As a medical student, do you ever wonder what it’s like to specialize in endocrinology? Meet AMA member Connie Newman, MD, an endocrinologist and a featured physician in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties.
Dr. Newman is also an internist and obesity medicine specialist. Check out her insights to help determine whether a career in endocrinology might be a good fit for you.
The AMA’s Specialty Guide simplifies medical students’ specialty selection process, highlight major specialties, detail training information, and provide access to related association information. It is produced by FREIDA™, the AMA Residency & Fellowship Database®.
“Shadowing” Dr. Newman (@ConniesMedicine)
Practice setting: Hospital.
Employment type: Employed by a medical school.
Years in practice: 30.
A typical day and week in my practice: I worked in academic medicine for most of my career. As a full-time faculty member engaged in grant funded research, much of my time was spent in the laboratory (basic research), or in the clinical research center, seeing patients enrolled in clinical trials. On most days I had some time to analyze data, read the literature, or work on a grant.
On one morning every week, I cared for patients with endocrine diseases and diabetes in the endocrinology and diabetes outpatient clinic at the VA hospital in Manhattan, which is part of New York University Medical Center. For one or two months a year, I served as an attending physician in the endocrine service, making rounds with the endocrine fellows.
In addition, I occasionally led seminars for medical students, or gave lectures to the residents in internal medicine. I attended endocrine grand rounds, and various endocrinology conferences. Overall, my hours were regular because I could schedule my research experiments or clinical study appointments. I did not work at night in the hospital. Occasionally, I traveled to give lectures in different parts of the country or to attend scientific meetings.
During this time, I was pregnant and then cared for my two children, who were 15 months apart in age. I lived near the medical center and was able to leave the lab or office by about 5:30 p.m. most days so that I would be home by 6 p.m. When my sons were young, a live-in nanny took care of them during the day. I was nearly always able to rearrange my schedule so that I could attend my children’s school activities, such as concerts or plays, or the Ellis Island reenactment in which the children were immigrants and the parents were the officials at Ellis Island. I was able to find the time to serve as a “class mother.”
Sometimes I worked at home at night—writing a paper or researching one—and sometimes I worked a few hours at home on the weekend. My responsibilities to my children and my family were important to me, and my dedication to my family did not prevent me from carrying out important research. Nor did it affect my promotion to associate professor with tenure.
Some of my colleagues in endocrinology work in private practice. They have varying schedules and might work in the office seeing patients about four days a week with time set aside for administrative tasks, and possibly to attend a university or medical center clinic one half day a week. Time is also spent on the phone, answering or returning calls from other doctors, or from their own patients. Generally, the hours of an endocrinologist in practice are regular, perhaps 40 hours a week, if working full time.
The most challenging and rewarding aspects of endocrinology: For me, the most challenging aspect is caring for patients with a poor prognosis—such as people with large pituitary tumors—that cannot be fully removed surgically, or people with diabetes who have vascular and renal complications. Some of the diseases we treat do not respond to medication or surgery—particularly large hormone-secreting tumors—and sometimes there may be no other therapy.
There are two very rewarding aspects: A good relationship with the patient and helping patients recover from unusual diseases, such as Cushing’s syndrome or acromegaly. A good relationship is important for the patient, as it can reduce anxiety and enhance the patient’s confidence in you as a physician. It is important for doctors too, as it brings more meaning into our careers and helps avoid “burnout.”
Patients with unusual diseases, such as those caused by a tumor secreting excess glucocorticoids or growth hormone, suffer from adverse effects of these hormones on various parts of the body and a change in facial and other physical characteristics. Successful treatment not only makes the patient feel better, but also improves the physical changes in the face and body. The improvement can be dramatic. It is gratifying to be able to help people who have diseases that could not be successfully treated 50 or more years ago.
Three adjectives to describe the typical endocrinologist: Compassionate. Thoughtful. Analytical.
How my lifestyle matches, or differs from, what I had envisioned: In medical school, I envisioned becoming a pediatrician in a private practice with regular hours so that I could take care of patients and also spend time with my family. My career path has been different—I did not pursue pediatrics. I became an internist with a subspecialty in endocrinology and metabolism and pursued a career in academic medicine that allowed research as well as patient care and teaching.
I was fortunate to be able to hire a nanny to help me and my husband raise our children. When my children were young, I had regular hours and the ability to take time off to participate in parent-child activities during elementary school. I have been able to find work-life balance by choosing a career with regular hours and making my family and my own wellness a priority.
My children, now in their early 30s, appreciated me as a mother-doctor. About two years ago, they wrote an essay, “The Doctor who Raised Us,” in which they stated, “We knew our mother as a doctor, so we came to see doctors as nurturing, gentle and kind. Moreover, we came to see women as intelligent, capable and strong. How could there be any contradiction in the twinned calling of doctor mom, when the aptitudes of each are so clearly inseparable from the other?”
Skills every physician in training should have for endocrinology but won’t be tested for on the board exam: Compassion, empathy, respect for people and the ability to listen are skills that every doctor should have. These are skills that are integral to the practice of humanistic medicine, and essential for a good patient-physician relationship.
Skills that every physician in training should have for the specialty of endocrinology include ability to solve problems, make decisions, communicate, and work in teams. Our patients present with symptoms and sometimes signs that can be puzzling, and must be evaluated or confirmed by lab tests—hormone measurements in blood or urine—and sometimes imaging.
Interpretation of all the data to decide upon a diagnosis and the appropriate treatment involves problem-solving and decision-making skills. As endocrinologists, we work closely with other specialists—surgeons, radiologists, nutritionists, etc. To do this effectively requires communication skills and teamwork.
One question physicians in training should ask themselves before pursuing endocrinology: Do I like evaluating complex problems? Am I comfortable with not making a definitive diagnosis at the first visit?
Books every medical student interested in endocrinology should be reading: These are books that could be helpful to many medical students, not just those interested in endocrinology.
God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine, and Slow Medicine: The Way to Healing, by Victoria Sweet, MD. These books show the importance of empathy and compassion and taking the time to get to know patients, make the right diagnosis, and choose the most appropriate therapies for each individual.
The Best of Bellevue Literary Review, edited by Danielle Ofri, MD, PhD. These short stories may help the reader or medical student gain a better understanding of people, their social situation and the way illness affects everyone, including the patient, their friends and family, and the doctor.
The online resource students interested in endocrinology should follow: Endocrine Society.
Quick insights I would give students who are considering endocrinology:
- Spend time with an endocrinologist to see if you like the practice of endocrinology.
- Read about some of the endocrine diseases in a medical textbook.
- Remember that endocrine diseases can be fascinating, but the disease does not define the patient.