Endocrinology at Bronx-Lebanon

Blue book elective
Hands down, my favorite rotation yet.

Usually third year medical students don't do electives since third year is reserved for the 5 cores but hey, this is AUC, I'm a January class, everything gets shuffled up. I actually don't start another core rotation till September (OB/gyn) but that's besides the point. Endocrine is a 4 week rotation, and you work closely with one resident and the attending. I'm the only medical student, which I actually prefer. Working with a bunch of other students sucks sometimes, especially if you are working with the "gunner" types who basically throw themselves at every resident being absolutely obnoxious as possible constantly asking if they can do this or that, trying to go above and beyond for no other reason than to seem like they care more than everyone else around them. Ah but I digress, that's a discussion for another day.

Working alone is fun! Having real responsibility for a change is fun. Coming to work actually means something for this rotation and I can't recommend it enough for those of you searching for an elective. I come into work everyday around 9 am and find the resident I'm working with for the day. Usually there's one or two residents on for the month, but since this is the end of the year and everyone is graduating, things have been chaotic in this respect. I go to the 8th floor residents' lounge and ask who's on for today. At this point everyone knows me as the endocrine girl so they've been good about informing me who I'll be working with. More often then not, the resident I am supposed to be working with is in clinic in the mornings (i.e. not in the hospital) so when a consult comes in, I get to do it.

What does that even mean, you ask? Well in a hospital, when patients are sick with something, they may have something else going on with them that might be outside the ability of the internal medicine docs who are caring for them.... that's where the consults come in. They call in the specialists for that particular field of medicine and since I'm doing endocrine these cases involve the hormones. Right now I'd say 80% of the consults are for uncontrolled or newly diagnosed diabetes. I've also had quite a few hyperthyroidism cases, one Hashimoto's, a few hypercalcemias, a couple panhypopituitarism, and a Cushing's disease case.

My resident will usually call me up and say "hey An-dreee-a [that's not how you pronounce it btw] we've got a consult. This is the patients name, MR number, and reason for consult. Go." I write this all down, take a look on the computer about what they're doing in the hospital and then I go interview and do a quick physical on the patient. That's another added bonus for consults- I just run up and down the floors during the day, see some of my friends in the process and yea, just the change of scenery does me wonders. Things get boring quick when you're relegated to the same 5 rooms for an entire day.

My interviews usually take 10-15 minutes where I'll ask about past medical history, social, family histories, a quick and very focused review of systems and then for physicals I just listen to the heart and lungs and press on the belly and ankles and my work is done. Of course if you are there for thyroid, you do have to do a thyroid exam. If you're there for diabetes it's good to look for acanthosis nigricans around the neck or axilla (Board question: acanthosis nigricans it most commonly seen in type 2 diabetics!!! Don't say stomach cancer) and asking about how long they've been diagnosed and what meds they are on to control it would be key.

After that I start my consult note and wait for the attending to arrive to the hospital so I can present the patients to her and then we round together and discuss what should be done with the patient. On average I'd say we've been getting three consults a day but I've had as much as six and as little as one.


The attending was absolutely fabulous. At Bronx they rotate attendings each month and I've been fortunate enough to meet both women who are each energetic, knowledgeable, and considerate. My attending was constantly teaching everyday during rounds which I loved and she seemed to enjoy it herself. Teaching attendings are far and few so don't waste the opportunity. You will learn a ton of endocrine during this rotation and if you couple this with some studying at home, you'll be great for boards. I can't recommend this rotation enough.