Challenges and opportunities to diabetes and endocrinology training during and beyond the COVID‐19 pandemic

Abstract

The National Health Service (NHS) relies on junior doctors in training to help deliver inpatient medical care. Through this service, trainees are able to gain experience and competence. The massive disruption to normal clinical practice brought about by the COVID-19 pandemic has exacerbated existing challenges in balancing health service provision and junior doctor training. The majority of trainees reported negative effects on their training during the first wave of infections, with those based in areas of higher COVID burden worst affected. [1][2][3] Here we explore the challenges for postgraduate diabetes and endocrinology (D&E) training in North East London faced during the pandemic, examine some of the solutions hastily put in place to mitigate those effects, and discuss how the response to the COVID-19 crisis could represent an opportunity for innovation. ChallengesWith rising COVID cases, significant changes to hospital staffing were required in order to provide safe patient care. Alteration of rota patterns, restructuring of clinical areas and staff redeployment were all introduced seemingly overnight. Rota changes frequently involved an increase in 'out of hours' work, as well as a move away from specialty team structures. This reduced trainee exposure to specialty-specific learning opportunities, including clinic attendance and taking referrals; such changes were not unique to D&E trainees, but were also reported by trainees in other specialties. 4,5 COVID-19 admissions predominated, while patients with other acute medical problems avoided