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Endocrinologist

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Have you ever wondered about a career in endocrinology? Endocrinologists are the doctors who diagnose, treat and research hormone-related conditions, such as diabetes, obesity, growth disorders and reproductive health.

Dr. Jean-Pierre Chanoine is head of an endocrine and diabetes unit at a children's hospital. Chanoine is a pediatric endocrinologist. That means he has a double specialization, as well as his MD.

Chanoine studied in Brussels, Belgium, and later in Massachusetts, where he concentrated on laboratory research. He has been involved with endocrinology since 1988.

Chanoine's job is different from that of most endocrinologists. "I am head of a division at the children's hospital. I have no private practice whatsoever. Everything I do happens at the children's hospital," he says.

"I do clinical practice two half-days a week, and I am on call every so often. When I am on call, I can go where I like, but I have to carry a pager. The rest of the time is spent on administration and conducting research."

That research includes the relationship between nutrition and hormones. "I like to study how nutrition can influence the way hormones behave. More precisely, I am studying the effect of nutrition on the development of obesity."

Chanoine first chose pediatrics because he liked kids. Later, he pursued endocrinology as his subspecialty. "I liked the person that taught endocrinology in Brussels. Second, I enjoyed a specialty where there are no weird emergencies," he says.

"I don't like going to an emergency room and setting up IVs. I like the type of work where I can sit down and think about the problems. So I chose endocrinology for my second specialty."

Chanoine also enjoys endocrinology because it is related to hormones, which are everywhere in the body. "You are not confined to working with one area. There are hormones in the brain, in the pituitary, the ovaries, the testes -- everything is included. It is related to many subspecialties."

In children, Chanoine treats diabetes, growth problems, puberty issues and hypothyroidism.

"Endocrinology is a very exciting field to be in," he says. "It's a booming field. You are studying how we are really made, discovering why we see some strange things occurring. You can travel around the world to meet with different people to discuss research. But it is a highly specialized field that usually combines both research and clinical work. You have to like both."

Dr. Barry Jacobs agrees that anyone considering going into endocrinology should be very sure that this is what he or she wants to do. "It's a very long time to study. If it's not right for you, you will be miserable."

After completing medical training at the University of Texas, Jacobs completed a residency in obstetrics and gynecology, and a fellowship in reproductive endocrinology at Baylor College of Medicine in Houston. He has been involved with endocrinology since 1976.

"My training was interrupted because I spent a couple of years in the air force," he says. "And that is where I became interested in reproductive endocrinology. I was stationed at a pilot training base, and saw a lot of pilot's wives who wanted to become pregnant but could not. I became fascinated with reproduction, so I decided to specialize in this field."

Jacobs' days are long. He works 60 to 80 hours a week. A typical day might include performing ultrasounds, checking estrogen levels, doing X-rays of uterine tubes or performing other operative procedures.

"But the fascinating thing is that almost nothing I learned in my fellowship is true anymore," he says. "I have to keep learning new things all the time. The field is moving so quickly. It's exciting and dynamic."

The best part of the work is being able to show a patient their pregnancy on ultrasound. "I get a real high out of that. So many patients are memorable. It just gives me so much pleasure to work with them. Lately, I've had a couple come here all the way from Turkey to see me. I had to use an interpreter to communicate."

The stresses come from dealing with insurance companies and from needing to know business skills. "Nowadays, you have to run your practice like a business, and I don't know enough about doing that. I really advise anyone who is going to become a doctor to study accounting, marketing and basic business skills. You definitely need to know those things."

Jacobs also suggests that a would-be endocrinologist learn elocution, public speaking and communication skills. In college, he suggests that you study the humanities. "This will be your only opportunity to study the humanities, so take advantage of it. When you are in medical school, it is all science. Studying Latin is useful too."

"But make sure that you are interested in a career in medicine," advises Dr. Sandra Sirrs. "Endocrinology is a subspecialty. You don't make decisions about your specialization until you have completed medical school."

Sirrs is a clinical instructor with the division of endocrinology at a university. She is also the medical director of the Adult Metabolic Diseases Clinic. After graduating from medical school, she specialized in internal medicine. She became an endocrinology fellow in 1995.

Next, Sirrs did some further training at a children's hospital. Specifically, she looked after adults with inborn errors of metabolism. "Inborn errors of metabolism include conditions such as galactosemia. Adults with these particular conditions had been looked after at the children's hospital, so we set up a transfer program for them," she says.

Sirrs chose endocrinology for two main reasons. First, she is interested in the processes of conditions such as diabetes and lipid disorders. Secondly, she finds that endocrinology offers attractive lifestyle features.

"You work with outpatients, so you are not as likely to be called out at 3 in the morning as you are with inpatients. Plus you get to see patients on an ongoing basis, which is nice. It's all to do with schedule. There are very few medical disciplines where you can expect to be home every night for dinner. It's a big factor in my career choice."

Typically, Sirrs works about 50 hours a week -- more if she is on call. "I start at 8 a.m. and my day runs to 5:30 or 6. I see patients and I teach. I teach medical students and I teach internal medicine residents and fellows in endocrinology. I also rotate through the endocrinology call schedule, meaning that I am on call to inpatient physicians for consultations."

Time management is stressful. "You get asked to do many things that you would like to do, but you don't have time for everything," she says. "Endocrinology is a really excellent field. It's a great mix of complicated things, but they are things that one can deal with in the daylight hours."

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