Throughout the Society’s history, the rapid development of our discipline has driven the growth of endocrine education and training. Indeed, the advancement of scientific and clinical education is at the forefront of the Society’s objectives. We asked contributors to reflect on significant recent steps supporting the development of endocrinologists today.

THE NEW CURRICULUM IN ENDOCRINOLOGY AND DIABETES

The Shape of Training review catalysed reform of postgraduate training for doctors, ensuring it is more patient-focused, more general in the early years, and has increased career flexibility. This chimed with the Future Hospital Commission and the Francis Inquiry report. An ageing population results in increasing complexities and multiple morbidities, requiring physicians to have broader capabilities.

The Joint Royal Colleges Postgraduate Training Board (JRCPTB) is responsible for the development of new curricula for physicians, which will be approved by the General Medical Council. The Specialist Advisory Committee for Endocrinology and Diabetes was tasked with the development of the curriculum for our area, which is a group 1 specialty (dually training with internal medicine).

This was an opportunity for a complete overhaul of our curriculum. The new curriculum is a collaborative and inclusive effort. We started with strong design principles and wanted to develop a document that would guide the training of highly competent consultants in our specialty, capable of providing leadership and fulfilling their evolving roles in the modern NHS: more than pure technical competency. The curriculum is a broad document that encapsulates the entire training pathway, culminating in specialist certification. It will take effect from August 2022.

There is a strong emphasis on the development of essential human skills, such as leading and managing multidisciplinary teams. The document needed to be as future-proof as possible, to reduce the administrative burden for trainers and trainees, and to be more meaningful.

CAPABILITIES IN PRACTICE

One of the key developments is the introduction of capabilities in practice (CiPs) which are higher level evaluations of capabilities rather than atomised competencies. There are CiPs for internal medicine which are common across all group 1 curricula, and seven CiPs which are specific to endocrinology and diabetes.

A non-exhaustive list of presentations and conditions will guide acquisition of specialist skills and should help trainers identify training requirements. A system of entrustability will lead trainees from close supervision through to independent practice. The GMC’s generic professional capabilities are interwoven through the document. The curriculum is a spiral, with cumulative acquisition of competencies through repetitive exposure.

ENSURING SUCCESSFUL IMPLEMENTATION

The challenges to successful implementation could be structural or human factors. The main concerns are associated with accrediting in internal medicine and endocrinology and diabetes in four years. There is a requirement for an indicative year of internal medicine in the four years of training. The JRCPTB is proposing models by which internal medicine and specialty curricula can be delivered, serving as implementation guidance. We have campaigned for some time to protect specialty training from the impact of internal medicine service requirements. Progress is being made, with endocrinology and diabetes gaining parity with other group 1 specialties, to ensure that our training models are similar and there is no unfair burden of service. Supervisors will need training with regards to the new learning requirements and CiPs, and there will be an inevitable learning curve.

The curriculum is an important component of the machinery required to develop highly capable specialists in endocrinology and diabetes, but by no means the only one. Other important factors include training facilities and environment, and the quality of trainers. Technologies will need to be developed to enhance and deliver some of the learning across the UK.

We believe that the future of training is exciting and the enhancements will result in further improvements to the quality of endocrinology and diabetes training in the UK.

ASIF ALI
Chair, Specialist Advisory Committee for Endocrinology and Diabetes, and Consultant Physician (Diabetes and Endocrinology) and Associate Dean, Health Education England, Thames Valley, Milton Keynes

Read the other articles in this issue on the evolution of education and training in endocrinology:

TRANSFORMING TEACHING IN HIGHER EDUCATION

EDUCATION AND TRAINING OPPORTUNITIES FOR NURSES

FROM PhD TO FELLOWSHIP: CREATING A NICHE