New Endocrinology and Diabetes curriculum

Quick Start guide to the 2010 curriculum

The following information is a brief introduction to the 2010 Endocrinology and Diabetes Mellitus curriculum which will become live on 1^st August.

1. Why has the curriculum been re-written

The JRCPTB are required to revise specialty curricula every 3 years in order to keep the curriculum up-to-date with standards set by the Regulator, medical advances, changes in the service and training. All of the specialty curricula under the auspices of the JRCPTB have been rewritten for 2010 to meet the six new PMETB standards as detailed in their ‘Standards for curricula and assessment’, to incorporate the framework documents produced by the Academy of Medical Royal Colleges (AoMRC) detailing Common, Medical Leadership and Health Inequality competencies, and to include 5 new assessment methods (Acute Care Assessment Tool, Case based Discussion, Patient Survey, Teaching Observation and Audit Assessment).

1. What does the curriculum tell you?

The curriculum defines

• the competencies needed and the assessment strategy for the award of a certificate of completion of training (CCT or CESR (CP)) in Endocrinology and Diabetes Mellitus.
• the process of training including entry requirements and criteria for annual progression for the award of a certificate of completion of training (CCT) in Endocrinology and Diabetes Mellitus.

1. Who does the curriculum benefit and how should they use it?
   • Trainees will be able to develop their personal development plans and chart their progress through training, ensuring they are gaining the appropriate experiences and continuing to develop towards a CCT. This contributes to appraisal, self-assessment, self-directed learning and educational meetings.
   • Trainers will be able to ensure their trainees are developing in the correct areas and ensure their teaching covers the right areas.  It will also help them complete their end of post review.
   • Training Programme Directors will be able to ensure local teaching programmes map to the curriculum.
   • Patients/ Lay people will be able to see what their specialists have to achieve during in their training.

1. How can you use the curriculum and its lay out?

The lay out of the curriculum has been designed with the aim of making it a more user-friendly reference guide for both trainers and trainees. The same familiar titles from previous versions have been used such as rationale, content of learning, assessment, and supervision and feedback. However the new curricula have been structured in a more logical order which details the trainees training pathway from enrolling with the specialty to the components of the training programme, the teaching and learning methods they will experience and the methods by which they will be assessed.. The more detailed contents page and use of sub-sections should also help the trainer and the trainee to navigate around the document.

The layout of the syllabus grids has also been redesigned so that each competency is now mapped to:

• Possible assessment methods: It is important to note that note all competencies have to be assessed and that where they are assessed, not every method will be used.
• One or more of the domains of Good Medical Practice: These domains are listed in section 3.2 of the curriculum.

1. Major Changes since the 2007 curriculum

• The previously known ‘Generic curriculum’ has been revised by the Academy of Medical Royal Colleges and is now embedded into the content of learning as common competencies.

• There is a more explicit requirement to develop leadership skills (personal qualities, setting direction, improving services, managing services and working with others) – these have been incorporated into the knowledge, skills and behaviours relating to specific sections of the syllabus where appropriate.

• There is a clearer acknowledgement of the importance of the recognition of existing health inequalities – these have been incorporated into the knowledge, skills and behaviours relating to specific sections of the syllabus where appropriate.

• The importance of the principles of the GMC’s Good Medical Practice have been recognised and incorporated in line with the new formulation as four domains: knowledge, skills and performance; safety and quality; communication, partnership and teamwork; maintaining Trust.

• The assessment system has been updated.

• The assessment ‘blueprint’ has been embedded within the clinical syllabus.

• Details of the structure and function of the new assessment methods have been included CBD – Case Cased Discussions, ACAT – Acute Care Assessment Tool, PS – Patient Survey, DOPS – Direct Observation of Procedural Skills, AA – Audit Assessment and TO – Teaching Observation.

• The ARCP decision grid has been updated to include the new assessment methods.

• Since the last revision of the curriculum it has become increasingly apparent that diabetes services are offered in a different variety of settings within the country. It is important for any trainee to be able to manage a diabetes service within these different health economies and so more emphasis has been placed upon the management of the diabetes service (diabetes section 2 linking with medical leadership).

• Management of lipid disorders (diabetes section 2.7.6) has been modified to include lipid disorders outside the context of diabetes. This is to recognise the fact that in many hospitals it is the consultant diabetologist who is called upon to provide the lipid clinic either in conjunction with a chemical pathologist or, in the absence of a medically qualified chemical pathologist, by themselves.

• In the section on calcium endocrinology (endocrinology section 3.6) knowledge of renal stones is required.  This brings the requirements for trainees in diabetes and endocrinology in line with those training in metabolic medicine.

• The section on appetite and weight management (endocrinology section 3.7) has been updated and clarified to reflect the increasing use of bariatric surgery and the role of the endocrinologist in the assessment and follow-up of these patients.

• The section on endocrine imaging (endocrinology section 3.9) has been rewritten to take account of the fact that most endocrinologists will not report their own images but will discuss them within the appropriate multidisciplinary team. The list of nuclear medicine investigations has been increased to reflect current practice.