The clinical service at the MGH receives approximately 500 new in-patient consultations and 13,000 out-patient visits annually. This setting also provides a source of patients and data for clinical research in diabetes, neuroendocrinology and thyroid disorders. During the remainder of the time, the residents perform in-patient and Emergency Department consultations, and follow patients on the wards.
The Diabetes Teaching Clinic is a well-developed and busy clinic which is held weekly on Tuesdays under the direction of Dr. N. Garfield and Dr. G. Tsoukas. A multidisciplinary team approach by physicians, nurse educators and dieticians is employed but within an out-patient clinical setting rather than a day care setting as at the RVH.
The Thyroid Teaching Clinic is directed by Dr. J. How and brings unique expertise in the diagnosis and treatment of thyroid diseases. Patients with thyroid disorders account for approximately a quarter of all out-patient visits and Dr. J. How has one of the largest thyroid practices in the country and the MGH is also one of the few centres in Canada offering a joint thyroid clinic wherein the patient is seen jointly by a thyroidologist (Dr. J. How) and a thyroid surgeon (Dr. R. Tabah). The thyroid clinic attracts a diverse range of common and complex thyroid problems and provides regular instruction to the endocrine trainees, including formal instruction in fine needle biopsy, recombinant TSH and radioiodine therapy for thyroid cancer, as well as optimal use and interpretation of PET-CT scanning.
The Neuroendocrinology Clinic has a significant and strong presence at the MGH and is directed by Dr. S. Marcovitz who also provides the expertise for endocrine work-up, perioperative care and follow-up of many patients with prolactinomas, acromegaly and Cushing's disease. Trainees are exposed to this interesting array of endocrine cases that, because of the large numbers, have additionally formed the basis of many clinical research projects.
Another group of neuroendocrine patients are those with hormone-producing intestinal tumours such as carcinoid and various pancreatic islet cell tumors. These disorders are rare and personal experience of individual endocrinologists is limited. Dr. R. Benoit (Wednesday PM Endocrine Clinic) has extensive knowledge and experience of these tumors and he has acquired a reputation for diagnosing and managing these difficult problems. His opinion is regularly sought by colleagues working in other teaching hospitals in Montreal.
The Bone Clinic is directed by Dr. G. Tsoukas, in which the trainee is exposed to a vast array of bone and mineral disorders, from osteoporosis to hyperparathyroidism and Paget’s disease.
The General Endocrine Teaching Clinics are held every Monday morning and afternoon and Thursday afternoon under the direction of Dr. G. Tsoukas and Dr. L. Vautour and serves as a referral base for new endocrine consultations originating from the Emergency Room, Ambulatory Clinics from within the hospital and outside physicians. The clinic offers trainees the opportunity of gaining experience and proficiency in a wide variety of endocrine problems.