This is a part of a series of interviews with adults with different professions. This series was intended to assist teens as they figure out what job they would like in the future. This interview is with Dr. Nairi Berner, an endocrinologist.

Natalie: So, could you explain what endocrinology entails?

Dr. Nairi Berner: Sure. So, endocrinology is the study or the practice of medicine of hormones, and most people think of hormones as the things that help us grow from kids to adults or the way that our bodies change over time, but really, there are lots of different hormones that endocrinologists study and deal with. The primary ones are probably insulin, which is the hormone that is deficient in patients with Type 1 diabetes. We also deal with a lot of patients with thyroid problems, and hormones even play a part in keeping bones strong, and so men and women with a history of osteoporosis or poor bone density, we help them as well, so there isn’t a specific part of the body that endocrinologists are sort of responsible for looking at. We do look at the whole body because hormones are typically all over the body and have many, many system effects.

Natalie: What types of patients do you deal with in this medical field?

Dr. Nairi Berner: So as an endocrinologist, probably about 50% of the patients I see are people with diabetes, either Type 1 or Type 2 or some of the other rarer forms of diabetes, but also, people who have thyroid problems, bone problems, and problems with any other glandular issues such as the adrenal gland and the pituitary gland. Those are all sort of in our field, so we do see people with those types of problems as well, but a large portion of our patients are people with diabetes or metabolic disorders.

Natalie: What sparked your interest in this medical field?

Dr. Nairi Berner: Well, it’s not that I always wanted to become an endocrinologist, you know. To become a doctor or to become a physician, for most people anyways, the road is we go to college and then after college, we enroll in medical school and after four years in medical school, we take some exams and then pick a residency. Residencies are sort of more general fields, so I picked internal medicine because internal medicine is what we mostly think of just a regular doctor who is overseeing our overall health. It’s not a surgical field, it’s not a specialized field, but after doing an internal medicine residency for three years, you can choose to become an internist or a generalist or you can narrow your field down and do what is called a fellowship in one of the more specialized fields like cardiology, dealing with heart disease, or pulmonology, dealing with lung disease or oncology which deals with cancer, and endocrinology is one of those fields.

I decided to become an endocrinologist when I was an internal medicine resident, probably around the end of my first to the beginning of my second year. It’s really because I liked having a longitudinal relationship with patients. Endocrinology has a lot to do with looking at labs and numbers and trying to figure out what is going on as far as whether someone’s medication needs to be tweaked or whether they have a hormonal disorder in one part of their body that is affecting another part of their body, and really, those are the things that sort of drew me to endocrinology. You kind of get to have a little bit of a hand in everything. You build long relationships with your patients because the conditions that we deal with are chronic conditions, requiring long term management care, and in many cases, particularly with diabetes, you really become a partner in the patients’ treatment with the person and their family because diabetes is a condition that we of course use medication for, but in many cases, it really has a lot to do with lifestyle, diet exercise, all those things, and you really become more of a team member in the care of your patients

Natalie: That’s a very interesting way that you came about endocrinology!

Dr. Nairi Berner: Yeah, I really like what I do. I always say being a doctor is the best job in the world, I don’t think I could’ve chosen anything else, and I really love it. Endocrinology was definitely the best choice for me, but I think after medical school, people have many different options and most of us end up practicing medicine. The types of medicine we end up practicing are very very different and our day to day lives are very very different and I spend most of my hours in a clinic setting, seeing patients, surgeons are in the OR, there are other doctors who are primarily hospital based, seeing patients who are admitted to the hospital, and there are lots of different avenues after medical school and because medicine has become so special because there is so much knowledge out there and so many things are changing so quickly, it has become important for trainees to become experts in our field because we’re often sent patients with problems that are not in our field, and so even though they are a doctor, they may not know much about the care that we could provide.

Natalie: So, while we’re on the subject, would you say that endocrinology is a more popular field that more people pursue or that it is a more unique position? Why?

Dr. Nairi Berner: No, I wouldn’t call it popular. I wouldn’t say its unpopular, but I would say that probably a bigger portion of medical school graduates in the United States pick fields that are procedure based because that’s just what people like to do. For example, surgical fields and even fields like gastroenterology, where procedures are common or cardiology, where procedures are common, those are probably a bit more popular, but it really depends on the personality and the likes and dislikes of the person. The field of medicine is just as varied as anything else and offers a lot of opportunities. There are some people who go to medical school and do not practice medicine. They go into the business field or the health administration field or they join a pharmaceutical company, and that degree gives them the background and the education to be able to pursue those types of things. I wouldn’t call endocrinology popular, but it is a growing field because the treatment options we have for a lot of the conditions we treat has grown, and we have a lot more ways to treat people than we previously had.

Natalie: I agree. I feel like endocrinology will most likely grow to be more popular over time.

Natalie: I know that in all jobs, there are stressful factors as well as good factors. What are some difficult situations that must be dealt with in your field?

Dr. Nairi Berner: For better or for worse, we always try to do our best for patients, and it doesn’t always work out. It’s always tough when it happens, and that can happen for a number of reasons. It can happen that a person gets sicker because they weren’t able to get the medication that we prescribed or that they simply didn’t want to take it or because of bad luck. I think that when things go wrong in medicine, when a person doesn’t get better or gets worse or we need a treatment option for the patient that, for whatever reason we cant have, that’s probably the most frustrating and most difficult challenge to deal with.

Other than that, I would say, less often, but it does happen when we have a patient who we think has something wrong with them, who has some symptoms that are unexplained and we can’t figure out what condition they have, even to start treatment. That’s a lot more rare, but it does happen and that’s extremely daunting because those things will keep us up at night. I would say the only other thing that is probably true in all of medicine is that we have to work to have a good work-life balance, to make sure doctors are taking care of themselves, their families, and their own health, in order to come in and take care of everyone else. That can be challenging because our jobs are challenging. Fortunately, over time, most of us are able to achieve a reasonable balance.

Natalie: Yes, it seems like in the medical field specifically, there are a lot of stressful factors involved.

Dr. Nairi Berner: Yeah, there is a lot of stress. It is a very long arduous road to get to where you are going, and that road starts well before even medical school because getting into medical school is difficult. You really have to be determined, know what you want to do, and be able to commit, and there are a lot of lost hours with family and friends and that can be hard to swallow, but I think for people like me, there are a lot of doctors out there that know that this is what they want to do. They’ve known that for many years before they came doctors, and it’s a very very fulfilling career, and those moments are definitely worth it in the end.

Natalie: Lastly, are there any pieces of advice or resources that you would recommend to teenagers who are interested in this career?

Dr. Nairi Berner: Yes. So what I would say is for teenagers who are generally interested in the field of medicine is to start volunteering at local hospitals, and if they are particularly interested in the field of endocrinology, the American Diabetes Association is a great organization that fundraises for patients with diabetes and diabetes research and that would be a great resource for them to get started with.

I think it’s really important to understand whether you feel like the working environment is something that you’ll be able to handle, something that you like, and something that you enjoy. Do you enjoy being around people? Do you enjoy helping? Do you enjoy forming these relationships with patients? Do you like the science of medicine? It’s important to understand those things early in teenagers, certainly in college, because once you take the step going into the medical field, you’re sort of making a commitment at that point and I think it’s important to evaluate if it is something you really want, and whether you want to go into it for the right reasons, because it is challenging and it’s also a big commitment of your time, and the years when you are young and would rather be doing something else.

I remember as a teenager volunteering at hospitals and doctors offices. There are lots more options now because there are probably a lot of web based things that can be learned. The ADA (American Diabetes Association) is one of my favorite organizations to tell people to join because anybody can go on that website and look for opportunities for volunteerism for learning about diabetes and local events, so I would say that that would be a great place to start. Don’t be afraid to reach out to local doctors to see if they are willing to talk and share their experiences, because we love to see young people going into medicine, so we are always willing to share our experiences and help young people pursue this really wonderful career.

Natalie: Thank you so much for making time for this interview! I am sure that it will be a helpful guide to teenagers who are still deciding what career they would like to pursue. Goodbye!