Diabetes and Endocrinology in East of England
Endocrinology and diabetes is a fascinating specialty encompassing 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 commonly encountered in the UK population and are increasing in prevalence and impact emphasising the need to continue to improve health care delivery in the specialty. Endocrine diseases and diabetes affect every physiological system of the body and specialists need a wide range of skills and expertise and make a major contribution to general medicine in its broadest sense. 
The specialty has something to offer for everyone. Many of the endocrine diseases we encounter are rare ones and pose diagnostic and therapeutic challenges, and present considerable intellectual stimulus. There are equally challenging less rare conditions that require working closely with many different multiprofessional colleagues. 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.
Why Train in the East of England?
The East of England provides a high standard of living combining city, country and coast, internationally recognised teaching and research, and great weather! One of the advantages of training in the east of England is the number of opportunities open to every trainee. In addition to high quality clinical training there are extra opportunities to develop skills in research, teaching, management or leadership both in and out of programme. If you choose to train in the East of England you would join a team of diabetologists and endocrinologists with a wide range of clinical and research interests who deliver nationally and internationally recognised services and contribute to clinical practice in the UK through their work on national networks, societies and guideline committees.
Unlike many other schools, successful trainees are aware of the location of all five years of their training programme at the time of appointment, which helps domestic planning. The East of England School of Medicine is located in a large region but as a school we prioritize arranging rotations to prevent unreasonable commuting distances. All trainees spend a minimum of 20 months in a teaching hospital either rotating to Addenbrooke’s Hospital or the Norfolk and Norwich University Hospital.
Post Graduate Certificates in Medical Education: many of our trainees have completed PGCE, sponsored by the School.
Research: There are well established academic clinical fellow (ACF) and clinical lecturer (CL) programmes within the region and we support all clinical trainees wishing to take time out of programme to undertake a higher degree. There are a wide range of research opportunities encompassing diabetes, obesity, endocrinology and metabolic medicine.
Clinical Excellence and Expertise in Diabetes and Endocrinology in East of England:
If you choose to train in the East of England you would join a team of diabetologists and endocrinologists with a wide range of clinical and research interests who deliver nationally and internationally recognised services and contribute to clinical practice in the UK through their work on national networks, societies and guideline committees.
Nationally recognised services in in several areas:
The National Severe Insulin Resistance Service at Addenbrookes provides a multidisciplinary NHS service for patients with severe insulin resistance and/or lipodystrophy from throughout England.
Diabetes in pregnancy: there are large research active Diabetes Antenatal Services at Addenbrookes and Norwich and throughout the region with studies using closed loop (“artificial pancreas”) led by Prof Helen Murphy. A recent Eastern Academic Health Science Network Diabetes Pre-pregnancy Care Project has ensured region-wide engagement with GPs, practice nurses, community diabetes teams, health visitors, sexual health teams and the public to promote diabetes preconception care.
Insulin pumps/ artificial pancreas: There are large insulin pump services at Addenbrookes and Norwich (paediatrics, transition, adults, pregnancy) with research into artificial pancreas or closed loop models at Addenbrookes.
Diabetic foot disease: there are large research-active diabetic foot clinics at Norwich and Ipswich.
The Metabolic Bone Clinic run by Prof Jeremy Turner and Prof Bill Fraser at Norfolk and Norwich University Hospital NHS Foundation Trust is one of only 10 centres to have been awarded the Paget’s Association Centre of Excellence award
Trainees Perspective
Dr Shoib Ur Rehman
Endocrinology and Diabetes is the most exciting subject in medicine as it encompasses the most variety of organs and conditions starting from hypothalamus down to the toes . Embedded with in it is the physiology of rhythm and delicate harmony of almost all human hormones and their far reaching affects . Diagnosing subtle abnormalities and restoring the balance is the most satisfying feeling one gets with this speciality .
The training programme designed for East of England Deanery is unique in terms of delivering high quality education and experience through regular regional training days and clinical work . Consultant colleagues across the region are extremely approachable and have keen interest in teaching and preparing consultants of future who meet high standards of patient care and expertise in the field.
The training programme takes 5 years and results in dual accreditation and CCT in Endocrinology & Diabetes and General Medicine. Being ‘The Medical Registrar’ is a challenging experience, but is also very rewarding in developing leadership skills ,managing all medical admissions and acting in charge of hospital organisation specially at night shifts. The rotations are usually set so most of general medical experience is expected to be achieved during smaller district general hospitals placements along with general Diabetes and Endocrinology exposure and at least 20 months of University Hospital placement (Cambridge University Hospitals/Norfolk & Norwich University Hospitals)where trainees gain experience in more complex and specialists clinics such as NET, Pituitary disorders , Bone Metabolism , Reproductive Endocrinology and obesity.
As a highly academic field of Medicine, there are also plenty of opportunities for research/audit/education. In fact, trainees are highly encouraged to pursue their academic interest. There are many world leading researchers of different interest within the Deanery (e.g. genetics in obesity, thyroid disorders, lipid disorders, etc.). This gives you a variety of research options that you can choose to embark on based on your interest.
Overall, the EOE Diabetes & Endocrinology Programme is a well-structured training setting which enables trainees to meet curriculum requirements set by JRCPBT coupled excellent guidance and support from consultants and senior registrar colleagues . It is a friendly deanery with good network of support, a great teaching environment with excellent local schools and beautiful landscapes on your doorstep. Most of the trainees on completion of their training stay in the region which in itself speaks volumes of trust development between trainers and trainees - as well as the quality of life in the East of England.
