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Address: No.325, Section 2, ChengKung road, Taipei City, Taiwan, ROC. Division of Endocrinology & Metabolism, Tri-Service General Hospital

Tel: + 886-2-87927182

Fax: +886-2-87927183

 

introduction

Department Introduction

Division of Endocrinology & Metabolism of Tri-Service General Hospital was established in 1953 and originally it dealt with metabolic, endocrine, renal and rheumatological diseases. In 1986 the renal unit was separated out and it became the Division of Nephrology. The staff of Division of Endocrinology & Metabolism consists of the Department Supervisor, 5 Specialist, several residents and 2 laboratory technician.

  1. The scope of disease

The department commonly manages diabetes mellitus, thyroid disease, adrenal gland disease, hyperlipidemia, obesity, amenorrhea and gout etc, and it can be broadly categorized into two groups:

  • Endocrine Diseases:

Disorders of the hypothalamic endocrine functions, pituitary gland, thyroid, parathyroid, pancreatic endocrine functions, diabetes, adrenal cortex, adrenal medulla, sex gland and chromosomal abnormality, as well as other diseases which mimic hormone functioning.

  • Metabolic Diseases:

Nutritional Impairment: Including obesity, malnutrition and vitamin deficiencies etc.
Impaired Carbohydrate Metabolism: Diabetes mellitus and glycogen storage disease.
Impaired Lipid Metabolism: Lipidemia etc.
Impaired Amino Acid Metabolism: phenylketonuria, cystine storage disease etc.
Impaired Calcium and Minerals Metabolism: Such as rickets and osteoporosis etc.
Other metabolic disorders: With nucleic acid metabolism and syndromes of abnormal mucopolysaccharide metabolism.

Medical Services Provided by this Department:

  1. This department is equipped with comprehensive equipments and staff, and case discussions are done every day. The average monthly admissions are about 50~80 patients.
  2. During the clinic hours of this department, on average approximately 6000~7000 patients are seen every month (not including emergencies).
  3. The endocrinology laboratory provides tests for serum insulin, growth hormone, parathyroid hormone, aldosterone, ACTH, rennin and thyroid receptor-stimulating antibodies etc. In addition there are also tests for rapid blood sugar determination and glycosylated hemoglobin.
  4. The main equipments of this department at present: Gamma counter, -75¢J and -20¢J freezers, ultraviolet photo colorimeter, rapid blood sugar analyzer, refrigerated centrifuge, ultracentrifuge, Biostat blood sugar analyzer, and high pressure liquid chromatography etc.

training

 Training Scheme

  1. Training Introduction

Our department is responsible for training in Internal Medicine, Endocrinology & Metabolism, Laboratory Diagnostics, Clinical Diagnostics and clinical medicine for nursing, at the National Defense Medical Center. Furthermore, lectures are also provided to Dentistry and in Public Health.? The students, interns and residents (includes Family Medicine residents) are clinically trained in this department, and further education is offered to specialists and chief residents, while specialists, postgraduate scholars, clinical research-physicians and technicians are also refined.

  • Training Goals
    1. Provide basic concepts and knowledge in metabolism and endocrinology.
    2. Cultivate skills in case analysis, organization, evaluation and management of metabolism and endocrinology patients.
    3. Encourage academic research and provide research-related knowledge, such as Radio Immuno-assay, laboratory quality-control and development of research plans.
    4. Train well-rounded modern physicians with proper medical ethics, extraordinary skills and health attitudes towards life, who shall serve the country and its people.
    5. Develop advanced medicine, such as research into molecular biology, national defense medicine and battle-field medicine etc.? The collaboration of advanced technology is expected to benefit patients through preventative work.

 

  • Training Classes and Qualifications

Levels

Minimum Qualification

  1. Medical student

Medical students in 4th or 5th year

  1. Intern Doctor

Medical students in 6th or 7th year

  1. Resident (Includes Family Medicine Residents)

Resident doctors with less than 4 years experience in internal medicine

  1. Senior Resident

Resident doctors who have completed 3 years of training in internal medicine and who have performed superbly

  1. Chief Resident

Residents doctors who have completed 4 years of training in internal medicine and are extraordinary

  1. Specialist

Physicians who have completed chief residency in metabolism and endocrinology

 

  • Minimum Training Periods

The minimum training periods for the various levels are listed below:

Levels

Minimum Period

  1. Medical student

According to curriculum

  1. Intern Doctor

1 month

  1. Resident (Includes Family Medicine Residents)

1 to 2 months

  1. Senior Resident

1 year

  1. Chief Resident

1 year

  1. Specialist

Must have attained all the above time

  • Training Program 
  1. Medical Students
    1. Training Content:
    2. Clinical Diagnostics:
      1. To be trained in history-taking, physical examination and case reporting.
      2. Under the guidance of residents, to learn ward management and common techniques such as stool and urine collection and testing, drawing of blood, taking blood-pressure and measuring blood glucose level etc.
      3. Case Presentation: To select typical, remarkable or atypical cases for educational presentation, with specific emphasis on provision of explanations, P.O.M.R. case-writing and S.O.A.P. progress note-making.
      4. To understand regular ward operations and its running.
      5. To learn to establish doctor-patient relationships.
      6. In this department the core educational contents are provided through common cases in metabolism and endocrinology that are presented by residents, chief residents or specialists, which are written into case reports after problem-discussion and are handed-in at end of the rotation for evaluation basis.
    3. Academic Events:

At present, due to spending only 4 hours every week at the hospital academic events are not attended.

    1. Clinical Research:
      1. Under the instruction of specialists, winter and summer breaks can be utilized for participation in clinical research.
      2. During semesters participation is limited by time.
    1. Instruction and Evaluation: Please refer to evaluation table.

 

  1. Intern Doctors:
  2. Training Content:
  3. Clinical Diagnostics:
      1. OPD Duty:
        1. To take thorough history from First-Visit patients and after physical examination, make a concise case summary, provide the preliminary diagnosis, the other possible diagnoses and their diagnostics steps (laboratory tests), and have case discussion with the specialists, whose instructions may include admission or OPD treatments.
        2. To practice the management and prescription principles of specialists and raise questions for discussion when necessary.
    1. Ward Work:
        1. Under the guidance of residents, to complete the Admission Progress Notes of newly admitted patients within 1 hour, and with 24 hours, to complete the case report, a full physical examination and routine investigations of blood, urine and stool.
        2. While on specialist ward rounds, to present the patients¡¦ cases, the findings in physical and laboratory tests and own evaluation and diagnoses, as well as recommendations on diagnostic steps, so that through interactive discussions how to fully manage patients can be understood.
        3. Under the guidance of specialist and residents, write up new and old patients¡¦ treatment orders and make alterations to management according to instructions of senior doctors.
        4. To be responsible for the emergency management of adverse incidents that has occurred in patients under their care, and when difficulty is encountered during management, to report to residents and seek assistance.
        5. To write progress notes according to the S.O.A.P structure, everyday, and at anytime when necessary.
        6. When receiving old patients that have been handed-over by previous intern doctors, the patients¡¦ past conditions, laboratory findings, progress of treatment and diagnosis, and awaiting diagnostic steps must be studied and recorded into summary notes.
        7. Under the guidance of residents, perform arterial/venous puncturing to obtain blood samples and order investigations.
  4. Academic Events:
    1. To provide case presentations during daily morning meetings, actively participate in discussions and record the discussion outcome into the files.
    2. Under the guidance of chief residents, to hold 1-2 weekly book clubs that concentrate on common diseases and concepts, with test being held afterwards from which the scores will be included as part of the internship score.
  5. Clinical Research:

With the explanation of guidance provided by the specialists, clinical research may be participated on part-time basis, however the project coordinator must be able to provide proper tutoring and off-work time should not be used for research.

  1. Instruction and Evaluation: Please refer to evaluation table.

 

  1. Resident (Includes Family Medicine residents)
  2. Training Content:
  3. Clinical Diagnostics:
      1. To perform ward duty by example and guide intern doctors and medical students, to be responsible for the writing up case notes, physiological testing, and perform and decide on individual special investigations and diagnostic procedures. Outside of academic medical teaching, guidance in doctor-patient and doctor-nurse relationships should also be provided, so that comprehensive education in knowledge, work and problem-solving can be ensured.
      2. To inspect and instruct intern doctors in recording progress, prescriptions, ordering of special investigations and carrying out orders from chief residents, specialists of supervisors.
      3. To timely provide condition update during ward rounds with supervisors or specialists, and discuss possible special investigations with supervisors.
      4. To participate in OPD duty, under the guidance of specialists, and carefully assess patients¡¦ problems.
    1. Academic Activity:
      1. Responsible for the data collection and preparation of the various case discussion meetings, joint discussions and meetings in internal medicine.
      2. To finish reading the chapters related to metabolism and endocrinology in the prescribed books (7), (8), (9) and (10).
      3. To visit the library at anytime and read up on the latest literature related to the patients under their care, in order to tutor intern doctors.
      4. To assist specialists and more senior members to prepare for the publishing of thesis and data collection. A book report should be handed-in at least once a month.
      5. To assist and participate in intern doctors¡¦ weekly book clubs.
    2. Clinical Research:

To participate in various clinical researches under the guidance of specialists who are responsible for teaching the residents the research methods and principles.

  1. Instruction and Evaluation: Please refer to evaluation table.

 

  1. Chief Resident:
  2. Training Content:
    1. Clinical Diagnostics:
    2. Ward Duty: To host metabolism and endocrinology morning ward reports, assist intern doctors in management and, under the guidance of specialists, perform diagnosis and follow-up of various diseases in this department.
    3. OPD Duty: To participate at least twice a week in our department¡¦s OPD, under the assistance and guidance of specialists, in order to cultivate skills to work in OPD independently.
    4. Consultation: Chief residents are the first-line for consults from our department, so that under the guidance of specialists, skills in assessment, diagnosis and solving of complex problems can be cultivated.
    5. Clinical Teaching: Plan and conduct the various academic activities within the department, is in-charge of the clinical teaching of residents and intern doctors, and assists the department supervisor and specialists in the clinical teaching of residents and intern doctors.
    6. Administrative Duty:
        1. If promoted to Division Chief Resident, then he/she will be trained with the program for division chief residents, else training for departmental chief resident will be offered.
        2. To received ordinary administrative training and trainings in departmental relationships.
    7. Academic Activities:
      1. Must at least finish reading all prescribed text during the training period.
      2. To actively peruse literature on cases of interest and regularly present reports during book clubs.
      3. To actively participate in various activities within the department and practice voicing own opinion during meetings.
    8. Clinical Research:
      1. To follow the guidance and assistance from the departmental supervisor and specialists and promote, conduct, coordinate and collect data on the researches planned by this department.
      2. To independently formulate research topics for independent research, write at least one thesis annually for publishing in formal national and international medical periodicals, and presents reports during annual metabolism and endocrinology meetings.
  1. Instruction and Evaluation: Please refer to evaluation table.

 

  1. Specialists:
  2. Training Content:
  3. Clinical Management:
    1. Under the guidance of the departmental supervisor, they are responsible for all diagnosis and treatment of the department¡¦s patients, including the formulation of principles in clinical tests and treatment choice, however when problems are encountered they should report to the supervisor and seek opinion from colleagues.
    2. Under the guidance of the departmental supervisor, to further study the department¡¦s general and specialized medical knowledge and techniques, and to further specialize in his/her diseases of interest.
    3. Routine ward rounds and teaching ward rounds are centered on the specialists, who are responsible for the planning and management and monitoring of implementation. Clinical problems should be sought and explored in depth-in, for self-education and to instruct junior doctors in solving present medical problems.
    4. Responsible for consults from other departments, but the chief resident can respond to consults under the instruction of specialists.
  4. OPD Duty: They are in charge of our department¡¦s OPD, and are responsible for, under the leadership of the supervisor, the follow-up and evaluation of treatment of discharged patients, the decision for admission, the management of first-visit patients, and the medical services for regular OPD patients. Specialists also assist in instructing the chief residents, residents and intern doctors in OPD operations. Furthermore, where necessary the specialists will arrange for the management of a weekly combined health insurance clinic, for health insurance patients and the following-up of admitted and discharged patients. They are responsible for assisting the overall medical work.
  1. Clinical Teaching:
    1. Responsible for lecturing fundamental classes.
    2. During teaching rounds, should utilize current problems to make assessment, discussion and conclusion, as they are responsible for the clinical teaching and lecturing of fundamental classes to chief residents, residents and intern doctors.
    3. Responsible for the lectures in metabolism and endocrinology and related lectures in principles of internal medicine, Laboratory Diagnostics and clinical diagnostics, at the National Defense Medical Center.

 

  1. Academic Activities:
    1. To participate in case discussions within the department and provide deeper discussions.? Normally responsible for choice of cases.
    2. Rotate to report the summaries of medical periodicals.
    3. Under the instruction of the supervisor, they are responsible for presenting in academic discussions in internal medicine and presenting in hospital metabolism and endocrinology discussions.
    4. To offer opinions and answer metabolism-related questions during the clinical pathology and mortality meetings of the department of internal medicine,
  2. Clinical Research:
    1. Under the leadership and instruction of the supervisor, every specialist must conduct at least one clinical research ad publish at least one thesis or progress report every year.
    2. The hospital may, after assessing a specialist¡¦s experience and performance, send he/she to an advanced centre overseas for further studies, in order to develop more specialized personnel and to later stimulate the medical development of this department, this hospital and this country.
    3. To participate in various hospital events to broaden knowledge.

Instruction and Evaluation: Implemented according to internal medicine department regulations.

opd schedules

 Physician Timetable for Endocrine and Metabolic Clinic

Tri-Service General Hospital Computerized Voice Booking Line: (02) 8792-7111,
(Military) 610385 
Staff-Assisted Booking Line: (02) 8792-7222

Specialist

Time

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Yi-Jen Hung

09:00-12:00

Tingjhou

 

 

Neihu

 

 

14:00-17:00

 

Tingjhou

 

 

Neihu

 

Chang-Hsun Hsieh

09:00-12:00

 

Neihu

 

 

Neihu

 

14:00-17:00

Tingjhou

 

Tingjhou    

 

18:00-21:00            

Ling-Yi Wu

09:00-12:00

Neihu

 

Tingjhou

Neihu

   

14:00-17:00

 

 

Neihu

 

 

 

Chih-Tsueng He

09:00-12:00

 

Tingjhou

Neihu

 

 

 

14:00-17:00

 

 

 

 

 

 

Giian-Hsieng Li

09:00-12:00

       

Neihu

 

14:00-17:00

Neihu

 

 

 

Tingjhou

 

Giieh-Hua Lu

18:00-21:00 Neihu          
Fone-Ching Hsiao 09:00-12:00            

Kuang-Chung Shih

14:00-17:00

 

 

 

Neihu

 

 

Hsing-Ya Liu

09:00-12:00

 

 

 

Tingjhou

 

 

Tsao-Chin Yang

18:00-21:00

 

Neihu

 

 

 

 

 

(Note) Neihu: Neihu Clinic of Tri-Service General Hospital

Tingjhou: Tingjhou Clinic of Tri-Service General Hospital