Meet Joanne Brown – Early Career Nurse Member

Joanne Brown is the first Endocrine Clinical Nurse Specialist at Stockport NHS Foundation Trust. She tells us about her nursing career path, experience at our Endocrine Nurse Update meeting and her role in the Society.

What inspired you to choose endocrinology?

My career started in theatres, recovery and then critical care. I completed an MSc in advanced practice whilst working within a busy regional neurosurgical centre. I then returned as an advanced critical care practitioner and independent prescriber for a couple of years. It was during my time working as an advanced nurse practitioner in neurosurgery that my interest in endocrinology was sparked. I then started to look for a job in endocrinology that would give me a better work life balance, but that I still found interesting and challenging.

What do you enjoy most about your work?

One of the best things about my role is how varied it is; I have my own nurse-led clinics for thyroid and I’m developing my knowledge for hyperparathyroid nurse-led clinics too. I also manage a weekly endocrine investigation unit, develop clinical protocols and standard operating procedures and produce patient information leaflets. I have led on a service evaluation and organised a way to receive patient feedback for the endocrine investigation unit. I teach and support patients and staff throughout the Trust about how to manage adrenal insufficiency safely. I am also a member of the Society’s Early Career and Nurse Committees. My role has also opened opportunities for me to be involved with writing for peer-reviewed publication and to participate in a podcast about my career. It is truly very varied.

“Being involved with the Society can enhance patient care or your services and will expand your knowledge, whilst building on your CV”

There is something special about supporting patients, for example, those who are newly diagnosed with adrenal insufficiency, teaching them and their family members; being there for them when they have concerns or questions. It’s rewarding to have a long relationship with patients and understand how their disease impacts on them personally.

What you are most proud of in your career so far?

I am really proud to be the first endocrine clinical nurse specialist at Stockport NHS Foundation Trust and I believe my role is now making a difference to patient care. Setting up an endocrine investigation unit was challenging but a huge achievement and is benefitting patient care and management. I’m also proud that I successfully managed to contact all our patients with primary or secondary adrenal insufficiency during the start of the COVID-19 pandemic to provide them with support regarding sick day rules. I haven’t yet completed any research, though I have an interest in patient experience and would welcome research opportunities in this area.

How has the COVID-19 pandemic affected your research work?

I started my role just before lockdown, so I can’t really compare it to before COVID-19. However, during the pandemic whilst face-to-face clinics were cancelled, we set up a telephone clinic. I could run the clinic from home, contacting our patients with primary or secondary adrenal insufficiency and provide education about sick day rules and COVID-19. I also ensured that each patient had an emergency injection kit prescribed and were provided with a new steroid emergency card. This clinic proved that some elements of our jobs can be completed over the telephone, it also highlighted that many patients prefer face-to-face contact. I think it’s important and beneficial to be able to offer a range of appointment styles to patients, to support their preferences and clinical need.

How did you enjoy your first Endocrine Nurse Update meeting?

It was so nice to meet other endocrine specialist nurses from around the country and swap contact details, to support each other. It was fantastic to meet members of the Nurse Committee too and to be involved as a speaker. It was all such a great experience.

The lectures were all interesting and relevant, I particularly enjoyed the clinical case presentations and steroid management group session, which gave me a lot to think about how I could improve my practice. The exhibition stands enabled me to speak to various support groups and that has proven very beneficial.

Since attending the meeting I have placed thyroid information leaflet QR codes in our out-patient area to make the information more readily accessible for patients.

I have also been supported by the Addison’s Disease Self-Help Group and carried out a successful Addison’s Disease Awareness Day event at Stockport NHS Trust for staff.

What have you gained from joining the Early Career Committee?

“I would recommend getting involved in events and any activities that are advertised through the Society, it’s an excellent way to meet other endocrine specialist nurses”

The Society website had lots of supportive information that benefitted me as a new endocrine specialist nurse, so I joined to gain full access to the nursing resources. The Society helped me to contact an experienced nurse who listened to my plans and ideas for my role and offered me support, guidance and encouragement. I then presented an Endocrine Nurse Skills webinar on nurse-led clinics, and hosted another.

These were both great experiences and something I hadn’t done before, so I found it all really interesting. I then applied to be part of the Early Career Committee, as I had ideas about how early career nurses could be better supported by the Society. It has also enabled me to be a voice regarding what other early career nurses feel would benefit them. I then applied for a position on the Nurse Committee, which is useful for linking early career ideas into the Nurse Committee and fantastic for supporting the wider nursing community.

What do you think are the biggest challenges in your field?

The biggest challenge I find is managing patient expectations with limited resources, when we all want the patient experience to be good. There is a lot of pressure on the service for appointments with the consultant team. There is much more that could be done by a clinical nurse specialist and I would hope in the future to expand the service. Patients are however very grateful for my support and the part I play in their care.

Would you advise others to apply for roles within the Society?

I would recommend getting involved in events and activities advertised through the Society, it’s an excellent way to meet other endocrine specialist nurses. I received peer support from Emily Falconer, who was also relatively new to her role at the time when I first started my job.

Being involved with the Society can enhance patient care or your services and will expand your knowledge, whilst building on your CV. Check the Society’s website for details of the committee roles available and I’m always happy to talk to you about the role and the areas I am involved in, so feel free to contact me too.

How have mentors helped your career so far?

My clinical mentor is Dr E.D Aflorei, who has been incredible at supporting me to build my knowledge, experience and confidence with patients. Dr Aflorei also encouraged me to join the Society. I will remain grateful for this advice as it enabled me to contact Sherwin Criseno, who then supported and guided me. Sherwin helped me to focus on the Society for Endocrinology Competency Framework for Adult Endocrine Nursing a bit at a time, rather than feeling overwhelmed with it all and guided me with regards developing clinical guidelines and patient information leaflets.

Support from a nurse mentor and clinical mentor is essential when you are developing your role, it gave me confidence to get involved in Society activities too and reach out to other nurses across the country. Working as the only endocrine specialist nurse in a district general hospital could feel lonely, but knowing I can contact many nurses, very easily, really does support me in my practice.

Visit our dedicated endocrine nurse careers webpages for more advice and opportunities.

Meet Louise Breen our first Nurse Committee Chair Elect

Louise Breen is an Advanced Nurse Practitioner and Lead Nurse in Endocrinology at Guy’s and St Thomas’ NHS Foundation Trust. Here she tells us about her path to nursing and her involvement in the Society which culminated in her becoming the first Chair Elect of the Nurse Committee.

How did you get into endocrinology?

My interest in endocrinology was triggered in 1996 working as a staff nurse for pre-assessment and endocrine testing during a 3 month line of work at the Diabetes and Endocrine Department at St Thomas’. I returned the following year as a research nurse undertaking pharmaceutical company sponsored clinical trials in diabetes and endocrinology. It was the research in adult growth hormone deficiency that interested me most.

I was extremely fortunate to work with Professor Peter Sonksen who had a very progressive and supportive attitude to the advancement of endocrine nursing, he encouraged me to push myself in developing my knowledge and skills. I continue to be surrounded by an innovative, enthusiastic and supportive team.

“If you feel you don’t have time for a committee position, think about putting yourself forward to present at Society conferences, Chair a session or submit and present an abstract”

What do you enjoy most about your work?

  • Team work
  • Making a difference to patient care
  • Continued learning & development in my role, clinically and strategically
  • Mentoring staff

Can you tell us what you’re most proud of in your career, so far?

When I started out there was no designated endocrine specialist nurse, in 2003 we successfully proposed the first ESN role, I got the job and our ESN service has continued to grow.  We now have a team of eight, and provide the following services: Nurse-Led Clinics, MDT support (Pituitary, Adrenal and NET), Endocrine Testing and Reporting, Patient Education, Education for other HCP and active input into research, audit, the development of guidelines/protocols and standard operating procedures.

My qualifications in Advanced Assessment and my registration as a Non-Medical Prescriber have allowed me more autonomy in practice and improved my knowledge and skills in endocrinology.

In 2011, I established the Nurse Led Virtual Thyroid Clinic which was well received by patients and has gone from strength to strength. Pre-COVID we undertook on average 30 virtual reviews per week, which put us in a good position during the pandemic.

How has the COVID-19 pandemic affected your work?

Fortunately we were well set up for virtual reviews and maintained a reasonable amount of scheduled activity, albeit with staff deployment. We are gradually getting through the backlog and returning our focus to ongoing service developments, research and audits. Remote meetings have been invaluable and in many cases a more productive and inclusive way to meet.

On reflection I have identified areas where we can be more efficient and recognised that we had little give in our service for ESN cover, as a result we proposed and created Band 6 and Registered Nursing Associate roles.

Why do you think it’s important to get involved with Society roles?

The Society are an excellent organisation to work with and the team supporting the Nurse Committee are very motivated, enthusiastic and supportive. I have served two four-year tenures and am now in my one year term as Chair Elect before I proceed to the role of Chair. My organisation views these roles as important for professional development, supporting me to attend relevant Society meetings.

Being at the hub of endocrine nursing in the UK has so many advantages in improving your knowledge and expertise in endocrinology and in my case has aided career progression.

The progression and advancement of endocrine nursing and my career have motivated me to continue my work with the Society. I have been extremely fortunate to work with exceptional people in this role and have made long lasting friendships.

What inspired you to apply to be Chair Elect of the Nurse Committee?

It is a pivotal time for the advancement of endocrine nursing and I wanted to be part of that ongoing process. The GIRFT report made it clear that we must focus on the retention and progression of nurses in endocrinology.

My experience and close working relationship with the Society and the Nurse Committee has readied me to take on this position. As Chair Elect it is a huge advantage to work alongside Anne Marland, our current Chair, to better understand the roles and responsibilities of the position and to continue to push the nursing agenda forward as I move into the role of Chair.

“The Society is an excellent organisation to work with and the team supporting the Nurse Committee are very motivated, enthusiastic and supportive”

What advice would you give to anyone considering being more active in Society activities?

Believe me when I say there is always something you can contribute. Many nurses hold back from applying for committee positions, thinking they don’t have enough experience, expertise or time. The committee is very welcoming and supportive.

Getting your employer on board to support time to attend meetings and undertake committee tasks is an important consideration, most employers will generally see the mutual benefit of this role. Travel expenses are covered and there are a number of virtual meetings to avoid too much time out of clinical roles.

If you feel you don’t have time for a committee position, think about putting yourself forward to present at Society conferences, Chair a session or submit and present an abstract. Get in touch with the Nurse Committee if you have any queries.

Visit our dedicated endocrine nurse careers webpages for more advice and opportunities.


Endocrine Ambassadors’ new teaching series gives confidence to clinical trainees

Society Endocrine Ambassadors Dr Gemma Gardner and Dr May Khine are both foundation year two clinicians in the Peninsular deanery (Torbay and Derriford Hospital) who intend to specialise in endocrinology and diabetes. In this short blog they share the endocrinology and diabetes teaching series they have developed.

We are both very excited to share our endocrinology and diabetes teaching series which took place between October and November 2021. When working as foundation year one trainees, we felt that dealing with diabetic and endocrinology related dilemmas on the ward was often daunting for junior members of the medical team. We decided to develop and organise a five-session teaching series aimed at junior doctors, physician associates and medical trainees with the aim of improving their confidence and knowledge for managing endocrine and diabetic issues on the ward and on call.  

“It was a great opportunity for students to ask and discuss topics with experienced endocrinologists which ultimately gave medical trainees a confidence boost to manage endocrinology and diabetes ward/ on-call dilemmas.”

The teaching sessions were delivered online by endocrine and diabetes registrars and consultants, both at Torbay and Derriford Hospital, who kindly gave up their time to be involved in the teaching sessions. The sessions were highly informative and interactive with top tips shared around each topic. It was a great opportunity for students to ask and discuss topics with experienced endocrinologists which ultimately gave medical trainees a confidence boost to manage endocrinology and diabetes ward/ on-call dilemmas. 

It was a valuable experience to host and lead this teaching series and we were very pleased to receive such positive feedback from participants which attended from across the Peninsular deanery. These are some typical examples of feedback we received:

Type 1 diabetes and types of insulins – “A really helpful lecture on a topic that I am often uncertain about managing on cover shifts. It was really useful to have stepwise advice as to what to do when called to see a hyperglycaemic patient on the ward and how to adjust their insulin in response”.  

Great practical advice pitched at a good level for junior doctors about common issues” .

Electrolyte abnormalities – “Picked out important points and gave clear algorithms, thank you for organising”.

Endocrine emergencies and disorders – “Information was concise and cleared up some misconceptions I had”.

We look forward to inspiring and promoting the Society for Endocrinology to the younger trainee population in future events. Look out for more events through our teaching platform “How2Doc” on Facebook or contact us through email gemma.gardner9@nhs.net or may.khine1@nhs.net.

If you want to find out more about our Endocrine Ambassadors or would like to apply to become one please visit our webpage.

Meet Aldons Chua the Endocrine Nurse Grant Awardee

Aldons Chua is a nurse manager of the endocrine investigation suite in Eastbourne. In our interview he tells us about how he came to this role and the research he is doing with his Endocrine Nurse Grant.

How did you get into endocrinology?

I began my career working as an endoscopy and liver transplant nurse in the Philippines. I set foot in England in 2016 and started as a staff nurse in an acute medical unit at Eastbourne DGH. Endocrinology nursing was unknown to me until a colleague and friend who is now my manager, Maria Ravelo, invited me to do some extra shifts in the endocrine suite. During my shifts, I met patients with rare endocrine conditions and hearing their stories made me fascinated with the specialty.

Can you tell us about your current position?

My main role at present is managing the endocrine investigation suite, covering two district general hospitals, which includes performing dynamic function tests and providing health education for patients with adrenal insufficiency. I also facilitate the commencement and monitoring of treatment for general endocrine disorders.

What do you most enjoy about your work?

What I really enjoy is the autonomy as a nurse and collaboration with the multidisciplinary team. There is also so much support from colleagues even from different organisations and a variety of opportunities to grow personally and professionally. And, of course, seeing my patients have an improved quality of life through the care our team provided is the most rewarding part.

What are you most proud of in your career?

Becoming a nurse in the UK is what I consider as my proudest moment. As an overseas Filipino worker, it was a big leap of faith to move away from my family and homeland to work in another country with so much difference in language and culture. But it is such a blessing to have very supportive colleagues and managers who I have worked with since the very beginning, especially when it comes into my career aspirations.

How has your work been affected by the COVID-19 pandemic?

It has been very challenging. My associate practitioner and I were re-deployed to a COVID ward for 2 months during the first lockdown and our endocrine service was placed on a 10% service capacity. This caused a significant impact on the timings of our patient appointments, especially the investigations and teaching. However, it also made us resilient and innovative in our efforts to maintain the quality of care we provide while ensuring patient safety.

What do you think are the biggest challenges in your field?

We have a vision in our endocrine nursing service to provide excellent, safe and compassionate patient-centred nursing care. The biggest challenge is to keep the vision going, knowing that we only have very limited time and resources.

You have been awarded an Endocrine Nurse Grant, what was the application process and how did you find it?

Initially, I was reluctant to apply, as I had reservations about whether I qualified as I am still an early career nurse. I am very grateful to my mentor/research supervisor Dr Sofia Llahana who encouraged and guided me throughout the process. Also, the Society for Endocrinology set clear guidance on the website and the team were helpful in responding to my queries which made the process easier to follow.

What will the grant be used for?

The grant will be used to fund our research project which is investigating the barriers and enablers in the use of injection devices during adrenal crises for adrenal insufficiency (AI) patients. In the UK, most centres provide 3ml syringes and a needle or a safety syringe, depending on the centre, which are included in an emergency hydrocortisone injection pack. Although AI patients receive training on how to use these syringes there are still reports that they are unable to administer the hydrocortisone injection during an adrenal crisis due to the complexity of the device. First-hand reports of these problems from our own AI patients led to the research project. Adrenal crisis is a life-threatening event and the emergency injection of hydrocortisone can save a patient’s life. This grant will help us explore the experiences of AI patients on their use of the current hydrocortisone device during an adrenal crisis. The outcome will provide evidence of potentially modifiable barriers associated with the use of the current parenteral hydrocortisone in preventing adrenal crisis and will inform the development of future interventions.

What are your plans after completing this project?

I am looking forward to take on future projects looking at how we can further help and support our patients with adrenal insufficiency manage their condition even better. We are starting new nurse-led clinics soon and expanding the endocrine nursing service to help accommodate our increasing number of endocrine patients.

What advice would you give to anyone considering applying for the Endocrine Nurse Grant?

My first challenge was how to begin, so I connected with a mentor who works in the same area. Then, I familiarised myself with how to make a competitive research proposal as this is my first application. I believe that as nurses we have a huge desire to make a difference to the lives of our patients, and research is just one way. Take courage, and if you fail on the first attempt don’t lose heart, just keep on trying and improving.

Learn more about the Society’s Endocrine Nurse Grant and how to apply before the next deadline. Visit our dedicated endocrine nurse careers webpages for more advice and opportunities.

Meet Roland Stimson the Society’s 2021 Starling Medallist

Roland Stimson is a clinical academic endocrinologist, Professor of endocrinology and a CSO Scottish Senior Clinical Fellow at the University of Edinburgh as well as an honorary consultant at the Royal Infirmary of Edinburgh. His main research interests are obesity, type 2 diabetes and energy metabolism. Here he tells us about breaking convention to build a career and why loves the discipline.

Tell us about your career path
Although you’re generally told not to stay in one place I’ve done exactly that, I went to university in Edinburgh then undertook my early clinical training just over the water in Fife. I didn’t do a BSc at university as I was keen to start seeing patients during my early clinical training. But I was really interested in human endocrine physiology so developed an interest in research and applied for a clinical fellow position to undertake my PhD with Professors Brian Walker and Ruth Andrew back in Edinburgh. I very much enjoyed this post and continued my clinical and research training with a clinical lecturer position thereafter. Subsequently, I obtained a MRC Clinician Scientist intermediate fellowship and more recently a Scottish Senior fellowship that has allowed me to continue my research in combination with my clinical work as an endocrinologist.

“I was always fascinated by the feedback mechanisms in endocrinology and how you could use these to pinpoint the pathology…”

What inspired you into research?
I’m really interested in human physiology and its dysregulation in disease, from the beginning I wanted to undertake research in humans and have tried to develop new techniques to better understand human physiology. I was always fascinated by the feedback mechanisms in endocrinology and how you could use these to pinpoint the pathology, by definition endocrinology is very much a multisystem discipline and it provides you with tremendous variety.

What do you enjoy most about your work?
I really enjoy discovering new mechanisms controlling human physiology, I find that fascinating and I particularly enjoy designing studies to try and answer research questions.

What will you be presenting in your lecture at SfE BES 2021?
I will be talking about our recent research on brown adipose tissue or brown fat in adult humans. This is an organ that increases energy expenditure to generate heat and a lack of brown fat is associated with poorer metabolic health. We’ve undertaken a number of studies in healthy volunteers to determine how human brown fat is regulated and I’ll be talking about the insights we’ve gained.

“I think this is incredibly important to improve patient outcomes not just for our own local patients, but the wider community, and often takes you down paths you never would have imagined so it is a very fulfilling career.”

What do you think are the main challenges in your field right now?
The prevalence of obesity continues to increase and is a major global health problem, therefore we need to find better treatments to safely help people lose weight and prevent the adverse metabolic sequelae of obesity. Many obesity treatments have been withdrawn due to safety concerns so finding pharmacotherapy that can safely achieve weight loss is a major challenge, although there have been some really promising, new developments recently in this area.

Any words of wisdom for aspiring endocrinologists?
I’m not sure I have any words of wisdom but I think endocrinology is a fascinating specialty that will continue to be intellectually stimulating for the duration of your career and contains so much variety that everyone should be able to find areas of particular interest to them. I would also certainly encourage young endocrinologists to become involved in research, I think this is incredibly important to improve patient outcomes not just for our own local patients but the wider community, and often takes you down paths you never would have imagined so it is a very fulfilling career.


You can attend Professor Roland Stimson’s Medal Lecture, “Strategies to turn up the heat – investigating human brown adipose tissue function” on Monday 8 November at 2:30pm.

Find out more about the scientific programme for SfE BES 2021.

Meet Heike Heuer the 2021 Pitt-Rivers Lecturer

Professor Heike Heuer is Professor for Molecular Thyroidology at the Department of Endocrinology, Diabetes and Metabolism at University Hospital Essen – University Duisburg-Essen in Germany. She is interested in thyroid hormone actions in the central nervous system (CNS) and uses mouse models to investigate the function of thyroid hormone transporters and to develop treatment strategies for patients with Allan-Herndon-Dudley syndrome. As the 2021 British Thyroid Association Pitt-Rivers Lecturer, she will present a plenary at SfE BES 2021. In our interview, she talks about her research and highlights how preclinical animal studies can lead to important and useful clinical advances.

Tell us about your career so far

I studied biochemistry at the Leibniz University in Hanover, followed by a PhD in neuroendocrinology at the Max-Planck Institute for Experimental Endocrinology. As a postdoctoral fellow I joined Carol Mason’s lab in the Center for Neurobiology and Behavior at Columbia University, New York, where I extended my neurobiology training. I was appointed as an independent, junior group leader at the Leibniz Institute on Aging/Fritz Lipmann Institute in Jena, where I headed a neuroendocrinology group working on thyroid hormone transporters. Later I became a tenured group leader at the Leibniz Research Institute for Environmental Medicine in Düsseldorf and in 2018, I was appointed as a University Professor for Molecular Thyroidology in Essen.

What inspired you into research?

“I’m pleased that our findings contributed to the rapid establishment of a treatment option for patients with a rare and devastating disease.”

I became interested in neuroendocrinology during my undergraduate degree, as I found it fascinating how peripheral organs communicated with the brain and vice versa. Encouraged by my mentors, Karl Bauer and Theo Visser, I started my research career by examining the thyrotropin-releasing hormone (TRH) signaling system in the rodent CNS. I then became intrigued by the profound effects that thyroid hormones exerted on brain development and function. The breakthrough discovery of the highly specific thyroid hormone transporter MCT8 by Theo Visser and colleagues strongly influenced my research. It became unequivocally clear that thyroid hormones need transporters for transmembrane passage and, consequently, for reaching their receptors. The profound neurological phenotype of patients with inactivating MCT8 mutations (also known as Allan-Herndon-Dudley syndrome) encouraged us to develop mouse models in order to understand the underlying pathogenic mechanisms and also to investigate treatment strategies.

Now, a major focus of my group is to analyse cell-specific TH transporter mouse mutants as we aim to understand which proteins act as critical ‘gate-keepers’ for TH in the CNS, as well as in peripheral organs and how their transport activity is affected under pathophysiological conditions.

“Endocrinology is, in my opinion, a very attractive and exciting research field that offers many interdisciplinary interactions and cross-links with other disciplines.”

What are you proudest of in your career, so far?

With the generation of mice lacking both thyroid hormone transporter Mct8 and Oatp1c1, we successfully established a mouse model that replicates many clinical features of patients with Allan-Herndon-Dudley syndrome, a severe form of psychomotor retardation. Using this animal model, we were able to test therapeutic strategies including the application of the thyroid hormone analog, Triac. This treatment improved many neural impairments and based on our preclinical data, a first Triac Trial was successfully conducted, and a second Triac Trial is in progress. This highlights the importance of preclinical animal studies and I’m pleased that our findings contributed to the rapid establishment of a treatment option for patients with a rare and devastating disease.

What do you enjoy most about your work?

I mostly enjoy lively discussions with colleagues, coworkers and students about scientific studies and novel results.

What will you be presenting in your lecture at SfE BES 2021?

It is indeed a great honor for me to present the Pitt-Rivers lecture at the SfE BES 2021 as Rosalind Pitt-Rivers not only discovered T3 in her pioneering work, but was also the first to establish that the thyroid hormone metabolite, Triac, exerts T3-like effects in animals. To acknowledge her seminal achievements, I will highlight not only the impact of thyroid hormone transporter deficiency on brain development but also discuss how Triac application can improve neural differentiation, and may be a promising treatment option for patients with Allan-Herndon-Dudley syndrome.

What do you think are the main challenges in your field right now?

According to the classical view, TH action is largely determined by circulating TH levels that are mainly regulated by negative feedback loops within the hypothalamus-pituitary-thyroid axis. However, with the recent discovery of patients harboring defects in local TH signaling, e.g. due to genetic TH transporter or receptor mutations, this classical concept of TH action has been challenged. These patients clearly display a discordance between serum TH and TSH concentrations on the one hand, and tissue-specific TH deficiency and/or excess on the other hand. In other words, patients with TH and TSH concentrations within the normal range may still have a “hypothyroid” brain despite a “euthyroid” liver and may benefit from a CNS-specific TH supply. A major challenge is now to identify suitable biomarkers that indicate a tissue-specific change in TH status and to develop clinical strategies to modulate TH status in a cell/organ-specific manner. Certainly, a change in perspective from systemic towards local, tissue-oriented TH action will be needed for comprehensive understanding of TH effects in the body and will ultimately pave the way for the development of novel approaches for modulating cell-specific TH signaling under certain pathophysiological conditions.

What do you think will be the next breakthrough in your field?

I envision that the discoveries of novel mechanisms underlying local control of thyroid hormone action (e.g. identification of additional TH specific transporters or novel modes of TH action) will open new avenues to modulate TH signaling in a tissue- or even cell-specific manner (by applying e.g. novel TH receptor agonists, specific TH transporter inhibitors or novel trojan-horse hormone compounds).

Any words of wisdom for aspiring endocrinologists?

Endocrinology is, in my opinion, a very attractive and exciting research field that offers many interdisciplinary interactions and cross-links with other disciplines. Therefore, I can only strongly encourage young researchers or clinicians to become “endocrinologists”.

And for some words of wisdom, ‘Endocrine systems and their regulatory mechanisms and modes of action are complex – thus do not rely on selected serum values only. Always aim for the complete picture or you might miss important (and maybe yet unknown) local effects.’

You can attend Professor Heike Heuer’s Medal Lecture, Role of thyroid hormone transporters in brain development and function on Monday 8 November at 14:00 GMT.

Find out more about the scientific programme for SfE BES 2021.

Meet Greet Van den Berghe the Society’s 2021 European Medal winner

Professor Greet Van den Berghe is the head of the clinical department and laboratory of Intensive Care Medicine at KU Leuven University and its University Hospitals in Belgium. The Leuven Clinical Intensive Care department is a large, tertiary referral centre treating over 3,100 patients per year. She is also Professor of Medicine at KU Leuven and actively researches the endocrinology and metabolism of critical illness. Here she tells about her career, research and how important it is to break boundaries and challenge classical ideas in the pursuit of better patient care.

Tell us a little about your career path
After obtaining my medical degree, I trained in anesthesiology and intensive care, then in biostatistics and later completed a PhD in endocrinology. I followed this path so that I could work at the boundaries of several disciplines, which provided an excellent opportunity to build a multidisciplinary research team and to expand on translational research in endocrinology and metabolism of critical illness, from bed to bench and back.

What inspired you into research?
When I was a junior attending physician in the intensive care unit (ICU), I observed that long-stay ICU patients, both children and adults, quickly began to look much older than their chronological age. At the same time they showed endocrine and metabolic abnormalities that mimicked certain characteristic of ‘ageing’. I hypothesised that maybe this ‘accelerated ageing’ phenotype of ICU patients could in part be iatrogenic, and if so, may be preventable. These thoughts formed the basis for my PhD research, in which I demonstrated that dopamine infusion, a drug commonly used at the time for haemodynamic and renal support, was causing an iatrogenic suppression of the anterior pituitary with harmful consequences. Based on these findings the practice of infusing dopamine in the ICU was abandoned.

“Together we have made exciting discoveries and we were able to repeatedly close the loop from an original idea triggered by patient care, to basic research in the lab and back to randomised-controlled trials in patients.”

In my postdoctoral research, we went a step further and identified biphasic neuroendocrine and metabolic responses to acute and prolonged critical illness in both patients and animal models. This research clarified many earlier, apparent paradoxes and provided the basis for our later work that focused on the acute and long-term harmful impact of hyperglycemia, the early use of parenteral nutrition and the pathophysiology of the HPA axis response to the stress of critical illness.

What are you proudest of in your career, so far?
In 2002, I inherited a very large and well organised clinical intensive care department to chair, upon which I have built research from bed to bench and back again. There was no research in the department when I started, so I had to build everything from scratch. Over the years, this growing symbiosis, between high-level patient care and research, has proved to be very successful. This also allowed me to recruit the best clinicians and scientists who now work effectively together as a very close team.

“I enjoy thinking outside the box, creating new ideas by crossing boundaries between classical disciplines”

Together we have made exciting discoveries and we were able to repeatedly close the loop from an original idea triggered by patient care, to basic research in the lab and back to randomized-controlled trials in patients. That is such great fun! So, I am most proud of my team, and grateful to them for making me happy every day!

What do you enjoy most about your work?
I enjoy thinking outside the box, creating new ideas by crossing boundaries between classical disciplines, and working with young, enthusiastic physicians and scientists, to generate new knowledge that forms a solid basis for better patient care.

What will you be presenting in your lecture at SfE BES 2021?
In my talk, entitled “Re-thinking critical illness induced corticosteroid insufficiency”, I will present novel insights from our recent research on HPA axis changes that occur in response to acute and prolonged critical illness. I will challenge the classical paradigm of stress-induced increased ACTH-driven cortisol production as the basis for increased systemic cortisol availability in severely ill patients. I will also challenge the idea that a short ACTH stimulation test can diagnose failure of this stress response.

To say it with a metaphor: “What you see is not always what you get”.

Any words of wisdom for aspiring endocrinologists?
Look further than the boundaries of your own discipline, there is much to be learnt and innovated when you go beyond them!

You can attend Professor Van den Berghe’s Medal Lecture, Re-thinking critical illness induced corticosteroid insufficiency on Tuesday 9 November at 18:45.

Find out more about the scientific programme for SfE BES 2021.

Enhancing endocrine education: for medical students by medical students

Vaishali Limbachia is an intercalating medical student at Norwich Medical School, University of East Anglia (UEA). Vaishali has completed four years of the course enter their final year in September 2021. Last year, Vaishali became Secretary of UEA Endocrinology Society and in November 2020 became an Endocrine Ambassador for the Society for Endocrinology. In this guest blog, Vaishali shares what the UEA Endocrinology Society has been up to so far, and the importance of supporting and encouraging students in endocrinology.

*pictured Vice President, Vaishali Limbachia (left), and President of UEA Endocrinology Society, Milly Green (right).

First, I would like to introduce our society. We are a society run by medical students, for medical students. The committee consists of 4th year, intercalating, and 5th year medical students. Guided by the President, we organise revision sessions for medical students currently learning diabetes and endocrinology, in addition to other events that aim to raise interest in endocrinology. We also run social media pages, keeping our members informed of our society news and events, as well as Society for Endocrinology activities. To further engage with our members, weekly diabetes and endocrinology exam-style, multiple-choice questions are created by the committee members and posted on our social media pages.

Each academic term we have organised and delivered a teaching session on diabetes and on endocrinology. The aim of these sessions is to revise content from the medical school curriculum, which at Norwich Medical School, is taught in year 3. The presentation slides used for lectures are constructed by committee members. It can be challenging to cover a module worth of content in a couple of hours. The sessions are taught by medical students who have undergone diabetes and endocrinology teaching, placements and exams, so are able to provide useful tips.

On top of the teaching sessions, we organise and run mock objective structured clinical examinations (OSCEs), aiming to give medical students a practice run. We design 6 stations, for example a diabetic foot examination and communication skills station, to give members a realistic experience of the summative OSCE. Each committee member runs one station to keep that station consistently delivered. At the end of each station, we feedback verbally to students. In addition, we provide a marking scheme, which we constructed for written feedback, so students can see where marks were given. This allows students to gauge their learning needs in preparation for their summative OSCE. These mock exams are highly subscribed and the feedback is very positive.

This year I organised our first Diabetes and Endocrinology Careers Event, targeted at medical students. Three consultants kindly volunteered their time to speak at the event. Each spoke about their motivating force that led them to choose this specialism, their professional journey, what their day-to-day life is like and shared top tips for medical students. This was followed by an opportunity to ask questions. Speakers shared highly interesting patient cases, showing how the specialism involves detective work and how endocrinology impacts multiple systems. Each speaker’s professional journey was very different, emphasising how there is more than one path to follow. Many useful tips were shared, for example getting involved in research, and opportunities at the Society for Endocrinology. It was a highly inspiring and informative event, that I personally enjoyed, and the feedback was positive, with the only suggestions for improvement being they wished it was longer! I found the event reinforced my passion for specialising in diabetes and endocrinology in the future.

I have had a fantastic year working with great colleagues, who share an interest in diabetes and endocrinology, in organising events and sharing our interests with other students. Next academic year, I will fortunately continue being a part of this brilliant society and assume the role of Vice President of UEA Endocrinology Society. I look forward to working with the new committee members, putting on more events and continuing to share Society for Endocrinology activities and opportunities to members.

Find out more and apply to become an Endocrine Ambassador.

Please email ambassadors@endocrinology.org if you have any questions.

Embracing the diversity of endocrinology: an interview with Dr Alexander Comninos

Dr Alexander Comninos is a consultant in endocrinology and diabetes and honorary clinical senior lecturer at Imperial College London. His research interests are in reproductive endocrinology and metabolic bone disease and he has presented internationally, winning several prestigious prizes including the Society’s Early Career and Clinical Endocrinology Trust Prizes. Alex currently sits on the Society’s Science Committee and is a previous Leadership and Development Awards Programme Awardee. Read our interview with him to find out about his career, the current challenges in his field, and how he thinks endocrinology will change in the future.

*A late night collaborative meeting at a Kebab House during SfE BES 2015

Tell us about your current position

I feel very fortunate as my current role combines clinical work, research and teaching. One day I may be running our endocrine bone clinic, the next day I could be on call for acute medicine, or analysing data and finishing a research paper, lecturing and tutoring undergraduates, or meeting my PhD students. I really enjoy the fact that each day is different and endocrinology is the theme through most of it, with so many opportunities to combine clinical and academic work.

I love endocrinology because it encompasses the whole body system and has so many possibilities for research to improve patient care.

What are you proudest of in your career so far?

Looking back on my career so far, I am so happy that I made it through all the harder times in medicine and academia. Long runs of night-shifts and previous unsuccessful grant applications certainly tested my perseverance but made me stronger!

What do you think are the biggest challenges in endocrinology right now?

With increasing patient use of social media and the internet in general sometimes misinforming patients, we have to ensure that we provide clear and accurate information to patients and address their concerns. In addition, although we are hopefully emerging from the COVID-19 pandemic, an element of remote medicine is clearly here to stay. With patient compliance, subtle symptoms and blood tests so integral to endocrinology, we need to find new ways to monitor these in a remote medicine environment.

How do you think your field of research will change in the future

Genetics is such a rapidly developing field. I suspect we will be routinely performing full cheap gene sequencing and using this information to guide management at an individual level.

In the future I think we will see the increasing incorporation of genetics to guide individualised treatment.

What is it like being involved with the Society for Endocrinology?

We are lucky to have such a well-run society. I currently sit on the Science Committee which is an absolute pleasure. Interacting with other basic and clinical endocrinologists, each with different opinions and interests is really fascinating and constantly thought-provoking. I would like to see the Society push on with in-person meetings, when safe to do so, as I feel this is so important for our morale on an individual as well as a collective basis.

Who are your most inspirational endocrinologists?

Like many others, Professor Karim Meeran is a large part of why I chose endocrinology, and Professor Waljit Dhillo is the inspiration behind my academic pursuits. Their dedication to trainee development, super approachable nature, calmness and sense of what is best, is really incredible and I am sure numerous trainees would agree. I also have to say that Dr Cox at St Mary’s has been a real clinical inspiration for me. I was his house-officer many years ago, and now to sit next door as a consultant colleague always makes me smile. His incredible experience, knowledge and deep interest in endocrine physiology have certainly helped shape my early consultant years, and we have had many enthralling clinical discussions!

Any words of wisdom for aspiring researchers in endocrinology?

It is a wonderful specialty, full of surprises and opportunities. Be inquisitive constantly, question things to understand concepts and remember the journey is lifelong.



The Society for Endocrinology is 75 years old in 2021. As part of our celebrations, we are collecting members’ opinions, with a focus towards the future – after a particularly hard year for us all!

We are keen to reflect the diversity and breadth of our discipline by hearing from members across all backgrounds, career stages, career types and geographical locations, to get a true flavour of the range of views, needs and challenges faced by our Society members.

Would you like to get involved and share your views? Simply complete this short questionnaire or send your comments to media@endocrinology.org.