Course Description

REBLS (Reproduction, Endocrine, Behavioral Health/Behavioral disorders, and Life Span topics) is a nine-week block covering reproduction, sexuality, and endocrinology related to the gonadal, growth hormone, prolactin, adrenocortical, parathyroid, and thyroid axes. In addition, behavioral health and the biological basis of the major psychiatric disorders will be covered. The coverage for these systems will include the basics of the anatomy, physiology, pathology, pharmacology, and clinical characteristics.  Normal physiology across the life span with particular attention to unique stages of the human lifespan, such as: pregnancy, lactation, infancy, childhood, adolescence, and aging will be included. In addition, selected pathophysiological and pharmacological aspects relevant to unique stages of the human lifespan listed above will be covered. An additional two weeks of PPD are divided up into one week segments that occur after each two weeks of REBLS content.

Learning Objectives

Educational Program Objectives are a subset of more broadly defined physician competencies, which represent general domains of performance for which the profession and the public hold physicians accountable.

Upon completing the Reproduction, Endocrine & Behavior Through the Lifespan (REBLS) Block, students should be able to:

  • Describe the key events in the embryology and development of the reproductive organs, as well as in the following endocrine organs: pituitary, thyroid, parathyroids and adrenals. 
  • Describe the normal histology and understand the common manifestations of pathology in the following organs: ovary, testis, female and male internal and external reproductive systems, breast, pituitary, thyroid, parathyroids and adrenals.
  • Describe the early embryological events in gamete development, fertilization and implantation. In addition, understand how alterations in embryologic development during gestation can lead to developmental disorders identified in the fetus or infant and describe the etiology of these disorders and syndromes based on genetic, environmental and biochemical processes.
  • Demonstrate understanding of the physiology of the reproductive system and articulate clinical presentations, formulate differential diagnoses, and describe the pathophysiology for common female and male reproductive disorders, including infectious diseases and neoplasms/cancer. 
  • Describe the approach to testing and treatment for patients who desire fertility and are experiencing subfertility and for those who desire contraception. 
  • Demonstrate understanding of the normal physiology of the prolactin, growth hormone, thyroid, parathyroid and adrenocortical endocrine axes. Articulate clinical presentations, formulate differential diagnoses and describe the pathophysiology for common disorders of these systems, including infectious diseases and neoplasms/cancer. 
  • Describe the mechanism of action and potential side effects of the medications that are used to treat disorders of the following endocrine systems: male and female reproductive, growth hormone, thyroid, adrenal glucocorticoid and prolactin axes. Include the mechanism and potential adverse effects of relevant treatments for infectious diseases of these systems including sexually transmitted infections (STIs).
  • Explain the physiological basis of sexual activity and the common etiologies of sexual dysfunction. Outline treatment strategies for sexual dysfunction. 
  • Discuss the differences between/aspects of: gender identity, sex assigned at birth, and sexual orientation. Understand the options for gender affirming care for patients who identify as transgender/gender-diverse and desire medical and/or surgical treatment.  In addition, understand the diagnostic strategies and care options for patients with DSD (differences in  sexual development).
  • Demonstrate understanding of the structure and physiology of the normal breast and the changes that occur with puberty, pregnancy, lactation and menopause. Outline the key features of breast pathology and neoplasms and the common treatment strategies.  
  • Demonstrate understanding of the biological basis of common psychiatric/behavioral disorders and explain the mechanism of action and possible side effects of the pharmacological agents used to treat these conditions. 
  • Describe the unique features of the physiological and psychological functioning of normal infants, children, adolescents and aging adults. In addition, understand the physiological and psychological alterations that occur during pregnancy, lactation and the puerperium. 
  • Articulate clinical presentations, formulate differential diagnoses and describe the pathophysiology for common disorders during different stages of the life cycle including: pregnancy, lactation, infancy, childhood, adolescence and aging. Understand pharmacological management of diseases within the context of life span stages such as pregnancy, infancy and aging.
  • Demonstrate understanding of the epidemiology of common disorders across the lifespan, current prevention strategies, including vaccines and recommended screening tests. 
  • Critically appraise and discuss issues related to public health, clinical ethics, sociopsychobiologic factors, delivery of healthcare and biotechnology as they apply to the reproductive, endocrine or behavioral health arenas. 
  • Demonstrate understanding of the impact of sex and gender, as well as cultural and ancestry factors on a patient's health and well-being. Discuss how to best prioritize diagnostic procedures and use evidence-based medicine in diagnostic workups. Describe how a cost-effective work-up supports the concepts of value-based care.  Understand how to design and complete a QI project and how to determine which screening guideline is applicable when there are conflicting guidelines.  (Health Care Transformations and Policy and Evidence Based Medicine LCT).