One-line ‘definition’ of specialty
The study and management of disease related to hormone secreting glands.
Brief run-down of training programme content and duration
The four-year programme typically rotates between smaller general and large teaching hospitals. Training will provide exposure to the many sub-specialties and is tailored to meet individual training needs and career aspirations.
Exam requirements
The Specialty Certificate Examination in Endocrinology and Diabetes.
Other requirements:
- Logbook of outpatient clinics and patient numbers.
- Eportfolio work-place based assessments (WPBA)
- Attendance at specialist training courses in diabetes and endocrinology run by the Royal College of Physicians or specialist societies
- Audit activity
Opportunities/expectations for out of programme/research
Given the strong academic tradition, many trainees in this specialty undertake a period of research leading to a postgraduate degree, though this is not mandatory and depends on personal interests and career aspirations. There is a huge range of research opportunities within basic science, particularly within the fields of stem cell biology and molecular genetics. With established national and local networks, this area has some of the best clinical research opportunities of any specialty. I have undertaken research into the role of technology such as insulin pumps and continuous glucose sensors in the management of type 1 diabetes. I have colleagues undertaking research in a wide range of other areas including new treatments for Addison’s disease and the use of functional magnetic resonance imaging to investigate insulin resistance.
A day in the life of a diabetes and endocrinology Registrar/Consultant
Each day is extremely varied, consisting of many different activities e.g. insulin pump clinic, new patient endocrinology clinic, supervising dynamic endocrine testing, multi-disciplinary thyroid meeting, clinical teaching, young person diabetes clinic, ward rounds, specialised endocrine clinics, general diabetes clinic and general medical take.
Pros and Cons of working in this specialty
Pros
- Camaraderie of multi-disciplinary team working
- Opportunity to use problem solving/analytical skills to make diagnoses
- Excellent research opportunities with clinical research well-integrated into NHS care
- Wide range of effective therapies available, leading to rewarding practice
- Mostly outpatient based therefore facilitating flexible working.
- Opportunity to develop long-term patient relationships
- Broad range of patient groups
Cons
- Few practical procedures
How this specialty differs to others and what made me choose it
When I took the opportunity during my Senior House Officer (SHO) rotation to attend outpatient clinics, the wide range of patient groups/ages and the intellectual challenge of applying knowledge of physiology and biochemistry to make diagnoses helped me realise this was the medical specialty for me. In this specialty there is time to be methodical and logical in the decision-making approach to making the diagnosis, which I found appealing.
Within the clinical practice of diabetes there are many unique challenges. At an epidemiological level there is the worldwide epidemic of type 2 diabetes requiring a new generation of clinicians to lead the medical profession’s response. At an individual level there is the challenge of using excellent communication, consulting and teaching skills to motivate change among our patients to prevent the long-term complications of the condition. Given the complex and chronic nature of many of the conditions within the specialty, attention needs to be paid to all aspects of well-being including physical and psychosocial health.
With advances in the understanding of many endocrine disorders, particularly with regards clinical genetics, there are new therapies becoming available, making it an extremely exciting time to follow a career in this specialty.
Tips for success in applying for this specialty
- Arrange a ‘taster session’/placement with your local department. As the specialty is mostly outpatient based, unfortunately many foundation and Internal Medicine Training (IMT) trainees do not get any insight into what a career in the specialty is really like
- Speak to local Specialty trainees about their experience and shadow them while they are working
- Speak to a local Consultant about undertaking an audit or being involved with a research project