Endocrinology and diabetes is a broad ranging subject and therefore an enticing one for trainees and consultants alike, since it encompasses basic mechanisms of physiology and pharmacology, coupled with the ability to improve quality of life and long-term outcomes through effective disease control and often cure.
Endocrine and metabolic diseases are some of the most commonly encountered ones in the UK population, and are increasing in prevalence and impact in terms of health of the nation, emphasising the need to continue to strive towards improved health care delivery in our speciality. Endocrine diseases and diabetes affect every physiological system of the body determining that our specialists enjoy a wide range of skills and expertise and make a major contribution to general medicine in its broadest sense.
The speciality has something to offer for everyone. Historically, endocrinology and diabetes have been at the forefront of both basic science and clinical research determining that much of what we do has a strong evidence base. Every trainee and specialist has the opportunity to contribute further to that growing evidence base, which has led to so many innovations in recent years. There are many common conditions we help to manage, and in doing so we work closely with many different multiprofessional colleagues. Particular intellectual stimulation arises because many of the diseases we encounter are uncommon ones, presenting special diagnostic and therapeutic challenges. A broad training in endocrinology and diabetes provides the basis for progression to specialist posts in a wide range of settings from the smaller hospital to the large tertiary referral centre, from the community base to the University academic department.
This is an All Wales training programme which extends across ten centres in South Wales and two centres in North East Wales. Each centre provides a wealth of experience in all aspects of diabetes, and general endocrinology, whilst tertiary lipidology and endocrinology experience is available at the University Hospital in Cardiff. All trainees will gain tertiary hospital experience. The location of the training centres enables trainees to gain experience in inner city, suburban and rural practices.
The standard of clinical practice in Wales is as good as can be found anywhere in the UK but has the added benefit of attractive surroundings, high quality lifestyle, reasonably priced housing, good quality schools, access to stunning countryside, and as a consequence, excellent work life balance. All training centres are based within an hour's drive of major cities, their amenities and airports in South Wales (Swansea and Cardiff) and North Wales (Liverpool and Manchester).
The diabetes and endocrinology training programme has a long track record of delivering successful training and education. The training centres are recognised for the quality of their sub-specialty and general internal medicine training, and all possess vibrant undergraduate and postgraduate centres which provide trainees with ample opportunity to learn from, and contribute to, regional and local teaching programmes.
Each diabetes and endocrinology trainee is given a single Educational Supervisor for the whole of their five year training period. These carefully selected and trained Educational Supervisors have the ability, interest and enthusiasm to support their trainees. The structure provides continuity and a personal and informed opinion of a trainee's development and requirements. The trainee will not work directly for their Educational Supervisor, thereby separating clinical and educational supervision and ensuring impartial advice. This trainee-centred approach to educational supervision has been well received and has improved relationships between trainees and their Educational Supervisors, the latter often becoming mentors to their trainees during their transition to newly-appointed consultants.
In addition to local sub-specialty training, five mandatory sub-specialty training days are provided per annum covering the diabetes and endocrinology curriculum over a four year cycle. Trainees are also expected to participate in the Welsh Endocrine and Diabetes Society postgraduate meetings which are held twice a year and attended by all training centres. High quality regional mandatory general internal medicine teaching is also provided.
Research opportunities are readily available, particularly in Cardiff, Swansea and Wrexham, with up to four trainees out of programme at any one time. The majority of trainees will undertake a period of research during their training and the quality of the opportunities is reflected in the high number of trainees undertaking out of programme research that are awarded higher degrees (85%), MD or PhD.
Dedicated knowledge-based assessment training is provided as part of the sub-specialty curriculum teaching days. To date the Welsh programme has a 100% pass rate at first attempt. All trainees completing the five year training programme in Wales have successfully obtained a consultant post within six months of their CCT during the last ten years.