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An Exploration of Pediatric Endocrinology

by Kylie Bachmann (’24)

As a Medical Sciences student, when asking classmates and peers what their future plans are, the responses are not diverse. The most common answers that I’ve heard include the following: pediatrics, ER physicians, surgeons, cardiologists, and family medicine now and then. While there are thousands of subspecialities and health-related careers, why are only a few discussed among undergraduates? Are these fields really that popular or are they just more familiar to the public? One of the many lesser known careers is Pediatric Endocrinology. Dr. Halley Wasserman works at Cincinnati Children’s hospital and has given some insight during the interview below on what it’s like to be a Pediatric Endocrinologist and some advice to students who may be interested in pursuing this career.

Q: What is your name and where do you work?

A: Halley Wasserman – Cincinnati Children’s Hospital

Q: What is pediatric endocrinology?

A: Endocrinology is the study of hormones systems including growth, metabolism and diabetes, puberty, thyroid, adrenal, pituitary function, parathyroid hormone, and others. Pediatric endocrinology is the study of these hormone systems in children.

Q: Why did you choose this career path?

A: I choose this path for several reasons. I love the continuity of general pediatrics but I wanted my clinic days to involve more pathology. When I was a med student, someone told me that there is something interesting about every specialty, but you’ve got to choose the one where you find the bread and butter interesting otherwise you will get bored. In pediatric endocrinology, abnormal growth and development (e.g. short stature, delayed or early puberty) is the crux of what we do. I also specialize in calcium and bone disorders like hypoparathyroidism and osteoporosis. These can be inherited conditions or secondary to other chronic illnesses. This is an area of medicine where hormone replacement has only recently been available as a treatment approach in adults and is only slowly trickling down into pediatrics. It is exciting to be in a field where I can be directly involved in changing clinical practice. These drugs and treatments were not taught in my medical school training but through my academic work, I hope to be able to contribute to the medical knowledge for future generations.

Q: What is your favorite thing about pediatric endocrinology?

A: I love calcium and phosphorus physiology. It is so complex with multiple hormones (PTH, FGF23, Vitamin D, calcitonin) and organs (parathyroid, kidney, bone, intestine) involved. I also really enjoy getting to think about growth of the skeleton on a more cellular level.

Q: If you had to convince someone to become a pediatric endocrinologist, what would you tell them?

A: This is a great field for someone who enjoys working with all specialties given the effect of hormones on all organ systems. For individuals who like puzzles, chemistry, and thinking about how changes on a molecular level have a profound impact on a person’s overall function, this specialty is also a good fit. Finally, while diagnosing an endocrine disorder in a child likely means they will have this condition for their whole lives, we have treatments for all hormone dysfunction conditions and in the vast majority of cases, our patients live completely full lives.

Q: What is your LEAST favorite thing about pediatric endocrinology?

A: For me, I find referrals for obesity to be the most challenging. Many people are hoping for a hormone issue to explain their child’s weight issues but it is rarely the case. Lifestyle habits for a whole family are difficult to change, but it is the most important thing to reach success. I think primary care doctors also think we have more resources at our disposal to help address weight issues. We do have more time to listen and strategize with families, but it still requires the day-to-day motivation and work.

Q: What does the day-to-day of pediatric oncology look like for you?

A: Primarily I am in clinic or conducting research. Hormone testing takes time to result and interpret, so there is a fair amount of follow up outside of clinic as well. We spend a good portion of time communicating with families in their home fine tuning treatments based on changes in the home setting, growth, or nutritional intake.

Q: What kind of schooling and how many years did it take to become a pediatric endocrinologist?

A: It is 3 years of pediatric residency and 3 years of fellowship training. I also got my Master’s in Clinical and Translational Research.

Q: What is your schedule like? Are you on call? Is it flexible?

A: My schedule is typically 8-5. At a major pediatric hospital like CCHMC, when we are call it is extremely busy but we are a large division so we are only on call 4 weeks out of a year. There are rare emergencies in our field, so it works well with my young family that I don’t get called into the hospital overnight.

Q: What type of skills does this career require? (e.g. attention to detail, critical thinking, working well under pressure, steady hand)

A: Definitely attention to detail and critical thinking. While there is certainly pressure in all areas of medicine, our specialty allows time to sit back and think a bit before acting. We do not do any procedures.

Q: What would you tell a medical student considering pediatric endocrinology?

A: Definitely do an outpatient elective during your training as the vast majority of our interesting cases come through the clinic as opposed to the hospital setting. Try to also participate in a diabetes camp to really see how these kids live their lives.

Q: Would you consider pediatric endocrinology a lesser-known career? If so, why do you think this is?

A: It is. I often tell families the endocrine system flies under the radar but is so important to make sure all the other organ systems function well (cardiac, neuro, musculoskeletal, etc). We may not get the immediate recognition from patients, friends or families for the importance of our work, but it is so satisfying to help treat patients and establish a long term relationship with them to help them lead full lives.

Q: Is there anything else you would like to add?

A: I focused primarily on the endocrine system, but diabetes is an important component of endocrine training. Some of my colleagues are what we consider “diabetologists” or focus primarily on the complexities of this disease in children and others do a mixture of both. There is flexibility to design a career that fits your personal interests and goals.

 
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