While on rotation in a tertiary care hospital, a 45‑year‑old woman presented with unexplained weight loss, palpitations, and episodic hypertension.

I needed to determine the underlying cause and initiate appropriate therapy promptly to prevent complications.

Ordered a comprehensive panel including serum calcium, PTH, thyroid function tests, and 24‑hour urinary catecholamines; imaging revealed a pheochromocytoma. Coordinated multidisciplinary care with surgery and endocrinology, adjusted antihypertensives, and educated the patient on peri‑operative management.

The tumor was resected successfully; the patient’s blood pressure normalized, and she reported a 15‑lb weight gain within three months, confirming effective treatment.

In my role as a clinic fellow, diabetes guidelines are updated biennially, affecting medication algorithms.

Ensure my prescribing practices reflect the latest evidence and share updates with the team.

Subscribe to ADA newsletters, attend quarterly endocrinology grand rounds, and review new journal articles using a structured appraisal tool. I also lead a monthly journal club where we discuss recent trials and update our clinic protocols.

Our clinic’s HbA1c reduction rate improved by 8% over the year, and we achieved a 95% adherence rate to the latest ADA recommendations.

A 58‑year‑old man received a fine‑needle aspiration confirming papillary thyroid carcinoma.

Communicate the diagnosis compassionately while outlining treatment options and addressing his anxiety about surgery and lifelong medication.

Scheduled a private, uninterrupted meeting; used plain language to explain pathology, prognosis, and surgical plan; provided visual aids; invited his spouse to the discussion; addressed concerns about voice changes and calcium supplementation; arranged a follow‑up counseling session with a nurse practitioner.

The patient expressed understanding and consented to total thyroidectomy; post‑operative satisfaction scores were 9/10, and he adhered to calcium monitoring without complications.

A 32‑year‑old woman with primary adrenal insufficiency repeatedly missed her hydrocortisone doses, leading to fatigue and occasional hypotension.

Improve adherence to prevent adrenal crisis.

Explored barriers through open‑ended questions; discovered she forgot doses due to a hectic work schedule. Implemented a simplified dosing schedule, set phone reminders, and provided a pill organizer. Coordinated with her primary care provider for regular follow‑up and reinforced sick‑day rules.

Adherence rose to >95% over three months; she reported increased energy and had no emergency visits for adrenal crisis.

During my fellowship, I noticed conflicting data on vitamin D’s role in insulin resistance among pre‑diabetic patients.

Design and execute a randomized controlled trial to clarify the relationship.

Secured IRB approval, recruited 120 participants, randomized them to high‑dose vitamin D3 or placebo for six months, measured HOMA‑IR, fasting glucose, and HbA1c at baseline and study end. Conducted intention‑to‑treat analysis and presented findings at the Endocrine Society meeting.

The trial demonstrated a modest but statistically significant improvement in HOMA‑IR (p=0.03) in the supplementation group, leading to a manuscript accepted in a peer‑reviewed journal and informing clinic protocol adjustments.

I was invited to speak at a regional conference about emerging insulin therapies, and the sponsor offered an honorarium.

Determine whether accepting the fee aligns with ethical standards and institutional policies.

Reviewed my institution’s conflict‑of‑interest policy, consulted the ethics committee, disclosed the offer to my department chair, and declined the honorarium while accepting travel reimbursement per policy. I ensured transparency by stating the sponsorship in my presentation disclosures.

Maintained professional integrity, avoided potential bias perception, and preserved trust with patients and colleagues.