Meet Stephen Shalet the Society’s 2021 Jubilee Medal Lecturer

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Professor Shalet is an Honorary Consultant Endocrinologist at the Christie Hospital, Manchester and Emeritus Professor of Endocrinology at the University of Manchester. His main research interests are late endocrine effects following treatment of cancers, pituitary disorders and in particular abnormalities of growth hormone secretion. In our latest interview, he talks about his career, the importance of keeping patient care at the forefront, complemented with an anecdote or two.

Tell us a little about your career path

I completed a BSc in Physiology at London University and qualified in medicine at the Royal London Hospital. My medical training posts in London and Bristol were followed by an appointment as Research Fellow in Endocrinology at the Christie Hospital, Manchester. I formally retired in 2005 but carried on seeing patients until around 2010. Now all I really do is I teach, I like the subject, so it’s not really work, it’s enjoyable. Occasionally, I referee a paper and participate in data safety monitoring boards. I still do a moderate amount of that work, which keeps me in the loop in terms of what’s going on in the field.

“Although I’d never done any research, the focus there was on childhood cancers. The survival figures for kids with cancer had massively increased but now these patients were having growth and puberty problems. That’s why an endocrinologist was needed there.”

What inspired you into research?

I always liked endocrinology, the science is very attractive. At first it makes logical sense, the pituitary controls the thyroid, the thyroid sends a message, the pituitary changes, but then hold on there’s the hypothalamus and it’s that complexity that makes the science really attractive. Clinically, you can have long-term relationships with patients. When qualified, I knew I wanted to do endocrinology but I was then doing a medical registrar job in Bristol and after attending a course on endocrinology, I realised I knew nothing. So I decided if that’s what I wanted to do, I had better learn some and then a Research Fellow position came up in Manchester – and that’s how I got started.

Although I’d never done any research, the focus there was on childhood cancers. The survival figures for kids with cancer had massively increased but now these patients were having growth and puberty problems. That’s why an endocrinologist was needed there.

What do you enjoy most about your work?

Clinical practice is what matters, I care about the patients. I’ve always cared about their outcomes. I also enjoy teaching and research. Those are the three components that I need and enjoy and of course they interact. At the end of the clinic, we all used to have discussions where you’d bring the rest of the team up to date, think about what we don’t know, why we don’t know it and how could we know it? That’s all part of the teaching training and research, thinking as well as doing the best for patients.

Has anyone particularly influenced your career?

I can’t tell you that I had a specific mentor but Colin Beardwell was a very good role model. He cared about patient outcome, was intelligent and an excellent teacher. He didn’t have an ego problem and was happy to see a younger colleague develop.

I’d also seen bad guys along the way, really unimpressive, and that showed me who I didn’t wish to become. I tried to feed off the bad guys and I knew I never wanted to be like that.

“At one point in Manchester, we published the worst surgical results for acromegaly in the world. At that time six surgeons did the operating instead of one. You need one because the number of cases isn’t high enough for six to obtain the volume of experience.”

What are you looking forward to at SfE BES 2021 in Edinburgh?

My lecture will look back over my career and research, and include an anecdote or two! When you get to my age, you have friends to catch up with, you may have known them 30 or 40 years and only have that once a year chat but I look forward to it.

I have a funny Edinburgh story from years ago. I flew from Manchester to Edinburgh and was waiting for a taxi outside the airport. A taxi driver approached me and asked something that sounded like ‘do you want sex’? The whole queue could hear as I replied, as reasonably as I could, that I did not want sex, it was November and very cold, but I thanked him very much for the offer. At that point the taxi driver clarified the taxi was a six seater and he wanted to know whether there was six people in my party! That was one of my most memorable Edinburgh conversations.

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

Late effects of cancer treatment is still a challenge. You’re always catching up as these can occur up to 10 years after treatment. There needs to be expert resource available to treat the problems as they arise. Another issue is transition to adult life. Bridging the gap between paediatric and adult care can be very difficult. New more targeted treatments such as proton beam therapy will still cause endocrine damage, which may need to be tackled differently.

What do you think will be the next major changes for endocrinology?

More centralisation of key procedures. You need real expertise for these procedures, which may not come up very often around the country, centralisation means that volume of experience is contained in a centre of excellence. Although this means fewer endocrinologists get that experience, we need to make sure that patients are getting the best care.

At one point in Manchester, we published the worst surgical results for acromegaly in the world. At that time six surgeons did the operating instead of one. You need one because the number of cases isn’t high enough for six to obtain the volume of experience. Now Manchester has one surgeon and the results are as good as anywhere else. That’s why I think centralisation of certain key procedures will be better for patient care.

Any words of wisdom for aspiring endocrinologists?

Try to get a reasonable understanding of yourself. I think that’s the journey. Not everybody is destined to do lots of research, just as some people are better suited to clinical practice whilst others are destined, particularly in a subject like endocrinology, to be lab-based. You should try to work out what combination of clinical work, teaching and research works best for you. 

You can attend Professor Stephen Shalet’s Medal Lecture, “Cancer treatment endocrinopathies and growth hormone status throughout life” on Wednesday 10 November at 4:40pm.

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

Meet Roland Stimson the Society’s 2021 Starling Medallist

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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

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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 Mark Febbraio the Society’s 2021 International Medal winner

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Professor Mark Febbraio is a Senior Principal Research Fellow and Investigator of the NHMRC and Head of the Cellular and Molecular Metabolism Laboratory within the Drug Discovery Program at Monash Institute of Pharmaceutical Sciences, at Monash University, Australia. He is also the CSO of N-Gene Research Laboratories Inc., a USA-based Biotechnology Company. His research focusses on understanding mechanisms associated with exercise, obesity, type 2 diabetes and cancer, with the aim of developing novel drugs to treat lifestyle-related diseases. Here he tells us about his unconventional route into research and how he helped start a new subfield of endocrinology!

Tell us about your career path so far

“Being a scientist is a balancing act between small wins and frequent disappointment. Experiments often don’t work out, papers are frequently rejected and grant applications are often not funded. The key is to savour the small wins.”

I didn’t take the conventional scientific path. After completing my undergraduate degree in exercise science, I became a full-time (semi-professional) triathlete. During a race in Japan, I become extremely heat stressed and dehydrated, so I decided to go back to do a PhD looking at the effect of environmental temperature on muscle metabolism during exercise. For the next 6 years, I worked as an exercise physiologist and undergraduate lecturer until I met Professor Bente Pedersen, a clinician from the University of Copenhagen, which got me into research. Since then, approximately 20 years ago, I’ve devoted 100% of my time to research as an NHMRC Research Fellow and Investigator in the area of tissue crosstalk, exercise and metabolic disease.

What inspired you into research?

Professor Bente Pedersen and I shared data that we had independently gathered showing that during exercise, muscle produces and releases IL-6, a cytokine previously thought to be made predominantly by immune cells in response to inflammation. We coined the term “myokine” (muscle-producing cytokine).

Muscle then became known as an endocrine organ. About 15 years earlier my friends and colleagues, Jeff Flier and Bruce Spiegleman, discovered that adipsin, a serine protease homolog, was synthesised and secreted by adipose tissue, and the field of adipokines was created. Muscle was a little late to the party but we got there eventually!

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

Of course the IL-6 story was a proud moment, but our work on heat shock protein 70 as a therapeutic target for treating metabolic disease, as well as our recent work on extracellular vesicles and the synthesis of the chimeric protein IC7Fc to treat metabolic disease also make me proud.

What do you enjoy most about your work?

By far, training and interacting with my mentees. It has been wonderful to see so many great people transition through the laboratory and go on to be highly successful independent scientists.

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

Basically, I will be presenting the historical story of how we came to discover that IC7Fc could be a viable treatment for metabolic disease. The story has many twists and turns!

“My feelings are that the next breakthrough will come from the global push towards artificial intelligence in drug discovery.”

I think the main challenge is that a complex problem like metabolic disease can’t be cured by simple solutions. Whilst “the molecular age” produced so much important knowledge, it become clear that there is no single molecule that, if targeted, will produce the magic bullet to treat or cure a disease that is so complex.

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

My feelings are that the next breakthrough will come from the global push towards artificial intelligence (AI) in drug discovery. I’m not saying that we will get the “slam dunk” from AI, but I’m sure we will learn so much via the big data revolution.

Any words of wisdom for aspiring endocrinologists?

Being a scientist is a balancing act between small wins and frequent disappointment. Experiments often don’t work out, papers are frequently rejected and grant applications are often not funded. The key is to savour the small wins and understand that the failures are part of building success. I often tell my trainees “in order to be successful you must be prepared to fail”. It’s OK, in fact it’s normal. Above all enjoy the process and don’t focus on the outcome.

You can attend Professor Mark Febbraio’s Medal Lecture, “Activation of the gp130 receptor: a panacea for the treatment of metabolic diseases?” on Tuesday 9 November at 09:00.

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

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

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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.

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Enhancing endocrine education: for medical students by medical students

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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.

How can the Masters-level Module in Endocrine Nursing help your career?

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Recent graduate Helen Loo reveals all

Helen Loo, Endocrine Specialist Nurse at Oxford University Hospitals, is one of our first students to successfully complete the Oxford Brookes Masters-level Module in Endocrine Nursing. This module provides nurses with an opportunity to develop their careers and improve standards of patient care in line with the Competency Framework for Adult Endocrine Nursing. The Society collaborates with Oxford Brookes to deliver this 40-credit module, enabling nurses to get academic recognition for all their hard work. All credits can be directly counted towards the Oxford Brookes University MSc in Health Sciences or transferred to Masters-level qualifications at other institutions.

Read our interview with Helen to get valuable insights in to the module and find out about her career as an endocrine nurse.

What inspired you to choose endocrinology as a career?

Before I started working in endocrinology I was living abroad. When my family and I decided to move to the UK, I saw a position advertised to work in endocrinology. After I started researching the area, I was inspired to apply. Endocrinology appealed to me as the discipline is so vast and mixes both acute medicine and chronic disease management.

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

I work in a large endocrine team at a busy tertiary referral centre at Oxford University Hospitals, and see patients with many diverse endocrine disorders. Endocrinology is a rewarding area to work and study within as the discipline is constantly changing. There are many opportunities to learn and to apply your learning in practice. I particularly enjoy developing innovative solutions to improve quality of care and nursing practice. As an endocrine nurse, I also feel very privileged to be able to support our patients holistically through the various stages of their diagnosis and treatment.

Tell us about your main research interest

I take a special interest in the areas of male fertility, adrenal insufficiency, gender dysphoria and support the treatment and diagnosis of patients with Cushing’s syndrome. During my Masters-level Module in Endocrine Nursing, I specifically looked at the management of adrenal insufficiency, prevention strategies, and innovation in endocrine nursing care. I was interested in this area of endocrinology because I was inspired by a complex patient who came to us with a medical alert dog, who alerts the patient when their cortisol levels drop. In 2019, I presented a poster at the Society’s Annual BES Conference on this subject and was privileged to be the recipient of the Annette Louis Award. You can read more about this in The Endocrinologist.

Why did you decide to apply for the Oxford Brookes module?

I applied for the Oxford Brookes module as I wanted to build on my experience, knowledge, and skills in endocrine nursing, while advancing my understanding of the health needs that directly relate to our patients. I hoped that it would develop my confidence in undertaking research, enhance my critical enquiry skills and improve my evidence-based practice.  All these expectations were met and more!

What is your advice for anyone considering doing the Oxford Brookes module?

This is an excellent course and will really help to give you more expertise in your chosen area and develop your profession. I would advise those considering the module to plan well and to take a responsible approach to their own learning.

What were the challenges of the module and how were you supported?

My biggest challenges were that it had been quite a few years since I had done academic work and I also had two primary aged children. The university provided me with support to get back into writing academically and I reduced my hours to enable me to have a better work life balance. My mentor was also amazing. She supported and encouraged me to manage my own learning to develop my skills and maximise my potential.

What are the biggest challenges in your field?

I think some of the biggest challenges are working within the constraints of the NHS, as well as the effects of the pandemic on health care. Challenges always provide opportunity however, and it is with this mind set I move forward.

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

Endocrine nursing is a continually evolving specialty and is now becoming academically accredited. The competency framework benchmarks endocrine nursing with continual scope for development and innovation. I am really excited for the future and the part I will play.

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

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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

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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.