THU008 Coverage Of Education And Training Of Traumatic Brain Injury-induced Growth Hormone Deficiency In US Endocrinology Fellowship Programs
Authors: Ji Yuen Kevin Choong , Adiga Radhika , Kelepouris Nicky , Cardenas Javier 
Published: October 2023

Disclosure: K.C. Yuen: Advisory Board Member; Self; Novo Nordisk, Ascendis, Corcept, Ipsen, Amryt, Strongbridge, Crinetics, Recordati and Xeris. Grant Recipient; Self; Crinetics, Ascendis, Corcept, and Amryt. Speaker; Self; Corcept, Novo Nordisk and Recordati. R. Adiga: Employee; Self; Novo Nordisk, Inc. Stock Owner; Self; Novo Nordisk, Inc. N. Kelepouris: Employee; Self; Novo Nordisk, Inc. Stock Owner; Self; Novo Nordisk, Inc. J. Cardenas: Consulting Fee; Self; National Football League.

Background: Growth hormone deficiency (GHD) is a common sequela following traumatic brain injury (TBI). We aimed to understand how education and training of TBI-induced GHD is currently covered in US-based fellowship training program curricula and to identify knowledge gaps and opportunities to address this topic further. Methods: An online survey was conducted among endocrinology fellowship program directors between January 19, 2022, and March 28, 2022. Email and postal mailers were used to recruit potential survey respondents. The study received an IRB exemption. Results: A total of 167 endocrinology fellowship programs were invited to participate; 28 program directors completed the survey. Education on TBI-induced hypopituitarism was considered fairly/very important and appropriate to be included in the training curricula, according to 71% and 79% of program directors, respectively. Although all or almost all respondents believed endocrinologists should be fairly/very responsible for managing hypopituitarism including GHD (100%), screening for the condition (89%) and educating patients (93%), only 57% reported that TBI-induced GHD was formally covered in their curriculum. Endocrinology program directors reported that the key topics related to TBI-induced GHD were covered to a great extent by only one-fifth of programs, at most. Management of GH replacement in patients with GHD following TBI was not covered at all or covered to a very little extent in fellowship programs according to 57% of respondents; topics including the long-term use and safety of GH replacement and screening/diagnosis for TBI-induced GHD had greater coverage. Less than half of respondents (43%) believed their fellows were fairly/very prepared to manage GHD in patients with hypopituitarism following TBI. One-quarter (25%) of endocrinology fellowship programs reported that their institution planned to expand formal education of hypopituitarism in their curricula. According to the surveyed program directors, the main barrier to including education on TBI-induced GHD was the rarity of the condition (64%), lack of room/time in the curriculum (50%), lack of clinical management guidelines (43%), and scarcity of research data on the condition (43%). Respondents thought having consensus clinical guidelines for hypopituitarism following TBI (100%) and the availability of more data on the condition (89%) would provide the greatest impact on the development of educational curricula on this topic. Conferences (71%) and professional associations (68%) were seen as the most effective conduits for providing additional training on TBI-induced GHD. Conclusions: There is a need for more education and training on the management of TBI-induced GHD in US endocrinology fellowship programs to prepare future endocrinologists to effectively screen, diagnose, and optimally treat their patients with TBI-induced GHD.

Presentation: Thursday, June 15, 2023