Reflections on Training
This part of the website will showcase the reflections of current and former trainees in the region. These short articles will give an insight into some of the diverse opportunities for training, leadership and research that are available in the Northern Deanery.
I have a freshly minted CCT in diabetes, endocrine and general medicine. I trained in and am still working in the North-East, now in my first consultant job. My training in the Northern Deanery started at CMT level; I decided it was finally time to leave my beloved home country of Scotland to explore new challenges and was attracted to the North-East as a leading and internationally-recognised centre of diabetes research. I took 3 years out-of-program at ST5 level undertaking research under the supervision of Professor Walker at Newcastle University to investigate deterioration in beta cell function in early type 2 diabetes. This involved a multicentre trial working with teams across Europe which was an exciting and interesting venture, and involved a lot of travel and networking. I also included some laboratory work which introduced some very different challenges compared to hospital medicine. Alongside I continued doing clinics and on-calls to maintain my clinical skills. Dr Arutchelvam, my training programme director at the time, and the deanery were both very supportive of my research period and the application process was straightforward. My time in research has given me new transferable skills and a much better appreciation of the breadth of work involved in both clinical and laboratory research. I hugely benefitted from my research period and can highly recommend doing so in the Northern Deanery with all the support and research expertise provided.
I became interested in basic science research as a medical student, when I undertook an intercalated MRes degree after 4th year of medical school. I spent 6 months in the mitochondrial genetics lab with Prof Turnbull and found the work fascinating. Keen to undertake more research in my future career, I applied for an Academic Clinical Fellow post in care of the elderly in 2007, following the foundation programme, which allowed me 8 months of dedicated research time. During this time, I was introduced to Prof Pearce who runs the Endocrine Genetics Group at the Centre for Life, and quickly got involved in a clinical project looking at levothyroxine prescribing trends in the UK and some data from the Newcastle 85+ study, and a basic science project investigating the association of PD-L1 gene variants in autoimmune Addison’s disease and Graves’ disease. The latter pilot data helped me to successfully apply for an MRC fellowship to investigate further the genomics of familial autoimmune Addison’s disease, and by this stage, I was certain that I wanted to be an endocrinologist, and so I applied for a training number in Diabetes and Endocrinology. I completed my PhD in 2013, and started back full time in a clinical post. A year later, the opportunity arose to apply for an Academic Clinical Lecturer (ACL) post in Diabetes and Endocrinology, and so I successfully applied. This post allowed me to use 50% of my clinical training time for research purposes.
I have been involved in endocrine research in the North East for almost a decade now and it has brought great variety to my day to day working life. I have gained numerous transferable skills (scientific writing, project management, public speaking, data interpretation, critical appraisal to name just a few examples) and have fostered some highly productive ongoing collaborations as a result of the projects that I have undertaken. There have been challenges too, such as balancing the need to gain clinical experience when half of your training time is dedicated to research as an ACL, but on the whole my experience has been extremely positive. The North East is fortunate to boast a number of highly respected, productive, inspiring and approachable senior researchers in both diabetes and endocrinology and I would encourage trainees wanting to get involved to contact them to express an interest – you won’t regret it!
Training in the North East offers not just high quality clinical and practical experience but also gives the much-needed exposure in management and leadership skills. This piece is a reflection on my experiences as a member of the Specialist Training Committee as well as a member of the North East training programme CME organising committee and the Management Forum. I joined the CME organising team and the Management forum when I was in my 3rd year of training. It seemed like a good place to develop one’s networking skills not just with your fellow colleagues in the region but also with trainees and trainers across the country. I was not wrong. During the two years of my time, I have made more friends, liaised with senior figures across the country and developed a working partnership with the pharma. The experience sharpened my organising and team building skills and developed my ability to delegate work. The STC trainee representative post gave me a platform to not just voice trainee issues but also gave me an insight into the practicalities of everyday functioning of the NHS. I would also like to think the roles enabled me in a small way to shape the teaching training programme for the better. All in all, it was an enriching and enjoyable experience and I would highly recommend it to my fellow trainees.
It’s now almost a decade since I began my registrar training in Endocrinology and Diabetes in the North East. Before this, I was introduced to weekly diabetes clinics during my time as an SHO at South Tyneside – this was daunting at the time, but great experience, and a reminder why it’s important to encourage trainees off the wards and into clinic. When I reflect on the last ten years, there are undoubtedly highs and lows, but I had a great time and experienced diverse and high-quality training around the region.
After my first couple of years as a registrar, a gap in the rota provided an opportunity to spend a few months on the Programmed Investigation Unit at the RVI. I saw lots of fascinating patients with unusual clinical presentations, necessitating a fair amount of time spent interpreting biochemistry and reading up on complex endocrinology. A short time later, Professor Simon Pearce was looking for someone to carry out a novel clinical study in autoimmune Addison’s disease and I was in the right place at the right time. I moved to a Clinical Research Associate post at the Institute of Genetic Medicine, Newcastle University and spent three years out of programme (OOP) doing clinical and lab-based research into autoimmune endocrine diseases, working towards a PhD in Clinical and Molecular Endocrinology.
This time in research was absolutely invaluable for improving my knowledge and developing new skills. It was a sideways step that facilitated a refreshing break from years of medical registrar on-calls and the opportunity to get to grips with a subspecialty area of Endocrinology. That said, I had never undertaken a research project before, and it was a steep learning curve. I loved the clinical research, but getting to grips with laboratory techniques was challenging. I dealt with this by making lots of new friends who helped me out and I learned to approach problems from a different perspective. Day to day life in research might be more relaxed than working in a clinical setting, but the challenging times were certainly trickier to navigate than a tough day on the wards! Returning to studying years after graduating from medical school was enlightening, and much more enjoyable than first time around! During my time in research, I presented at conferences in the UK and US, accrued lots of experience in teaching and the day to day supervision of students, and embraced many opportunities to broaden my CV. I did continue some clinical work during my time OOP, and these extra years undoubtedly allowed me to develop my clinical acumen.
It was only once I had I finished my time OOP and returned to clinical medicine that I was able to reflect and appreciate what an invaluable opportunity it was. I am more inquisitive, think more critically and take a broader view to problem solving than I ever did before.
Overall, I would wholeheartedly recommend training in our specialty in the North East. It’s a beautiful place to live and we’re lucky to have inspiring leaders who encourage us to embrace opportunities for learning and research. Taking time out along the way can be enriching in so many ways, and every bump in the road gets you a bit closer to where you want to end up.