Embracing the diversity of endocrinology: an interview with Dr Julia Prague

Dr Julia Prague is a clinical consultant and clinical academic at the Royal Devon and Exeter NHS Trust and University of Exeter. In our interview, she tells us about her clinical practice and research projects, as well as how she thinks endocrine practice will evolve after the COVID-19 pandemic.

Tell us a bit about your current position and what you enjoy most

As a clinical consultant and clinical academic I split my time almost 50/50 through the week. At the moment, my clinical commitments include outpatient endocrinology, and inpatient endocrinology, diabetes and general medicine. I moved from London to Exeter last year, and one of the big reasons to move was that near 50/50 split between clinical commitments and research. It’s a great balance that gives me time and space, not only to be with the patients, but also to investigate and take forward some of the issues that they bring up in clinic. Forming new collaborations and being in a new unit with new colleagues is pretty exciting too.

Don’t let yourself be put off by the general medicine component or thinking that it’s all diabetic feet!

Research wise, I’m particularly interested in the menopause through a number of different collaborations. I’m working with the respiratory department on a project looking at lung conditions and sex hormones. Investigating the impact of the menopause in diabetes. I’m also still involved in establishing the role of neurokinin 3 receptor (NK3R) antagonists to treat hot flushes and improve sleep during the menopause.

What got you interested in research on menopause?

Spending hours with the women in our research study of a new treatment for menopausal flushes, and from receiving hundreds of emails from menopausal women wanting to take part. My admiration for them was huge, not least because they so often described themselves as struggling to cope, yet they were the complete opposite of that, meeting endless challenges with amazing fortitude and whilst mostly suffering in silence. To then see them leave misery and suffering behind and find themselves feeling vibrant and human again was rewarding beyond measure. 

Furthermore, the majority of women will have menopausal symptoms that impact on all aspects of their daily life, but many will also have co-existing medical conditions before their menopause and these can also be impacted too. Many medical conditions are influenced by the menstrual cycle and that’s an aspect that is under-investigated and I think is really interesting. Inflammatory bowel disease, for example, can fluctuate during the menstrual cycle and Crohn’s disease typically gets better in pregnancy.

Diabetes is also impacted by the menstrual cycle, and it’s the same hormones that are changing during the menopause but this hasn’t been investigated, which is why I’m now interested in this, as this is something patients often report as being a problem for them. I think it’s important to listen to what patients are telling you and then try and investigate why that is, to hopefully find an improved solution for them.

There will be far fewer centres doing more complex endocrinology, and the development of this could be guided by some of what we have learnt regarding remote consultations and remote networking during the pandemic.

How was your work affected by the COVID-19 pandemic?

I was a Senior Registrar at King’s College Hospital  at the height of the first wave, so I became involved in  a lot of  the management and service re-design work within the diabetes and endocrinology department, including rota management to facilitate re-deployment to general medicine but whilst maintaining a core specialist service and whilst supporting our junior trainees and particularly our international medical graduates who were isolated from their families, and  ensuring our patients were supported and aware of sick day rules and  had all the medications they needed. Our department was also therefore part of the frontline team. I was the medical registrar on call for the first peak weekend of King’s admissions. Then I got COVID-19 and could not get out of bed/off the sofa for 4 weeks.

I moved to Exeter towards the end of summer 2020 to take up my Consultant job. Since then I have continued to do quite a lot of frontline COVID inpatient medicine. Now we’re involved in recovery and trying to catch up. Many patients couldn’t be seen through the pandemic because resources had to be syphoned off elsewhere.

The Society has become much more inclusive, and far more diverse, with a much broader mix of people, and I think that should really be celebrated and welcomed.

I never imagined I would interview for my consultant job on Zoom! Moving to a new city, a new department, a new consultant role and a new research role during the pandemic was definitely an interesting twist at such a significant stage of my life and career.

What are you proudest of in your career so far?

My work on menopause and NK3R antagonists – being published in The Lancet was a huge honour, and the potential that this work has to relieve suffering of women is incredible. As a doctor, all you want is to relieve suffering in your patients and this has that opportunity. It’s also given me a platform to continue working in that field and to be invited to speak at international conferences, as well as develop new collaborations.  

This drug class are now in phase three studies and it looks like they’re probably going to be marketed from around 2023/2024. This research is still advancing within the pharmaceutical field, butte top-line results coming out continue to show great promise for the therapy. Seeing the NK3R antagonists come to market will be amazing. For me, to have played some part in that will be awesome and to see patients being able to go to clinicians and get that medication prescribed will be great.

There will be far fewer centres doing more complex endocrinology, and the development of this could be guided by some of what we have learnt regarding remote consultations and remote networking during the pandemic.

What do you think are the biggest challenges in endocrinology?

We have to mention COVID recovery, in what was an already overstretched system. However, somewhat linked to that, is the pull of general medicine on our time as endocrinologists. The pandemic has further highlighted this to be an important issue. Hospital inpatient medicine is busy and can’t be cancelled. However, it is essential for recruitment, training, and retention that our specialist time is more protected. The new internal medicine training (IMT) programme will change the number of specialty training years to shorten it, which could have some quite big consequences for the endocrine discipline.  

COVID-19 has brought some positives though; it’s highlighted that we can achieve quite a lot remotely with patients using virtual appointments, and some patients prefer fitting their appointments in to their life rather than having to attend the hospital. How this translates going forward though could involve big changes for the specialty.

The Society has become much more inclusive, and far more diverse, with a much broader mix of people, and I think that should really be celebrated and welcomed.

What do you think will be the major changes in the future of endocrinology?

I think there will continue to be a drive for a smaller number of national centres of excellence in endocrinology. There will be far fewer centres doing more complex endocrinology, and the development of this could be guided by some of what we have learnt regarding remote consultations and remote networking during the pandemic. That will be good for patients overall but the downside could be that there will be a smaller number of centres with specialist services, which means that staff  may have less involvement in specialist endocrinology. A lot of these changes will be driven by the GIRFT recommendations, which will affect how all services are delivered going forward.

What challenges do you see for your research?

Availability of funding will be critical. COVID has had an impact on available funding but so has Brexit, there’s now a lot of European grants that UK researchers will not be eligible for. Universities have less money because they’ve had fewer students and international students may think differently about studying in the UK post-Brexit and post-pandemic. Charities that fund research have also been hit as many of their fundraising activities were suspended during the COVID restrictions. The Government has a significant financial deficit to address. Availability of research funding was already challenging but it’s going to be even more difficult in the years to come. It’s usually funding that restricts research activity rather than a lack of ideas or collaborations.

How would you like to see the Society develop?

My overwhelming memory of attending my first Society meetings in 2006/2007 is of a lot of senior white men wearing tweed jackets! Now every time I come to Society meetings it’s such a stark change from that. Everything that the Society has done, and is doing, to make itself more reflective of everyone within it is really important. Recruiting the next generation is also a huge part of that, and it is great to also see more focus on this now than then too. The Society has become much more inclusive, and far more diverse, with a much broader mix of people, and I think that should really be celebrated and welcomed.

That level of change takes time and effort and over the years I’ve tried to play some part in helping to make the Society a more different place to the one that I initially knew.

As a Leadership and Development Awardee I was really looking forward to SfE BES 2020 as we were going to be paired with award lecturers, and it is also always a great opportunity to catch up with friends, previous colleagues, and previous as well as potential new collaborators. But of course, that didn’t happen. I’ve just been finding my feet as a new consultant and researcher in a new city but being an Awardee has opened up other opportunities. I’ve been involved in discussions with an external organisation exploring new collaborations and identifying our shared goals and objectives that we could achieve together. I’m sure that being an Awardee has helped me be offered these opportunities.

Who have you been most inspired by?

Prof John Wass, obviously, but I have also been very lucky to have amazing clinical and research mentors. From the literal beginning to the end of my clinical training and beyond (now over 15 years!) with Dr Simon Aylwin at King’s and Dr Roderick Clifton-Bligh in Sydney. I also learnt a lot from Prof Waljit Dhillo whilst doing my PhD at Imperial.

Why do you love endocrinology?

The balance of the acute and long-term follow up of patients, and the importance of making the right diagnosis for patients based on their history, examination and targeted investigation. Many patients with endocrine conditions go undiagnosed or misdiagnosed for a long time, so when you make the right diagnosis and instigate the right treatment, they feel and do so much better and you often see it unfold in front of you. As endocrinologists we are also part of a much wider multidisciplinary team, which is great.

Any words of wisdom for aspiring endocrinologists? 

I’ve always tried to be involved with the Society in recruiting the next generation. It’s important that they get to see the ‘real’ endocrinology and diabetes because often, those rotation attachments are mostly inpatient general medicine.

My advice would be to try to get to clinic as much as possible because a lot of our patients are outpatients, and also to go and review specialty patients on the wards when they are admitted. Remember also that there’s lots of different sub-specialties within endocrinology (and diabetes) so there is a place for everyone and an opportunity to be involved in the areas that you find most interesting/rewarding.

Don’t let yourself be put off by the general medicine component or thinking that it’s all diabetic feet! I also always recommend going to SfE BES, it’s a really good platform for meeting other clinicians and scientists involved in the field, and hearing about the patients that we look after. Get involved, come along and see what the specialty really has to offer.


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.

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.

Embracing the diversity of endocrinology: an interview with Dr Gareth Nye

Dr Gareth Nye is a lecturer in anatomy and physiology at the University of Chester. His main research interests are maternal and foetal health. In our interview, he tells us about his career so far, his research and how he thinks his field will develop in the future.

Tell us a bit about your current position

My recent research has been focused on improving outcomes for both mum and baby before, during and after pregnancy. More specifically I’ve been researching placental causes of foetal growth restriction, whilst also looking into the ongoing impact of the COVID-19 outbreak on maternity care.

I love endocrinology because it impacts every aspect of human health and disease

The most enjoyable aspect of my role as a lecturer is getting engagement from the students. When a student is really exploring a topic and that enthusiasm comes out in lectures or otherwise, it’s such a great feeling. With my research being in a field where you can make such a huge difference is also so rewarding. There’s still so much we don’t fully understand around pregnancy, so there is always new areas to look into.

What are you proudest of in your career so far?

There are many career moments that I’m proud of, for a wide range of reasons. Being nominated for “most inspirational lecturer” from students at the University of Chester is an achievement I’m proud of, for both personal and professional reasons.

Additionally, I’m particularly proud of our review of placental oxygenation in the Journal of Physiology and finally, speaking at the International Federation of Placenta Associations conference in Tokyo was an amazing experience!

What do you think are the biggest challenges in your field of research right now?

I think there are multiple challenges within maternal and foetal health and pregnancy research. If I had to name three major themes they would be

  • Ensuring every baby is delivered healthy and that every mum remains healthy, during and after the pregnancy. Finding novel interventions to improve foetal outcomes in utero, without the need for early delivery and shining a spotlight on the physical and mental changes that pregnancy has on the mother’s body, both during and after the pregnancy itself
  • Fully understanding the impact the maternal environment has on foetal lifelong outcomes – this involves the discussion around Developmental Origins of Health and Disease
  • Exploring the maternal/foetal interface to improve outcomes for the baby – this includes the placenta, breastmilk and circumstances following birth

Can you explain more about how you think your field of research will change in the future?

In the future we will challenge the current understanding around pregnancy and early childhood. Not enough is known yet and it's limiting our ability to intervene productively.

As pregnancy research, particularly in humans, is challenging for a number of reasons I can see the field collaborating more with other disciplines, even though not necessarily involved in medicine. For example, I have recent research papers with mathematicians, engineers and physicists, who can bring their knowledge and expertise to fill in gaps in our biological knowledge. Additionally, with the improvement of imaging techniques, we can slowly begin to understand the important microanatomy of the placenta and uterus to see if/how we can improve pregnancy outcomes. Without thinking of our research fields as one slice in a huge pie, we can never make true advances and so collaborating with different areas is key. Particularly as everything can be influenced by the body’s endocrinology!

What is it like being a Society for Endocrinology member?

I have to say, since joining this society I have felt so welcomed into a community. I’ve been given opportunities that have never been presented to me before from other societies. The Society on the whole seems to actively push and support their more junior members.

Unfortunately, I’ve not had the chance to attend any Society events in person yet but hopefully I will get the opportunity to attend soon!

Who is your most inspirational scientist?
Again, speaking personally, the most inspirational endocrinologist to me is Frederick Banting, the discoverer of insulin. This is because my 4 year old daughter has type 1 diabetes and without insulin, she wouldn’t be with us anymore! I think a lot of people have Banting’s discovery to thank!

John Hunter always sticks out as someone who should be more famous than he is. He truly is one of the greatest anatomists of our time, discovering much of what we know now around anatomy and physiology all without a formal school education. Of interest to my work – he was the first to note that maternal and foetal blood supplies are separate during pregnancy

Any words of wisdom for aspiring researchers in endocrinology?

Speaking from experience, something I like to tell my students is not to stick to your own little bubble. Everything in medicine and biology is connected in one way or another and keeping an open mind to your research can allow you to progress, where you may not have otherwise. Due to this, don’t be afraid to switch “topics” because you can always find common themes.

Finally, make sure you enjoy what you do! I’ve been lucky to work in some amazing areas, with amazing people but what’s really helped is enjoying my work!



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.

Embracing the diversity of endocrinology: an interview with Professor Rachel Crowley

Professor Rachel Crowley is a consultant endocrinologist at St Vincent’s University Hospital Dublin and a Clinical Professor at University College Dublin in Ireland. In our interview, she tells us about her career, shares her thoughts on the future of endocrinology and considers the possible improvements patient care.

Tell us a bit about your current position

My job is a mix of clinical work, research and teaching. Ours is a busy centre for neuroendocrine tumours and adrenal pathology, and I run the rare bone disease service which is a national Orphanet clinic. I also cover pituitary, gonadal, thyroid and general endocrine clinics, inpatient diabetes and endocrinology consults and general internal medicine. I love endocrinology because for each patient I assess and reason from scratch, it’s never boring.

What are you proudest of in your career so far?

I love endocrinology because for each patient I assess and reason from scratch, it’s never boring.

I’m proud of how the trainees I have worked with on my team have progressed in their own careers and how they have kept in contact. The Christmas cards, emails and WhatsApp messages from around the world are lovely to receive. I gave a talk at virtual ENDO this year and a trainee in Canada realised I would be getting a train home late from work after the panel discussion – she messaged me to be sure I got home safely! These personal connections make a big difference.

How much has your work changed since you started your career?

The general internal medicine commitment has increased, even in the relatively short time since I have been a consultant. The developments in endocrine genetics and in adrenal medicine have happened quickly in the last 10 years so it can be challenging to keep our practice up to the standards we expect of ourselves. The increased contact with patient advocacy groups is very welcome and rewarding – that was something that we didn’t learn about as undergraduates or have much exposure to as trainees.

The more access we have to genomics and proteomics, the more I think we’ll be able to deliver an individual treatment plan for the patient sitting in front of us – I think that’s really attractive to patients and satisfying for us in our own practice.

What do you think have been the major milestones in clinical practice during your career?

There is far more insight into the impact of genetic profiling on the clinical care plan for individual patients. Immunotherapy has had a huge impact on clinical oncology but has generated a whole new cohort of patients for us as endocrinologists. Improvement in oncology patient survival has also generated a cohort of survivors who have a wide range of endocrine late effects we need to address, as well as recognising the psychological impact of their experience.

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

I think the big challenge is reconciling the need for specialisation with the need for good basic care. Endocrinologists are often committed heavily to general internal medicine and I think we’re very good at it, because our specialty is broad and our training makes us excellent problem solvers. Our specialty contribution should not be overlooked because of our general medicine contribution. And of course we need to recognise when we need expert input and when we need to step up and become that expert ourselves.

What are you most looking forward to as part of the future of endocrinology?

The increased contact with patient advocacy groups is very welcome and rewarding – that was something that we didn’t learn about as undergraduates or have much exposure to as trainees.

I’m looking forward to more recognition of our specialty by outside stakeholders – because I think that will lead to more robust funding of doctors, nurses and research by national bodies. I think we’re working hard towards that increase in profile. The more access we have to genomics and proteomics, the more I think we’ll be able to deliver an individual treatment plan for the patient sitting in front of us – I think that’s really attractive to patients and satisfying for us in our own practice.

Who has inspired you most in your career?

I have had the benefit of lots of mentors over my career. Chris Thompson supervised my MD in craniopharyngioma and I learned the importance of intellectual rigour and patient-focused intervention from him. His colleague Mark Sherlock was a peer mentor, if such a thing can be said; Mark’s value for collegiality and networking to deliver better patient outcomes has led to ongoing clinical and research collaboration today. In my time at the University of Birmingham Paul Stewart and Wiebke Arlt led by expecting the highest standards from all of us – everybody raised their game – and Neil Gittoes was a key link with the Society for Endocrinology and my career development after completing training.

Do you have any words of wisdom for aspiring endocrinologists?

Keep reading. Keep asking questions. Keep going to meetings and thinking – how does this apply to my patients? Keep talking to your patients and telling them about these new developments you’re hearing about. Keep in touch with your former colleagues and be a good collaborator. Keep an open mind, apply scientific rigour and make up your own mind.


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.

Meet the editor – Professor Martin Haluzík

Meet Professor Martin Haluzík, Professor of Internal Medicine at the Charles University in Prague, Deputy Head of Centre for Experimental Medicine and Head of the Department of Experimental Diabetology at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic. Professor Haluzík is a deputy editor of the Journal of Endocrinology and Journal of Molecular Endocrinology. His major research focus is on the etiopathogenesis of obesity, insulin resistance and type 2 diabetes. In this interview, Professor Haluzík tells us more about his research and career.

Tell us about your particular field and research?

Our lab explores the etiopathogenesis of obesity and type 2 diabetes aiming to find preventive and treatment strategies. We are particularly interested in bariatric surgery and endoscopic methods of treatment along with novel pharmaceutical targets. Our research is both experimental and clinical, involving patients with obesity and type 2 diabetes.

What techniques do you use in your research?

At the moment, a lot of our research is focused on immunometabolism/subclinical inflammation in adipose tissue using flow cytometry and continuously trying to refine it. We are also using metabolomic and proteomic methods in collaboration with other laboratories. In patients, we often use glucose clamps to characterise insulin sensitivity before and after interventions. We are also testing numerous novel endoscopic methods for treatment of obesity/type 2 diabetes in both experimental models and in patients.

What inspired you into endocrinology?

It was primarily my mentor, Professor Vratislav Schreiber, who was a leading, internationally-recognised, experimental endocrinologist. His primary focus was hypothalamus/hypophysis research but he was the one who, after discovery of adipose tissue hormone leptin, came up with the idea that we should focus on the endocrine function of fat.

What do you enjoy most about work?

I really enjoy its variability – doing both experimental and clinical research brings some challenges but this combination is never boring. I very much like scientific discussion with my colleagues about our results and brainstorming how to explain it and put it into context. I also like writing the papers, especially when nobody is calling and I have a couple of hours to focus on thinking about data and writing.

What does your day-to-day work life involve?

I do both clinical work (seeing patients with diabetes/endocrine diseases) and experimental research. Nevertheless, I have to admit that I am not very useful in the lab anymore. My job is mostly to write grant applications, organize things, write and refine the papers and support my colleagues and PhD students.

What are you most looking forward to in becoming an editor?

I am very much looking forward to a chance to contribute to shaping and refining the focus of such well-respected journals of Journal of Endocrinology and Journal of Molecular Endocrinology. Also, I really like interaction with the Editorial Board and other members of the team that bring most interesting ideas that help us to improve the journal.

Who/what research has inspired you the most?

My first mentor, Professor Vratislav Schreiber, who contributed to the discovery of TRH. He was very inspiring by a combination of being extremely smart and modest at the same time, while having an unforgettable sense of humour.

What is the best feedback or advice you have ever received?

“Work smart not hard” although I am still learning how to do it, which involves a lot of hard work.

Is there any advice you can give to someone just starting off in science?

Go for it! I would make the same choice again if I could start over. It is a lot of work but you don’t really need any other hobbies. You can think about science all the time.

How can we inspire our future leaders in endocrinology and the Society?

Graham Williams with Award winners SfE BES 2017
Prof Graham Williams (centre) with Award winners SfE BES 2017

The Society has launched a new Leadership & Development Awards Programme, to recognise and nurture emerging talent in endocrinology and help Awardees become the future leaders of our discipline. In our interview, Prof Graham Williams, President of the Society for Endocrinology, introduces the Awards Programme and explains how it will be used to inspire and support our leaders of tomorrow, and why early career endocrinologists should apply.

What are the aims of the new Awards programme?

My main priorities as President of the Society have been to ensure that we cater for every member and that we are prepared for the future by being able to develop and respond to change. An important part of that is to support people who are enthusiastic and dedicated to endocrinology so they are equipped to be our future leaders. The Society Officers and Council have introduced the Leadership & Development Awards Programme to help identify these individuals and prepare them; by providing opportunities to learn more about how the Society works, how it is governed, how the committees work and what its strategic aims are. The main purpose is to give everybody an equal opportunity to become more involved, and to ensure that all categories of our membership are well represented in the future.

Towards this goal, the Awards Programme is open to clinicians, clinicians-in-training and research scientists. We are also considering, with the Nurse Committee, how to bring forward a similar initiative that will suit our nurse members, who have different career pathways and needs, and will require an alternative selection process.

The overall aim is to ensure the Society is in a strong position for the future, by securing the engagement of our most dedicated members to help grow and develop our community.

Why do we need an Awards Programme to identify our future leaders?

Our members have always been engaged with endocrinology but the discipline is rapidly changing. It is no longer so easy for people to identify themselves as endocrinologists. There has been a move away from a traditional organ and disease based focus, with increasing emphasis towards interdisciplinary science, whole organism physiology and cellular and molecular signalling. This means many more people are dipping in and out of endocrinology as a discipline, which in turn impacts on the Society. We need to move with the times and ensure we include cross-cutting disciplines that are integrated fully within the Society and endocrine community.

What are your hopes for the Awards Programme in the longer term?

I don’t want to predict the future but I think the Society needs to be agile and responsive as the discipline changes. So we aim to equip Awardees with the skills they need to influence Society strategy and develop our plans as the field advances. Endocrinology is also global discipline and I think that building collaborations with other medical disciplines will be essential both in the UK and also with colleagues all over the world.

What advice would you give to applicants for the Award?

Answer all the questions as completely as possible but most importantly be yourself. When people answer honestly, it allows them to express their true sense of excitement and enthusiasm – and that is what we are looking for – people who are the ‘enthusiastic doers’.  Of course we are looking for those who can demonstrate clinical and scientific excellence in endocrinology, but they need to be excellent communicators and ambassadors as well.

What qualities do you think are important in our future leaders?

I think openness, honesty and the ability to listen to, and to take advice from, others are some of the most important leadership qualities. By sitting on lots of committees you can learn a lot from the chairs. The best ones are great listeners, adept at summing up and have the ability to direct people towards a sensible consensus. Excellent communication skills and wanting to help others are essential qualities for all leaders.

Apart from a dedication to endocrinology, it is important that Awardees are rounded individuals with other outside interests . Working hard is important but it is important to switch off at times and enjoy other interests.  For me this has come from sport and the great outdoors, but whatever it is “work hard and play hard” and you won’t go far wrong!  Having diverse interests also helps with networking, getting to know colleagues and in developing long-lasting friendships that cement the endocrine family together.   

What have you enjoyed most while serving on Committees and as President?

It has to be the people. I feel in a really privileged position to be able to work in the field I love, but serving the Society has extended that experience into being part of a community. Being able to meet and work with like-minded and fantastic people, from different disciplines, from all over the world, and who all want to achieve similar things has been very inspiring.

Who were your early mentors?

I have been fortunate to have had many outstanding mentors over the years but here are the early ones that inspired me into endocrinology and then research. As a medical student, I loved anatomy and was all set to be a surgeon.  However, my first house job was with Professor David London at the Queen Elizabeth Hospital in Birmingham.  He is an eminent clinical endocrinologist and long-standing Society member.  During my time as his houseman, we had lots of interesting endocrine challenges and his infectious enthusiasm got me hooked, so I decided to change and take up a career in endocrinology.

After completing general medical training, I was encouraged to move into the laboratory to work on thyroid hormone action with Michael Sheppard and Jayne Franklyn.  They subsequently encouraged me to branch out and go to Boston to continue my research training at Harvard Medical School, and this move inspired me to pursue an academic career in basic clinical science.  Throughout my career many people have been inspirational and provided support and this never stops; you develop an expanding network that brings new ideas, collaborations and opportunities.  It is here that the Society makes such a difference and will continue to do so as the next generation takes the reins and leads us into the future.

I feel strongly that the new Leadership & Development Awards Programme will serve the future of the Society and the future of endocrinology well.  It will provide unique opportunities for those who apply and I hope it will help to support the careers of our talented trainees.  The applications are open to all so please don’t feel inhibited – just go for it!

Are you an early career endocrinologist interested in developing your leadership skills and becoming more involved with the Society? Applications for the Leadership & Development Awards Programme are open 1 April – 14 May 2019.

Full details of the selection process, benefits and how to apply are on our website.

Meet the Endocrinologist: Matthew Simmonds, expert in pancreatic transplant genomics

Meet the Endocrinologist: Meet Dr Matthew Simmonds a Senior Lecturer in Biomedical Science at the University of Lincoln. His research is focused on the genetics of pancreatic transplant function and he will be presenting at the Early Career session at SfE BES 2018, 19-21 November in Glasgow. In our latest interview, he tells us more about his work and what he is looking forward to at the SfE BES 2018 conference.

Can you tell us a little about your current position and research?

I am a Senior Lecturer at the University of Lincoln where I have been now for just over two years.  My research career has revolved around trying to identify genetic contributors to a series of autoimmune endocrine diseases including autoimmune thyroid disease and type-1 diabetes.  My current research is specifically focused on looking at genetic predictors of long-term pancreas transplant function in people with severe type 1 diabetes.

What inspired you in to this field?

The immune system is amazing and without it we would never have survived and evolved on this earth. What I find so interesting about the autoimmune endocrine diseases is how the immune system, which is meant to protect us, actually starts to attack parts of the body leading to changes in how the endocrine system works.  I am passionate about understanding how disease pathways are triggered/progress and how we can use these insights to inform better treatments for people with these different conditions.

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

I think the major challenge within pancreas transplantation is both the number of donor organs available for transplantation into people with severe type-1 diabetes and trying to ensure that the transplanted organ remains functional throughout the recipient’s life to ensure the benefits these transplants provide, of retuning insulin production and halting/reversing secondary diabetes related complication in that person, remain for as long as possible.

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

I think both the advances being made in using induced pluripotent stem cells, combined with gene editing, to create new beta cells, will provide unparalleled new opportunities for transplantation purposes. Combined with the decreased costs around genome and other proteomic screening for patients and our increased understanding of how genetic variation impact upon autoimmunity and transplant success this will give us new understanding of disease progression and provide better individual tailoring of therapeutics.

What will you be doing at SfE BES 2018 in Glasgow?

Well as you have asked – nothing like a bit of shameless plugging – I will be doing a talk on the Tuesday as part of the Early Careers session ‘Navigating the Academic Pathway’.  My talk is entitled ‘The lectureship route’ where I will be providing some insights into this career pathway, the challenges and benefits of this route and some tips on how to be get such a position.

What are you looking forward to at this year’s conference?

I think as an early career researcher I loved going to conferences to be able to present my work and network with others working in the field – which is the same reason I enjoy attending conferences to this day. Whilst there are lots of fantastic talks, plenaries and other sessions throughout the conference with something to suit everyone’s research interests, one thing I would suggest to early career researchers is to take time to speak to other early career researchers at the poster sessions and after their talks.  You would be surprised how much you have in common with other researchers and how random conversations at conferences can lead to new collaborations and possibly job offers in the future.

Who do you most admire and why?

 I have been really lucky to have worked with some of the most amazing researchers in diabetes and endocrinology throughout my career so far – both in the centres I have worked and through numerous collaborations. I have been very lucky to have some amazing mentors throughout the years, and think that whatever stage in your career you are at it is important to keep listening, learning and being inspired by researchers at every level.

What words of wisdom do you have for someone starting out in research?

These type of questions always make me feel old.  Joking aside, I think the best advice I can give to any early career researcher is to think about where you want your career to go but don’t be so rigid in your approach that you may miss out on some unexpected opportunities that come your way. Also listen to your gut feeling about career decisions.  Whilst is it perfectly normal to be scared to take on new challenges be it new techniques, moving into different project areas or new jobs, sometimes you instantly know if something is a good or a bad move. From my own experience I have learnt that sometimes saying no to something that is not right for you is as important as the opportunities you say yes to.

You can hear Dr Simmonds presentation, “The lectureship route” on Tuesday 20 November, as part of the Early Career: Navigating the Academic Pathway session at 16:00-17:30. Find out more about the scientific programme for SfE BES 2018.

 

 

Meet the Endocrinologist: Jeremy Turner, expert in bone and calcium endocrinology

Prof Jeremy Turner is a consultant endocrinologist at Norfolk and Norwich University Hospitals NHS Foundation Trust. He has a particular clinical interest in calcium and metabolic bone disorders and is a convenor of the Society’s Bone and Calcium Endocrine Network.

What inspired you into endocrinology, and bone and calcium in particular?

I was fortunate enough to undertake my early postgraduate training in endocrinology at the (then) Royal Post Graduate Medical School/Hammersmith Hospital in the mid-1990s, where I worked with some inspirational colleagues in the bone and calcium field. I then went on to undertake an MRC clinical training fellowship in Raj Thakker’s lab in Oxford. The latter experience firmly cemented the place of calcium and bone endocrinology in my endocrine repertoire.

Can you tell us a little about your current work?

I have been consultant endocrinologist for the last 9 years in Norwich and was more recently promoted to honorary professor at the Norwich Medical School. I run the clinical metabolic bone/calcium service in Norwich with my great friend and colleague Professor Bill Fraser. We have established a good reputation for our clinical service and referrals come in from far and wide. We provide over 120 consultant delivered lists per annum and have succeeded in getting Norwich recognised as a Paget’s Association Centre of Excellence.

Historically, bone and calcium disorders have been somewhat “Cinderella” conditions in the wider context of endocrine services and I particularly enjoy advocating for this population of patients and developing services in this area. I am medical advisor to Hypopara UK and of course promote the charity and its work to our large population of hypoparathyroid patients. I have led the writing of a number of clinical guidelines including a post-operative hypocalcaemia avoidance and management guideline, have developed services such as a one-stop osteoporosis clinic and am currently working with colleagues in Cambridge to set up a rare bone disease network in the East of England. Naturally, the achievement I am proudest of is being appointed as a network convenor for the Bone and Calcium Endocrine Network of the Society for Endocrinology!

Over the last decade or so, what do you think have been the most useful/impactful advances in bone and calcium?

As a pure endocrinologist, the single most exciting advance has been the arrival of recombinant human parathyroid hormone (PTH) for the treatment of hypoparathyroidism. Finally, clinical endocrinologists now have a “full set” of replacement hormones to use in hormone deficiency states and this day has been a long time coming. However, no answer to this question would be complete without reference to the arrival of the many new therapies for osteoporosis and perhaps, as importantly, the expansion in understanding of treatment of osteoporosis that has occurred in recent years. This has included appreciation of risks of treatments as well as benefits, how to use the different therapies, where they fit in relative to each other, the growing use of bone markers, fracture risk calculators and so on – all of which are driving more nuanced, considered and targeted clinical approaches to treatment of osteoporosis.

What do you think are the biggest challenges faced by endocrinologists?

In my opinion, the biggest challenge faced by all endocrinologists has to be management of remorselessly growing demand. The population is expanding and ageing and at the same time more treatments are available across endocrinology. Awareness is growing amongst patients and general practitioners and thus referral rates are rising. This is a good thing, it means that our specialty is able to help more and more people for whom perhaps help was not always available in the past and also means that the place of endocrinology in clinical medicine as a whole is better recognised and appreciated. However, it is up to us to manage this demand, find new ways to see and treat as many people as possible and to modernise aspects of our practice. Not changing how we work is probably not an option!

Are there any controversies in bone and calcium endocrinology?

Of course there are many controversies but one of the greatest at the moment is probably the recent recognition of the end-of-treatment effect of anti-RANK ligand therapy whereby fracture rates may rise quite fast in some patients upon withdrawal of this therapy. This is a very pressing clinical challenge as numbers on this exciting and novel treatment are quite large, we have been using this for a period of time that means that some are already arriving at what was originally intended to be the end of treatment but now we know that simply stopping the treatment is probably not the best option for many patients. At the same time, there is a relative lack of evidence base to inform us with regard to what we should be doing next. While it is helpful that some guidance is beginning to emerge, this is largely based on expert opinion and it will be very interesting to see how this controversy unfolds over the next few years.

What do you enjoy about being an Endocrine Network convenor?

 So far it is early days but I am enjoying working with my co-convenor (Caroline Gorvin), with colleagues in the society and am looking forward to playing my own very small part in further raising the profile of bone and calcium medicine and research within endocrinology.

Do you have any words of wisdom for aspiring endocrinologists?

Yes, this is perhaps the easiest question; Enjoy your endocrinology! If you are enjoying your clinical practice you will be happy and more importantly your patients will be happy, correctly diagnosed and correctly treated.

 

The Endocrine Networks are platforms for knowledge exchange and collaboration amongst basic and clinical researchers, clinical endocrinologists and endocrine nurses. The Networks enable members to discuss and find solutions to challenges within their specialist field.

To join an Endocrine Network login to the ‘My profile’ section of the Members’ Area and select ’Endocrine Networks’.

Meet the Endocrinologist: Petros Perros, thyroid disease expert

Dr Petros Perros is Honorary Clinical Senior Lecturer at Newcastle University, and a consultant in endocrinology at Newcastle Hospitals. His clinical and research interests focus on the study of thyroid disease, and he is a convenor of the Society’s Thyroid Network.

What inspired you into medicine and why did you focus on thyroid disease?

I got inspired into medicine through observing the impact of successful treatments on people’s lives and the misery brought onto those who are incurable. Appreciating that science was the key to solving those problems was my main motivator to pursue a career in medicine.

As a student, I was attracted by the relevance of endocrinology in every system and organ, and the beauty and elegance that was revealed from studying it. The frequency of thyroid conditions and the interests of my mentors contributed towards my focusing in this area. However, I can also recall how impressed I was when I read about the discovery of the therapeutic role of radioiodine in hyperthyroidism and thyroid cancer: a perfect marriage of physics and clinical medicine leading to the first “magic bullet” treatment in medicine.

Can you tell us a little about your work?

Graves’ orbitopathy (GO), also known as thyroid eye disease (TED), has been the focus of my clinical and academic interests. This has enabled me to work closely with colleagues in other disciplines, which has been immensely rewarding.

There are rapid advances in understanding the pathophysiology of GO, and a plethora of biologics are already available and beginning to be used with impressive results. Besides the high tech available, the realisation that low cost, conventional interventions can influence the course of this disease has also made the topic of implementation very interesting and challenging. Now is a fascinating time for people working in this area.

What do you think have been the most impactful advances in thyroid clinical practice and research?

For thyroid research, one of the most relevant outcomes of the Human Genome Atlas has been the demonstration that the commonest thyroid cancer (papillary) has one of the simplest genetic mutational repertoires, so the scope for therapeutic interventions to silence driver mutations is a realistic expectation. I anticipate that prognostic evaluations and novel thyroid cancer treatments will reach the clinical arena in the next decade as a direct result of this.

What will be the next breakthrough for treatment or diagnosis of thyroid conditions?

In my opinion, targeted therapies in advanced thyroid cancer are at the top of the list. Immunotherapies for autoimmune thyroid disease are also emerging. In basic research, we can expect to learn more about the application of regenerative medicine in thyroidology, and we will hear a lot more about the role of thyroid hormones in dementia.

What are the biggest challenges faced by your clinical specialty?

We need to reverse the tide of unnecessary investigations and treatments relating to endocrinology, as this has an enormous negative impact on patient care and wastes large amounts of resources. Another challenge is attracting the brightest doctors and scientists to our discipline, and strengthening the links between endocrinology as a clinical specialty and as a scientific area.

Are there any controversies in your practice area?

Some decades ago, we thought that we had solved the problem of thyroid hormone replacement. Yet, some patients remain dissatisfied, seek alternatives, and have recently launched a war against “conventional” endocrinologists. Unfortunately this is exacerbated by self-appointed experts from the dark alleys of alternative medicine, who exploit human suffering and desperation. However, on the bright side of things, this controversy has raised some valid research questions that are answerable by scientific investigation, and the new knowledge gained from it will help resolve some of these issues.

What do you enjoy about being a Network convenor?

I particularly enjoy the interaction with colleagues, especially the young ones. Endocrine networks have a great potential for bringing individuals with similar interests together and promoting research in endocrinology.

Do you have any words of wisdom for aspiring endocrinologists?

If you find endocrinology intriguing, delve into it and have a taste. Don’t be put off if it seems too complicated – it only means there is more to discover. Endocrinology is a great specialty full of surprises and rewards.

Find out more about the Society’s Endocrine Networks, and how they can provide a platform for knowledge exchange in your area of focus.