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 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.

Conference delegate SOS – help get our research proposals off the ground!

SfE BES is all about bringing endocrine professionals together to share knowledge and spark future collaborations. This year, for the first time, delegates are invited to hear specific research proposals and contribute their insights, data or resources to really help get these fledgling projects off the ground.

Here, Dr Kate Lines, from the Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, talks about her proposal to be presented at an Endocrine Network Research Incubator Meeting to further understanding of pancreatic neuroendocrine tumours. To complete her project, she needs SfE BES 2017 delegates to provide more patient samples!

My research mainly focuses on learning more about how pancreatic islet cell tumours (pancreatic neuroendocrine tumours) grow, and using this information to develop new therapies. One specific area that has begun to interest me recently is inflammation. Inflammation is a process in which the body sends cells of the immune system (or white blood cells) to specific areas to defend against foreign substances. It has now been shown that many tumours can hijack this system by releasing chemicals to lure in white blood cells. Once the white blood cells reach the tumour they are encouraged to secrete small proteins (cytokines), which help make the perfect environment for the tumour to grow. The perfect growth environment is different for different tumours, therefore the specific white blood cells and cytokines needed by each tumour is also different. Currently, not much is known about which white blood cells and cytokines are most important for supporting pancreatic neuroendocrine tumours.

I submitted a proposal for the Endocrine Neoplasia Syndromes Network Research Incubator Meeting at SfE BES 2017 that suggests examining the area around dissected tissue from pancreatic neuroendocrine tumours for these specific cells and cytokines. Once we have this information we can use it to either help diagnose the tumours (as the cytokines can be detected in the blood), or target them with specific drugs to try to make the environment less ideal for the tumour to grow. However, the trouble with pancreatic endocrine tumours is that although they can be deadly, they are also rare. This is the main stumbling block for the proposed study, as our hospital alone doesn’t have enough samples for us to be confident that the specific cells and cytokines we see are representative of those occurring in all patients.

The Endocrine Neoplasia Syndromes Network Research Incubator Meeting provides a rare opportunity for us to try to access these samples from different hospitals in different locations, which ultimately could provide a set of samples that is truly representative of all the pancreatic neuroendocrine patients in the UK. Not only could the members help by providing samples for this study, but as our work continues they could also provide further samples, such as blood, for future work stemming from this proposal. I therefore hope that the other members of the network will be as interested in this area as I am and would like to provide us with lots of patient samples to investigate. In addition, as an early career researcher it is rare to get the chance to present new ideas to my peers. I am therefore looking forward to what I hope will be an exciting and stimulating discussion on a new area of research for me.

The Endocrine Network Research Incubator Meetings will take place on Tuesday 7 and Wednesday 8 November, 07:45–08:30, come along to the Endocrine Network Meeting most relevant to your research interests and read the full scientific programme for SfE BES 2017 for more details.

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

Meet the Endocrinologist: Interview with Prof David Hodson

Meet Professor David Hodson, Society for Endocrinology Starling Medal winner for 2017. Prof Hodson is based at the University of Birmingham, where his work investigates how failure of pancreatic beta cell function contributes to type-2 diabetes. He is particularly interested in using multidisciplinary and innovative approaches to answer these research questions, which has earned him this award, to be presented the annual conference, SfE BES 2017, in Harrogate, 6-8 November 2017. Learn more about his endocrine journey in this exclusive interview.

Q:  Tell us a little about your career so far and how you ended up in Birmingham

I originally trained as a Veterinary Surgeon at the University of Bristol, where I studied for a PhD in reproductive neuroendocrinology. Tempted by warmer climes, I then migrated to the South of France to join Patrice Mollard’s lab at the CNRS Montpellier, France. This was an exciting time when Patrice had just discovered pituitary networks, and I was lucky enough to be involved in some of the seminal work that followed. This period cemented my passion for microscopy and method development. I then took up a post as a Non-Clinical Lecturer at Imperial College London in Guy Rutter’s Section, applying optical approaches to the study of islet biology and generally learning how to survive in academia. I moved to the University of Birmingham 18 months ago through their Birmingham Fellows Scheme, convinced that the availability of world-class imaging/metabolomics and abundance of young talent would help me to push my research to the next level. Now a Professorial Research Fellow, I am tasked with the exciting role of expanding diabetes research, as well as further developing our imaging capability. This despite my initial reservations about the city following the BAFTA award-winning “Peaky Blinders”!

 Q: What more specifically are you presenting at your Medal Lecture at SfE BES 2017?

It is becoming increasingly clear that, rather like society, beta cells are not equal. In fact, a small number of beta cells may be responsible for driving insulin release, as well as proliferation/renewal, similar to how just a few individuals own most of the world’s wealth. Or alternatively, how you are only ever six people away from knowing Kevin Bacon (of “Tremors” or “Footloose” fame). This is a really hot topic that challenges our understanding of how beta cells may fail (or respond to treatment) during type 2 diabetes. Therefore, I’ll talk about the recent questions that have arisen in terms of beta cell diversity, the tools we have developed to try and understand this and how this has changed our viewpoint of beta cell function under normal and diabetic conditions. There will be lots of colour, movies and practically no text.

Q: What are you particularly looking forward to at SfE BES 2017?

 My first SfE BES conference was last year and I’m a convert! It will be great to see how endocrinology is progressing in the UK and to catch up with colleagues whilst discussing research in a friendly, informal and supportive environment. In particular, I am looking forward to the “Tissue Engineering for Regenerative Medicine in Endocrinology” symposium. This holds promise not only for diabetes treatment, but also for many endocrine disorders. I’m also looking forward to the social programme. I’d be lying if I said that food and alcohol didn’t play an important role in any conference attendance!

Q: What has been your career highlight so far?

To be honest, I’m relatively new to this and the lab has been working across so many disciplines/topics that it’s difficult to pinpoint a particular highlight. I’m very appreciative that I’ve got excellent collaborators and we are just pleased to be involved in any output that falls under the ‘team science’ banner. Having said that, getting to see Wrestlemania 33 at the same time as ENDO 2017 this year in Florida has to be pretty good, right? Does this count as a career highlight?

Q: What do you think are the biggest challenges in your particular research area right now?

Our biggest challenge remains how to translate our basic findings on beta cell function from the bench to the bedside. We are amassing detailed knowledge regarding the mechanisms underlying insulin secretion, especially in the ‘omics era, but need to strive to harness this for therapeutic potential. On the flip side, lack of understanding about basic mechanisms will hold back progress on all fronts, so we should not make this the only criteria for our research.

Q: What are your future plans for your work & career?

Honestly, I haven’t really thought that far ahead. I’m content following up the avenues created by current research and just having fun doing what we’re doing. Maybe become a Vice-Chancellor? The pension seems decent.

Q: Who do you most admire professionally?

I have to admit that I most admire my postdocs, students and technicians. The fact that they have chosen to research diabetes with relatively little reward and in tough academic times really speaks volumes about their motivation and personalities. They do it because they love to do it. I am lucky to have such good people.

Q: Any words of wisdom for aspiring endocrinologists out there?

Endocrinology is bound by shared mechanisms and concepts. Therefore, as a basic or clinical researcher, don’t be afraid to apply thinking from one field to another field, as well as take risks with the research. The outcome and impact can be quite dramatic compared to the high-throughput, predictable science that the funding climate seems to encourage. If someone asks you what is the point of doing this, then it’s generally a positive thing!

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

There is a realisation that current drugs are difficult to improve upon. Certainly, pharma pipelines, profits and innovation are all shrinking as the list of FDA requirements rightly grows (e.g. concerning cardiovascular safety margins). Therefore, directed or personalised treatment may represent the next breakthrough in the field, for example through production of unimolecular agonists where a few licensed drugs are ‘bolted’ together or matching patient genotype to drug efficacy.

You can hear Prof Hodson’s Society for Endocrinology Starling Medal lecture, “Next generation tools to understand endocrine function in health and disease” on Monday 6 November, 18:00-18:30, and see the full scientific programme for SfE BES 2017.

 

Meet the Endocrinologists: Miriam Asia & Andrea Mason

Miriam Asia (right) and Andrea Mason (left), Clinical Nurse Specialists (CNS) in endocrinology at Queen Elizabeth Hospital Birmingham (QEHB) tell us about their work in endocrine nursing and what they are looking forward to at SfE BES 2017, 6-8 November in Harrogate.

Q: Tell us a little about yourself and where you work

Miriam: As an endocrine specialist nurse, I run the adrenal nurse-led clinic, post-traumatic brain injury endocrine screening clinic and support the young adult clinic. I have also completed the Non-Medical Prescribing course at Masters Level and I am planning to start a masters in endocrinology.

Andrea: I currently look after three nurse-led clinics; late effects of cancer treatment (transition clinic from children’s to adult services), pituitary and a new clinic that monitors patients who have developed immune-related adverse events in response to immune check-point inhibitor treatment. I have a particular interest in the quality of life issues surrounding endocrine conditions.

 Q: What inspired you to work in endocrinology?

Miriam: I only knew about endocrinology through nursing textbooks but now, being able to see endocrine patients, reviewing them in clinic and working with them through their endocrine journey makes me realise even more how fascinating and exciting endocrinology is. Especially when I see the difference it makes to our patients during and following treatment.

Andrea: During my nurse training I developed a keen interest in cancer nursing and worked in oncology for many years until an opportunity for me to branch out into endocrinology as a Clinical Nurse Specialist arose. This position was to cover maternity leave and I knew little about endocrinology, so I had to learn on the job quickly! During my first week, I attended the Society’s Endocrine Nurse Update and was totally blown away by the specialty. The journey had started; I spent evenings studying after work trying to get to grips with the basics.

 Q: What are you looking forward to at SfE BES 2017?

Miriam: As well as the plenaries and nurses’ sessions, I am also looking forward to the ‘Meet the Expert’ and ‘How Do I…’ sessions, especially those relevant to my clinical practice.

Andrea: This is my second SfE BES and I am looking forward to the nurses’ sessions, particularly those on opiate-induced endocrinopathy, and development of endocrinopathy following metastatic melanoma treatment. I also enjoy meeting and networking with other endocrine nurses.

Q: What are your career highlights so far?

Miriam: I recently completed a sky dive (see photo right), with some of my CNS colleagues, in support of our QEHB charity for the Young Adult Clinic!

Andrea: Highlights in my nursing career, include working as an Endocrine Nurse Specialist and successfully completing the Non-Medical Prescribing course at Masters Level.

Q: Who do you most admire professionally and why?

Miriam: My endocrine colleagues – nurses and doctors – at QEHB who work with such competence and dedication to look after our endocrine patients

Andrea: I have had an inspiring and passionate Endocrine Lead Nurse to guide me throughout the last five years and support my development. I have also had the support and patience from a caring team of endocrinologists.

Q: What advice would you give to someone starting out in endocrine nursing?

Miriam: Although endocrine nursing is a challenging specialist role that requires a lot of reading and studying, it is rewarding in the end.

Andrea: It does take time to understand the speciality and additional studying is required but when you understand the basics of the endocrine system, it is all very logical. I would say to any nurse…. go for it!

Q: What are your future career aspirations?

Miriam: To complete my masters in endocrinology and become more confident and competent in dealing with complex endocrine cases as a result. I also hope to see more nurse consultants and nurse led clinics being set up.

Andrea: My future plans are to remain in my current position and I am looking to complete a master’s degree in endocrinology.

Don’t miss the dedicated Nurses’ Lounge at SfE BES 2017, giving nurses the opportunity to meet and network in their own space. This is especially beneficial when you are travelling on your own, or if you are a first-time attendee, as there is nearly always somebody there to chat to. At designated break times there is at least one member of the Nurse Committee on hand for you to get to know.

Follow the links to find out more about SfE BES 2017, view the scientific program and register online.

Meet the Endocrinologist: Interview with Prof Simon Pearce

Meet Simon Pearce, Professor of Endocrinology at Newcastle University and Programme Secretary for SfE BES 2017, in Harrogate, 6-8 November. We caught up with him to find out more about his work and to discover his upcoming highlights and top tips for the conference.

 Q: Tell us a little about your career path and endocrine interests

I qualified in medicine at the Newcastle University, completed my postgraduate education at the Royal Postgraduate Medical School in Hammersmith, Brigham & Women’s Hospital in Boston and as a Lecturer in Newcastle. I was appointed Senior Lecturer in Endocrinology in 2001 at Newcastle University and became Professor in 2007.

My main research area is the treatment for autoimmune thyroid diseases and Addison’s disease. I have published around 150 papers over the last 20 years spanning molecular endocrinology, clinical trials and guideline papers.

Q: Tell us a little about your role as SfE Programme Secretary

As Programme Secretary I organise the scientific programme for the annual conference. It’s a great privilege to be able to choose the speakers that I want to learn from. My assumption is that if I am interested in the topic, then it will interest others too.

2016 was my first year as programme secretary and the informal feedback about the quality of the symposia and meet the expert sessions as the meeting progressed was great. I was very happy on the last day when it was all over though, with no significant hitches.

Q: What do you think are the programme highlights at SfE BES 2017?

There is a very strong programme on several subjects including calcium and bone, thyroid, and female reproductive endocrinology. Following the success of last year’s thyroid masterclass, we have scheduled a bone masterclass with two internationally respected experts on osteoporosis, a clinical management symposium on hyper- and hypo-calcaemia and a session on steroids and bone.

The meet the expert sessions on opiate-induced hypopituitarism, hyperthyroidism in pregnancy and next-generation DNA sequencing promise to keep you up to date on the latest advances in these important and fast-moving areas.

We also welcome more than 20 overseas speakers, including cutting edge plenary lectures from some giants in our field, Teresa Woodruff, Andrew Arnold and Martin Schlumberger. Home-grown highlights will also include two well-known members of our Society, Andrew Hattersley and Julia Buckingham, who never fail to both entertain and inform.

Q: What are you particularly looking forward to?

I always enjoy the plenary lectures, and Andrew Hattersley has been an inspirational role model for me; translating the highest quality laboratory science to change clinical practice and improve patient outcomes. So I think his talk will be a highlight.

Q: Do you have some words of wisdom for anyone attending SfE BES for the first time?

Have a good look at the programme at a glance page and plan your most interesting sessions carefully. I receive  frequent comments that there is too much going on at the same time during the meeting and people would like to split themselves in two. My advice is go to the session that you know least about, as you stand to learn the most from this, even if it feels slightly outside your normal ‘comfort zone’.

Q: What do you think will be the next major breakthrough in endocrinology?

It’s clear that there is a lot of pharma work on small molecules that target several receptors at the same time to modulate appetite and metabolic phenotypes. I am also excited that during the next 10 years we may see new treatments for hyperthyroidism; the first advance since the early 1950s.

Follow the links to find out more about SfE BES 2017, view the scientific program and register online.

Meet the Endocrinologist: Interview with Prof Antonio Vidal-Puig

Group Photo - June 2017

Meet Professor Antonio Vidal-Puig, endocrinologist and Society for Endocrinology Medal winner for 2017. Prof Vidal-Puig is based at the Institute of Metabolic Sciences, Cambridge University and at Addenbrooke’s Hospital, where his outstanding research, focusing on the link between obesity and associated metabolic complications, has earned him this award, to be presented the annual conference, SfE BES 2017, in Harrogate, 6-8 November 2017. Learn more about his endocrine journey in this exclusive interview.

Q: Tell us a little about your career so far and how you ended up in Cambridge.

Originally from Spain, I studied medicine and trained in endocrinology at Valencia Medical School and Granada Medical School. I held post-doctoral positions in Boston at the Massachussetts General Hospital and Beth Israel Hospital/Harvard Medical School from 1992-1999. There I had excellent mentors including Jeff Flier, Brad Lowell, David Moller and Leo Krall. This was a very intense, exciting and uncertain period, at the epicentre of major discoveries in the field of obesity. This was a period that defined my career, scientific focus, approach to science and reinforced my values. I have been developing my career in the UK, since arriving at Cambridge University in 2000, and now have an established laboratory and have become a Professor of Molecular Nutrition and Metabolism.

Q: Tell us more about your research that led to you being awarded the Society Medal

The lab is interested in why obesity results in diabetes, insulin resistance, fatty liver and ischaemic heart disease, in order to find ways of preventing these complications.

The key concept of our programme is lipotoxicity, which links obesity-related metabolic complications with the excessive accumulation of lipids outside adipose tissue, in organs including muscle, liver and heart. From the concept of lipotoxicity we have developed three main research directions:

  • understanding how the adipose tissue works, with the aim of improving its function and ensuring that lipids remain in adipose. This led to the development of our “adipose tissue expandability hypothesis”, which is now widely accepted by the scientific community
  • developing strategies to burn the excess lipids and prevent lipotoxicity through activation of brown fat
  • promoting that the quality of dietary lipids should be as healthy as possible, to prevent toxic effects.

My Medal Lecture at SfE BES 2017 will summarise our contribution to these three directions.

Q: What are you particularly looking forward to at SfE BES 2017?

I will use this conference for updating clinical aspects of my work. The presentation quality is always good and helpful. One session I am really curious about is Workshop 1: Tissue Engineering for Regenerative Medicine in Endocrinology. I think technology is essential to retain a competitive position in research and the topics presented are highly transferable and of interest. I think tissue engineering approaches to increase brown fat mass could be really helpful in preventing obesity and diabetes, I am curious about the concept and possibilities of using 3D bioprinting.

Q: What have been your career highlights so far?

I feel content about my career progression. I consider highlights to be our best pieces of research; our papers tend to be quite comprehensive and we believe they make important contributions. I think for this reason these contributions are well respected by our colleagues. Our reputation as a lab is important for us. Also as a proud introvert, I have not touted our highlights and have not needed to for our professional highlights to be widely acclaimed, however I do understand that it is important to make the public aware of their implications. Also, as a laboratory leader I know that to disseminate these highlights is important for the careers my lab members. In this respect, winning the Society for Endocrinology Medal is a highlight that reflects the quality and commitment of the present and past members of the laboratory.

At a more personal level, I admit I have an aesthetic approach to science. I enjoy understanding and identifying sophisticated mechanisms, developing models that explain reality and learning how biological systems self-regulate. I don’t think this is unusual amongst endocrinologists. Also, becoming a Professor at Cambridge University was a moment of satisfaction I shared with my colleagues and family. In some ways my career has provided me with professional freedom, which is a key value for me, beyond other motivations, such as power or fame, that I have always found energy draining and restrictive of my autonomy.

Q: What do you think are the biggest challenges in your research area right now?

I think a big challenge in my research area, and others, is how to extract value from the excessive information generated by recent technological advances. Our challenge is how to analyse this information to prioritise the types of mechanistic validation that are necessary for estimating its relevance. Also, it is not only the amount of data, but the amount of unnecessary noise coming from poor quality research that makes this task more difficult.

Q: What are your future plans for your work & career?

As you become more senior in science, you often suffer the disadvantage that your professional horizon is shorter. However, this position also has the advantage that you can be more selective in your choice of projects, with more freedom to take risks. I think my laboratory in this respect is quite entrepreneurial, we are innovating by entering new fields/technologies, which I think is important for remaining competitive.  For example, we have opened a new lab at Sanger, funded by the European Research Council to work on stem cells and adipose tissue. We are also developing two new programmes of research; one in Nanjing focused on murine models of fatty liver, and another in Bangalore focused on adipose tissue stem cell biology to model obesity and diabetes in India. These are exciting challenges that will provide opportunities for my younger associates in their future careers.

Q: Who do you most admire professionally?

I have learned a lot from many of my mentors, colleagues and trainees. In some way these experiences have shaped my values and my strong views about science and leadership. For example, I have always admired the intellectual rigour and scientific honesty of Brad Lowell. I admired the consistency and confident leadership of Jeff Flier and the legacy of Daniel Lane, who developed many academic scientists in his lab to share his cultural values and collegiality, which they now disseminate to the next generations. I find this very impressive.

Q: Any words of wisdom for aspiring endocrinologists out there?

Endocrinology is not a specialty that will make you rich, but it is a specialty where you can fulfill your intellectual scientific needs and enjoy the human aspect of practicing medicine. It is very satisfying because your patients get better and, given that treatments are required long term, an important factor in the success depends on establishing an empathetic relationship with them. You will get to know many of your patients well, from whom you will receive gratitude and a sense of meaning and fulfillment. In this respect it is a very rewarding profession.

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

I think real breakthrough with long term impact requires deep knowledge and new technologies, I have become quite sceptical about quick or easy breakthroughs that address complex problems. It is important to understand how regulatory systems operate, to learn what the adaptive changes of the organism or cell to maintain normality are, and to determine the intrinsic capacity of these systems to recover normality if the early factors of the disease are removed. For this reason, we focus on early disease events, aiming to prevent or reverse excessive damage to the homeostatic system and regain metabolic control. In this sense, we think it is as important to learn how the problem occurs as it is to learn the trigger and why it occurs. In our field I think understanding how lipids mediate disease could be used for prevention, early diagnostic and therapeutic purposes.

You can hear Prof Vidal-Puig’s Society for Endocrinology lecture on Wednesday 8 November, 15:45-16:45, and see the full scientific programme for SfE BES 2017.

From small seeds grow mighty oaks: how the Endocrine Nurse community is growing together to share knowledge

Lisa Shepherd, an Endocrinology Advanced Nurse Practitioner at Heart of England NHS Foundation Trust and Chair of the Society for Endocrinology Nurse Committee, discusses continuing education opportunities and the value of networking for endocrine nurses.

Endocrinology is a fascinating but complex area and nurses often work in isolation, so opportunities to develop and update their knowledge, benchmark their practice and network with other nurses are invaluable. The Society for Endocrinology Nurse Committee supports a number of strategies that promote networking amongst the Endocrine Nurse community.

Social media is increasingly used to build professional networks, so the Nurse Committee have set up an invite-only group on Facebook for endocrine nurses, which is a fast and easy way for the community to share protocols and information. Nurse Members of the Society also have a Twitter feed where training opportunities, research and nursing practice can be promoted to the wider community.

Face-to-face networking remains an effective means of sharing experience and learning from others, so a ‘nurses lounge’ was recently introduced at the SfE BES conference, to give nurses a dedicated space to meet each other in person. As many nurses are working in isolation it is valuable to provide a variety of opportunities, across different media that encourages endocrine nurses to support and learn from each other.

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Endocrine Nurse Update (ENU) is coming up soon. This yearly update is designed by nurses for nurses and offers a varied and active programme of endocrinology topics. I am very excited that this year’s ENU will feature the inaugural Endocrine Nurse Award lecture by winner, Nikki Kieffer. This award was introduced to recognise excellent nursing practice that can be shared to advance knowledge and understanding in the discipline. Nikki is an endocrine nurse specialist at Leicester Royal Infirmary and led the project that developed the Competency Framework for Adult Endocrine Nursing. This project is a great example of nurses working together to share best practice and Nikki will deliver the prize lecture at ENU 2017 in March.

There are also great benefits to networking with other closely related communities and this year, for the first time, ENU will include a workshop run collaboratively between clinician and nurse colleagues, Dr Richard Quinton, Dr Channa Jayasena and Dr Andrew Dwyer. Whether you are a nurse new to endocrinology or a nurse with many years of experience, the ENU programme, in combination with Clinical Update has something to offer all. I hope you can join us at the meeting or follow us online, to learn from your colleagues and share your experience.

Nominations for the 2018 Endocrine Nurse Award are open until 16 June 2017, find out more.

Travel grants are available for ENU 2017, apply before 15 March.

View the ENU 2017 programme.

 

Five tips for applying to medical school

Society member Seb Shaw is probably not your typical medical student. Currently studying for a Masters degree at Brighton and Sussex Medical School, he’s keen to dispel myths and give a little insight into the real world of medicine. Here are his five top tips for applying to med school….

Continue reading “Five tips for applying to medical school”