ENDOCRINOLOGY
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SUPERVISING COMMITTEE

DEFINITION OF SPECIALTY

GENERAL PRINCIPLES

COMPONENTS OF TRAINING

Core Training

Non Core Training

Procedural Skills

Other Specific Requirements

Research

Training Sites

Rural/Regional Training

SPECIAL SOCIETIES

 Vocational Training
 Endocrinology
Supervising Committee
Specialist Advisory Committee (SAC) in Endocrinology.

Definition of Specialty
The specialty of clinical endocrinology encompasses the diagnosis and management of disorders of the endocrine system. Endocrinologists provide treatment, diagnostic and laboratory analysis and conduct basic and applied research in a wide range of humoral and metabolic conditions. These include diabetes and its complications; thyroid; pituitary and adrenal disease; gonadal disorders and infertility; neuroendocrine conditions; benign and malignant glandular tumours; disorders of growth; genetic and congenital glandular dysfunction; lipid and nutritional disorders; menopausal disorders and osteoporosis and metabolic bone disease.

General Principles of Training
  1. Advanced physician training in endocrinology and metabolism consists of a 3 year program comprising core and non core training. Training will usually involve a combination of clinical endocrinology, laboratory medicine and research, but variations to match the requirements of individuals may be considered by the SAC.
  2. At least 2 years’ core training in endocrinology and metabolism is necessary. It is desirable, but not mandatory, that both these 2 years be in aspects of clinical endocrinology and metabolism training. However, regardless of the nature of the remainder of advanced training, one of these 2 core years must be a comprehensive general clinical endocrinology year at a level 3 teaching hospital with inpatient and outpatient responsibilities (the Required Clinical Year (RCY) - see below.) It is because programs of advanced training in endocrinology may be diverse, that the SAC insists on at least one comprehensive and structured year.
  3. Candidates are expected to acquire a depth and breadth of knowledge in clinical endocrinology and metabolism, including diabetes. They must develop a detailed understanding of the principles of endocrine physiology, biochemistry and cellular and hormonal metabolism that underlie clinical and diagnostic specialist practice.
  4. Trainees are expected to develop expertise with diagnostic laboratory endocrinology, with the current literature in both basic and applied endocrinology and become conversant with research activities in the endocrine field.
  5. It is desirable that training be undertaken at more than one institution and it is envisaged that this will be necessary for most trainees, to enable them to acquire a sufficient breadth of exposure and experience. Where training is entirely clinical, rather than combined with laboratory or research years, it is even more important that training takes place at more than one institution. In NZ three years at a good quality institution is acceptable.
  6. At least one year of advanced training should normally be undertaken in Australia or New Zealand, the RC year.
  7. Experience in clinical or laboratory research and in diagnostic endocrine laboratory medicine is highly desirable. Some exposure to these aspects of endocrinology may occur during clinical training or may form the major component of advanced training undertaken after the RC year. One, or at most 2, research years undertaken, e.g. towards an MD or PhD may be counted toward advanced training in endocrinology and metabolism, provided prospective approval for the research program is given. It is expected that the research will include some regular clinical commitment, e.g. ambulatory care.

Components of Training
Core Training
The Required Clinical Year (RCY)
The RCY 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.

The SAC strongly recommends that the RCY is completed on a full-time and continuous basis. The SAC will only approve applications for part-time training for the RCY in exceptional circumstances. Trainees are advised that, if they choose to undertake the RCY on a part-time basis, they may find it difficult to get another RCY position to complete this requirement. The SAC recommends that advanced trainees undertake the RCY in the first or second year of advanced training.

The requirements for the RCY are further dealt with in the section below on training posts.

Further Clinical Training (Core Year)
Trainees should consolidate the training received in the RCY 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.

The core year should include the equivalent of 12 months of full-time training at an accredited site with at least 50% of the trainee’s time devoted to the care of endocrine patients. The core year may be accrued pro-rata over more than one year provided that at least two half days per week are devoted to direct patient care during the period of core training.


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This page was last edited: December 2009