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Student Careers

Careers in diabetes and endocrinology

BMJ 2008; 336 doi: (Published 01 May 2008) Cite this as: BMJ 2008;336:0805202
  1. Jeevan Mettayil, specialist registrar in diabetes and endocrinology1,
  2. Richard Quinton, consultant and senior lecturer in endocrinology and regional specialty adviser2,
  3. Shahid Wahid, consultant physician and training programme director3
  1. 1James Cook University Hospital, Middlesbrough
  2. 2diabetes and endocrinology, Northern Deanery, Royal Victoria Infirmary and University of Newcastle
  3. 3diabetes and endocrinology, Northern Deanery, South Tyneside NHS Foundation Trust

Jeevan Mettayil and colleagues consider the demands and rewards

Bulging eye from thyrotoxicosis

Diabetes and endocrinology is one of the most challenging and rewarding of all medical specialties. In addition to the management of diabetes mellitus, it concerns disease management in relation to other key endocrine glands—pituitary, thyroid, adrenal, and gonad—as well as most aspects of metabolic disease. Endocrinologists also have a central role in coordinating the multidisciplinary teams involved in dealing with structural lesions of endocrine organs, including known or suspected cancers. Most endocrinologists also train in internal medicine. Given the ubiquity of endocrine systems modulating body tissues and organs, this makes a consultant endocrinologist a “true general physician,” as well as a dedicated specialist.

Why is the specialty important?

Endocrine disease is common and expensive to the National Health Service and society. Diabetes is archetypal given an estimated 2.35 million people with diabetes in the United Kingdom. Diabetes care accounts for 5% of NHS resources, a figure that is set to increase. The opportunity to diagnose and manage the more esoteric endocrine diseases adds spice to the lives of practising endocrinologists, but thyroid and gonadal disorders combined have a prevalence approaching that of diabetes and on-going management of most endocrine conditions cannot be done in primary care. Furthermore, regional experience has shown that over 15% of the acute medicine take consists of patients with diabetes and metabolic or electrolyte derangements, in addition to the rarer acute presentations of endocrine disease. Therefore, there remains a need for highly skilled professionals able to tackle these challenges.

What do endocrinologists actually do?

Thanks to past clinical, …

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