Reflections on my journey in pediatric endocrinology

My inspiration to specialize in Pediatric Endocrinology stemmed from my exposure to endocrine cases during my post-graduate pediatric training. The field intrigued me with its complexity and potential to transform lives. What truly fascinated me was the gratifying nature of treating endocrine disorders. Most of these conditions, whether congenital hypothyroidism, type 1 diabetes, or growth disorders, can be managed effectively, allowing affected children to lead near-normal lives. Witnessing these outcomes reinforced my commitment to pursue this subspecialty. My passion for this field was further solidified during my senior residency, when I had the opportunity to work for six months in the Pediatric Endocrinology division at All India Institute of Medical Sciences (AIIMS), New Delhi.

The path to entering a Doctorate of Medicine (DM) program in Pediatric Endocrinology was not without challenges. At the time, only one seat was available annually across India, offered solely at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. The competition was intense, with numerous highly qualified candidates vying for this coveted opportunity. Balancing preparation for the entrance examination with a demanding Senior Residency was particularly arduous and tested my resilience. Securing admission to PGIMER remains one of my most cherished accomplishments and a testament to perseverance and determination.

PGIMER, Chandigarh, was the first institute in India to offer a DM program in Pediatric Endocrinology, and its reputation as a center of excellence made joining this program a dream come true. My 3 years of training were profoundly enriching, marked by exposure to an unparalleled variety of cases. From rare genetic disorders to common endocrine conditions, the clinical diversity, along with the structured academic and clinical schedule, provided invaluable learning experiences. Dedicated academic sessions, including case discussions, seminars, and journal scans, combined with specialized clinics for general endocrinology and diabetes, as well as separate clinics for thyroid disorders, obesity, and disorders of sex development, provided the perfect blend of in-depth knowledge and extensive hands-on experience for managing a complex range of cases. In addition, adult endocrinology rotations, multidisciplinary sessions, and online sessions with other academic institutions enabled valuable interactions and enhanced learning. The faculty at PGIMER fostered a learning environment that felt both rigorous and nurturing. They were not just teachers but mentors who guided us with unwavering dedication. They were always approachable and would inspire us to seek the atypical in every case, and to question rather than simply accept. The camaraderie among my colleagues and the collaborative learning environment further enhanced my training. Beyond academics, the city of Chandigarh, with its clean and serene surroundings, offered an ideal backdrop for focused learning and personal growth.

Pediatric endocrinology is an evolving subspecialty in India, gaining increasing recognition in both private and government sectors. With the growing prevalence of conditions such as childhood diabetes, obesity, pubertal, and other endocrine disorders, the demand for specialists in this field is on the rise. Recent years have witnessed significant advancements in the training opportunities available for aspiring pediatric endocrinologists across India. DM programs are now also available at AIIMS, New Delhi and AIIMS, Bhopal, offering clinical and research training. In addition, the ISPAE-recognized 2-year fellowship courses at multiple centers in the country provide excellent specialization opportunities. Research and clinical advancements, including innovations in diabetes technology and genetics, continue to expand the scope of this specialty. The opportunities to contribute meaningfully – whether through clinical practice, teaching, or research – are both exciting and promising.

Post-training, the career prospects in pediatric endocrinology are diverse. Specialists can contribute to healthcare through clinical practice in tertiary care centers, private practice, or government hospitals. Beyond clinical work, there is tremendous scope for contributing to research, especially with the growing interest in rare disorders, early diagnosis, and personalized treatments. Opportunities in academia are also expanding, with increasing demand for teaching roles and research collaborations. One of the most exciting developments is the integration of artificial intelligence (AI) into various aspects of pediatric endocrinology, for instance, closed-loop insulin delivery devices, predictive algorithms, AI-based monitoring of growth, puberty, bone health, and more. Even with the over-reaching applications of AI in diagnostics and decision-making, clinical acumen and experience remain crucial in pediatric endocrinology to ensure ethical, compassionate, and context-based treatment decisions. Like other pediatric subspecialties, endocrinology is headed toward evolving into a standalone department at many institutions, which will, further, enhance career opportunities in this field.

As I reflect on my journey, I am deeply grateful to my mentors, whose constant belief in my abilities and inspirational guidance keep me going. The professional relationships and friendships I formed during my training remain a source of strength and motivation. I look forward to making impactful contributions to the field while continuing to learn from the stalwarts who have laid a robust foundation in this subspecialty. To those considering a career in pediatric endocrinology, my advice is simple: embrace the challenges with determination and an open mind. The field is immensely rewarding, offering the opportunity to make a tangible difference in the lives of children and their families. As Lao Tzu said, “The journey of a thousand miles begins with one step.”