Dr Nick Barwell, Consultant Physician
One-line ‘definition’ of specialty

Ongoing commitment to acute and general medicine with specialty and sub-specialty clinics in diabetes and endocrinology.

Brief run-down of training programme content and duration

A five-year programme of rotation between hospitals in Greater Glasgow and district general hospitals outside Glasgow. One high intensity year focused on General Internal Medicine (GIM) followed by continuing commitment to acute and general medicine but with increasing exposure to specialty clinics. Training requires experience in highly specialised fields within endocrinology and diabetes and the opportunity to engage in research of a traditionally high standard with a view to attainment of a higher degree.

Exam requirements
  • MRCP(UK)
  • Specialty Certificate in Diabetes and Endocrinology (not required during my training)
Other requirements
  • Competencies maintained and recorded through Eportfolio
  • Attendance at mandatory GIM teaching and specialty teaching
  • Attendance at generic management training sessions
  • Practical skills in general medical procedures
  • Practical skills in performing and interpreting complex endocrine testing
  • Expertise in multiple areas of diabetes and endocrinology sub-specialties
Opportunities/expectations for out of programme/research

Training in the West of Scotland has traditionally been very strong in allowing trainees to participate in funded research studies. Good clinical and academic support has seen recent trainees achieve good quality research, peer-reviewed publication and higher degrees (MD/PhD). The location of the British Heart Foundation (BHF) building on the Western campus and links with both the Scottish Diabetes Research Network and the University of Glasgow’s Institute of Biomedical and Life Sciences provides a variety of research opportunities.

A day in the life of a Registrar/Consultant
  • Strong commitment to general medicine
  • Opportunity for multi-disciplinary team (MDT) working in diabetes and endocrinology
  • Clinics in general diabetes and endocrinology but with opportunities to sub-specialise in a huge variety of areas
Pros and Cons of working in this specialty

Pros

  • GIM commitment
  • Excellent team ethos in most units
  • Great opportunity for cross specialty working (neurosurgeons/oncologists/radiologists/obstetricians/podiatrists etc.)
  • Interesting and diverse specialty which can be tailored to specialist interests
  • Great opportunity for ongoing research and publication.
  • Fun people to work with (mostly!)
  • Supportive of flexible training and working
  • Clinically extremely important to patient groups and to the NHS as a whole

Cons

  • GIM commitment (it’s both a positive and a negative).
  • Minimal ‘protected procedure’ time
How this specialty differs to others and what made me choose it

The MDT nature of the specialty combined with the complex physiology and biochemistry problems made this intellectually attractive. In practical terms there is an increasing body of evidence in the diabetes field and related opportunities to make a positive contribution to those with chronic disease. Sub-specialty clinics can be fascinating and there is excellent opportunity for ongoing research. Colleagues who work in diabetes and endocrinology are generally good clinicians with an excellent attitude to teamworking.

Tips for success in applying for this specialty:
  • Show an interest and passion for the specialty.
  • Do some audit or small project in diabetes and endocrinology (your local unit will nearly always have opportunities).
  • Attend diabetes and endocrine clinics and experience working in this area – make sure you enjoy the ‘nuts and bolts’ of the daily work.
  • Consider your academic interests; you don’t need to be a career academic but you must show an interest in, and appreciation of, audit and clinical research.
For more information

European Association for the Study of Diabetes

Society for Endocrinology

Diabetes UK

British Medical Journal Careers