Subspecialty Careers: Endocrinology, Diabetes, and Metabolism
From the Greek endon, "in, inner, or within" and krinein, "to separate or put apart." A term contrived to describe those glands that "put apart" and secrete substances that are used within the body.
Endocrinology is the diagnosis and care of disorders of the endocrine system. The principle endocrine problems include goiter, thyroid nodules, thyroid dysfunction, diabetes mellitus, hyper- and hypocalcemia, adrenal cortex dysfunction, endocrine hypertension, gonadal disorders, disorders of sodium and water balance, manifestations of pituitary disorders, disorders of bone metabolism, and hyperlipidemia. While not strictly an endocrine disorder, obesity is considered part of the spectrum of endocrinology because it often enters into the differential diagnosis of endocrine disease and is a major element in the management of type 2 diabetes. Prevention focuses on the complications of obesity, diabetes, hyperlipidemias, thyroid disease, and the iatrogenic effects of glucocorticoids.
Endocrinologists are expected to perform dexamethasone suppression tests, adrenocorticotropin (ACTH) stimulation tests, home blood glucose monitoring and fine needle thyroid biopsies. Additionally, endocrinologists commonly order and interpret bone densitometry tests, fasting and postprandial glucose determinations, glycohemoglobin concentrations, imaging studies of the sella turcica, serum gonadotropin concentrations, lipid profiles, and thyroid function studies.
Endocrinology fellowship training requires two years of accredited training beyond general internal medicine residency. Of the two years, a minimum of 12 months must include clinical training in the diagnosis and management of a broad spectrum of endocrine diseases.
For the 2010-2011 academic year, there are 127 ACGME-accredited training programs in Endocrinology, Diabetes and Metabolism with 554 active positions. Sixty-six percent of the trainees are female and 52% are U.S. medical graduates.
The American Board of Internal Medicine offers certification in Endocrinology, Diabetes, and Metabolism.
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