Components of Training

Core Training
The Required Clinical Year

The RC year should be undertaken in an endocrine unit, which receives patients from across the breadth of endocrinology, diabetes and metabolism. Trainees should have hands-on experience with the management of endocrine emergencies, with inpatient consultations and with relevant diagnostic and therapeutic procedures. Trainees are expected to have inpatient service responsibilities with patients admitted to beds under their care with the supervision of an endocrine specialist. The outpatient experience for trainees should include a substantial number of new patients reflecting the broad range of endocrinology, diabetes and metabolic bone disease and should include experience in diagnosis, investigation, management and follow up. In general, the SAC recommends that advanced trainees undertake the RC year in the first or second year of advanced training. The requirements for the RC year is further dealt with in the section below on training posts.

Further Clinical Training

Trainees should consolidate the training received in the RC year with further core endocrine clinical training either in general endocrinology and diabetes or in endocrine subspecialty areas. Although not always available, trainees should seek the opportunity to extend their experience in reproductive and paediatric endocrinology, in lipid disorders and endocrine cancer. Valuable experience may also be obtained in wider areas of metabolic bone disease, nuclear medicine and obstetric medicine.

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Procedural Skills
Endocrine trainees should be able to interpret biochemical tests relating to endocrine diagnosis and have a good understanding of the laboratory methods underlying these analyses and their limitations. Ideally, trainees should take responsibility for clinical reporting of routine endocrine results. Trainees should be familiar with organ imaging investigations, hormone implants and fine needle aspiration as they relate to endocrine diagnosis.

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Elective Training
Refer to the section of the guidelines under General Principles.

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Other Specific Requirements

• Trainees will be interviewed at least once during the course of their advanced training.
  
• Trainees should attend and preferably participate in at least two relevant national or international meetings over the three-year training period.
  
• Trainees should be an active member of a journal club or local clinical endocrine group.
  
• Trainees should be involved in preparation and presentation of teaching materials for tutorials, seminars and grand rounds for undergraduates or postgraduates.
  
• The SAC will seek confirmation from supervisors that trainees have achieved an appropriate level of performance in their training during the year and have fulfilled the requirements for presentation and/or publication noted above.

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Research
Trainees are encouraged to undertake one or more research projects during their training and to present their results at one of the Annual Scientific Meetings of the special societies. Research may involve work towards a higher degree or may be a smaller laboratory or clinical research project, a clinical audit, clinical epidemiology project or development of a clinical indicator. The experience should involve critical appraisal of the literature, formulation of a study design, practical experience with the running of the study, statistical analysis of results and preparation of material for presentation and publication. Trainees will be expected to present some aspect of their research at national or international meetings.

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Training Posts
There are many training positions that offer valuable experience in clinical endocrinology and the SAC encourages trainees to choose appropriate positions to broaden their endocrine training.

The RC year needs to be undertaken in a major endocrine unit that provides a broad spectrum of experience that can be properly supervised. Not all positions will be able to offer this. If training positions are able to deliver some, but not all the important elements of an RC year, the trainee will need to undertake further training until the RC year requirements are met.

Site visits are undertaken by the SAC to establish whether sites provide the range of experience needed for the RC year and whether changes in practice are impacting on training positions.

Trainees are required to identify a suitably qualified endocrinologist to act as supervisor for each core year of advanced training. The supervisor has the responsibility for overseeing the suitability of the training program during the year; for providing educational opportunities for the trainee; and for completing an appraisal report at the end of each year of training.

Centres at which the RC year in endocrinology can be undertaken should have the following:

• Two or more full-time endocrinologists or one full-time endocrinologist supported by additional visiting or academic endocrinologists.
  
• Inpatient beds with acute endocrine and diabetes admissions, which are managed by the trainee and an inpatient consultation service in endocrinology.
  
• Structure and policies to permit direct involvement by the trainee in the management of acute endocrine emergencies e.g. diabetic ketoacidosis.
  
• A variety of endocrinology out patient facilities in which the trainee will assess and make management decisions about patients.
  
• Access to a diagnostic endocrine laboratory and exposure to current diagnostic testing protocols in endocrinology, opportunity for reporting endocrine diagnostic tests.
  
• Facilities for nuclear medicine studies, radiology, and endocrine surgery.
  
• A diabetes centre with diabetes educator staff, an identified endocrinology department with office space for the use of the trainee.
  
• Access to a well-equipped library containing core endocrine reference materials and journals and current general reference material.
  
• Regular clinical and research meetings in endocrinology.

List of Accredited hospitals for training in endocrinology

It is recommended that trainees apply at an early stage for membership of the special societies.

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