: 7
3. Share health care information and plans with patients and their families
	3.1. Share information and explanations that are clear, accurate, and timely, while assessing for patient and family understanding							F: 1 · 4 · 4 · 4 C: 5 · 5 · 8 · 8
	3.2. Disclose harmful patient safety incidents to patients and their families
4. Engage patients and their families in developing plans that reflect the patient’s health care needs and goals
	4.1. Facilitate discussions with patients and their families in a way that is respectful, non-judgmental, and culturally safe							F: 4
	4.2. Assist patients and their families to identify, access, and make use of information and communication technologies to support their care and manage their health
	4.3. Use communication skills and strategies that help patients and their families make informed decisions regarding their health							F: 4 C: 9
5. Document and share written and electronic information about the medical encounter to optimize clinical decision-making, patient safety, confidentiality, and privacy
	5.1. Document clinical encounters in an accurate, complete, timely, and accessible manner, in compliance with regulatory and legal requirements							F: 2 C: 1 · 3 · 6 · 6 · 6 · 6 · 6 · 7 · 8 TTP: 1
	5.2. Communicate effectively using a written health record, electronic medical record, or other digital technology
	5.3. Share information with patients and others in a manner that enhances understanding and that respects patient privacy and confidentiality							C: 8

Collaborator

1. Work effectively with physicians and other colleagues in the health care professions
	1.1. Establish and maintain positive relationships with physicians and other colleagues in the health care professions to support relationship-centred collaborative care
	1.2. Negotiate overlapping and shared responsibilities with physicians and other colleagues in the health care professions in episodic and ongoing care							C: 1 · 1 · 2 · 5 · 6
	1.3. Engage in respectful shared decision-making with physicians and other colleagues in the health care professions							C: 4 · 7 · 10
2. Work with physicians and other colleagues in the health care professions to promote understanding, manage differences, and resolve conflicts
	2.1. Show respect toward collaborators
	2.2. Implement strategies to promote understanding, manage differences, and resolve conflict in a manner that supports a collaborative culture							C: 10
3. Hand over the care of a patient to another health care professional to facilitate continuity of safe patient care
	3.1. Determine when care should be transferred to another physician or health care professional							F: 2
	3.2. Demonstrate safe handover of care, using both oral and written communication, during a patient transition to a different health care professional, setting, or stage of care							C: 6

Leader

1. Contribute to the improvement of health care delivery in teams, organizations, and systems
	1.1. Apply the science of quality improvement to systems of patient care
	1.2. Contribute to a culture that promotes patient safety
	1.3. Analyze patient safety incidents to enhance systems of care
	1.4. Use health informatics to improve the quality of patient care and optimize patient safety
2. Engage in the stewardship of health care resources
	2.1. Allocate health care resources for optimal patient care							C: 2 · 3 · 7
	2.2. Apply evidence and management processes to achieve cost-appropriate care
3. Demonstrate leadership in health care systems
	3.1. Demonstrate leadership skills to enhance health care
	3.2. Facilitate change in health care to enhance services and outcomes
4. Manage career planning, finances, and health human resources in personal practice(s)
	4.1. Set priorities and manage time to integrate practice and personal life							C: 10 TTP: 1 · 1
	4.2. Manage personal professional practice(s) and career							C: 10 TTP: 1 · 2 · 2
	4.3. Implement processes to ensure personal practice improvement

Health Advocate

1. Respond to an individual patient’s health needs by advocating with the patient within and beyond the clinical environment
	1.1. Work with patients to address determinants of health that affect them and their access to needed health services or resources							C: 5
	1.2. Work with patients and their families to increase opportunities to adopt healthy behaviours							F: 2 · 4 · 4 C: 3 · 9 · 9
	1.3. Incorporate disease prevention, health promotion, and health surveillance into interactions with individual patients
2. Respond to the needs of the communities or populations they serve by advocating with them for system-level change in a socially accountable manner
	2.1. Work with a community or population to identify the determinants of health that affect them, including barriers to access to care and resources
	2.2. Improve clinical practice by applying a process of continuous quality improvement to disease prevention, health promotion, and health surveillance activities
	2.3. Contribute to a process to improve health in the community or population they serve

Scholar

1. Engage in the continuous enhancement of their professional activities through ongoing learning
	1.1. Develop, implement, monitor, and revise a personal learning plan to enhance professional practice							TTP: 2 · 2
	1.2. Identify opportunities for learning and improvement by regularly reflecting on and assessing their performance using various internal and external data sources							TTP: 2
	1.3. Engage in collaborative learning to continuously improve personal practice and contribute to collective improvements in practice
2. Teach students, residents, the public, and other health care professionals
	2.1. Recognize the influence of role modelling and the impact of the formal, informal, and hidden curricula on learners
	2.2. Promote a safe, respectful, and inclusive learning environment
	2.3. Ensure patient safety is maintained when learners are involved
	2.4. Plan and deliver learning activities
	2.5. Provide feedback to enhance learning and performance
	2.6. Assess and evaluate learners, teachers, and programs in an educationally appropriate manner
3. Integrate best available evidence into practice
	3.1. Recognize practice uncertainty and knowledge gaps in clinical and other professional encounters and generate focused questions that can address them
	3.2. Identify, select, and navigate pre-appraised resources
	3.3. Critically evaluate the integrity, reliability, and applicability of health-related research and literature
	3.4. Integrate evidence into decision-making in their practice							C: 2 · 10 TTP: 1
4. Contribute to the creation and dissemination of knowledge and practices applicable to health
	4.1. Demonstrate an understanding of the scientific principles of research and scholarly inquiry and the role of research evidence in health care
	4.2. Identify ethical principles for research and incorporate them into obtaining informed consent, considering potential harms and benefits, and considering vulnerable populations
	4.3. Contribute to the work of a research program
	4.4. Pose questions amenable to scholarly investigation and select appropriate methods to address them
	4.5. Summarize and communicate to professional and lay audiences, including patients and their families, the findings of relevant research and scholarly inquiry

Professional

1. Demonstrate a commitment to patients by applying best practices and adhering to high ethical standards
	1.1. Exhibit appropriate professional behaviours and relationships in all aspects of practice, demonstrating honesty, integrity, humility, commitment, compassion, respect, altruism, respect for diversity, and maintenance of confidentiality							TTD: 1 F: 3 · 4
	1.2. Demonstrate a commitment to excellence in all aspects of practice
	1.3. Recognize and respond to ethical issues encountered in practice
	1.4. Recognize and manage conflicts of interest
	1.5. Exhibit professional behaviours in the use of technology-enabled communication
2. Demonstrate a commitment to society by recognizing and responding to societal expectations in health care
	2.1. Demonstrate accountability to patients, society, and the profession by responding to societal expectations of physicians							TTP: 2
	2.2. Demonstrate a commitment to patient safety and quality improvement
3. Demonstrate a commitment to the profession by adhering to standards and participating in physician-led regulation
	3.1. Fulfil and adhere to professional and ethical codes, standards of practice, and laws governing practice
	3.2. Recognize and respond to unprofessional and unethical behaviours in physicians and other colleagues in the health care professions
	3.3. Participate in peer assessment and standard setting
4. Demonstrate a commitment to physician health and well-being to foster optimal patient care
	4.1. Exhibit self-awareness and manage influences on personal well-being and professional performance							C: 1 TTP: 1
	4.2. Manage personal and professional demands for a sustainable practice throughout the physician life cycle
	4.3. Promote a culture that recognizes, supports, and responds effectively to colleagues in need