Over the past decade, there have been fewer pediatric residents applying to pediatric endocrine fellowship. One possible contributor to this trend is a lack of exposure to pediatric endocrinology outpatient work while in residency. The aim of this narrative review is to describe a single center medical education experience to create a standardized framework for residents rotating through a pediatric endocrine rotation. In a multi-stage process, a working group consisting of medical educators developed a pediatric resident framework for subspeciality endocrine rotations and implemented it from 2019 to 2022. Afterwards, the new pediatric endocrine framework was evaluated. The conceptualization process and the implementation of the framework together can be represented as a modified Plan-Do-Study-Act (PDSA). A standardized pediatric endocrine framework resulted in increased resident satisfaction, faculty satisfaction, and popularity of the pediatric endocrinology selective course, thus exposing more residents to pediatric endocrinology. The process required 75-135 min of administrative time per resident (15 min of administrator time, 60-120 min of faculty time) and 120 min of teaching time per resident (medical education faculty team). This study shows that in a single academic center, restructuring the resident elective in pediatric endocrinology with an eye to customization based on resident interest led to increased resident satisfaction, faculty satisfaction, and increased popularity of the pediatric endocrinology elective course. In an era where overall popularity of pediatric endocrinology is dwindling, but need for specialized expertise is growing, this is a step towards increased resident exposure to the subspeciality.