In 2001, the Postgraduate Medical Education and Training Board gave approval for a training programme which would provide additional subspecialty recognition to programmes leading to a CCT (CCT) in Chemical Pathology or General Internal Medicine. A new training subcommittee was established, under the auspices of the JRCPTB, with membership drawn equally from the Royal College of Pathologists and the JRCPTB. This committee approves Regional programmes, and has developed the training record and other documentation necessary for both trainers and trainees.
What is the primary purpose of the sub specialty?
Metabolic Medicine can be defined as a group of overlapping areas of clinical practice with common dependence on detailed understanding of basic biochemistry and metabolism. It therefore falls within the areas of expertise of both the physician and chemical pathologist. Other training programmes do not adequately meet all requirements, particularly with respect to nutritional disorders and adult patients with inborn errors of metabolism (IEM). The areas included are:
- Disorders of nutrition
- IEM
- Disorders of lipid metabolism and CV risk assessment
- Disorders of calcium metabolism and bone Diabetes
- Diabetes
The main objectives of the Metabolic Medicine curriculum is to provide a scientific and clinical training for several areas of medicine which require greater knowledge of:
- Biochemistry, genetics and molecular biology than most organ-based specialities
- To develop the clinical training of Chemical Pathologists who wish to practice, predominantly on an outpatient basis, in these areas of medicine
- To support the academic progress and development of Metabolic Medicine This curriculum is set to the standards required by the JCHMT or Royal College of Pathologists and PMETB to ensure that trainees are fully prepared to lead a specialist clinical service in any of the five areas.
Choosing a career in Metabolic Medicine
Metabolic Medicine training with General Medicine is likely to be chosen by individuals with specific academic interests or those who wish to work with patients with inherited metabolic diseases. New drug treatments and better nutritional products for these individually rare conditions have resulted in improvements and changes to these individuals' prognosis. This developing field is very rewarding to work in and rapidly changing.
Trainees in Chemical Pathology can also gain subspecialty accreditation in Metabolic Medicine, and develop competencies to lead predominantly outpatient clinics in one or more of the clinical modalities of Metabolic Medicine. They would also be closely involved in laboratory work and usually lead the service. They would ensure the quality of laboratory results and guide clinicians to maximize the clinical benefits of laboratory tests in diagnosis, prognosis and monitoring.
Core Competencies
All trainees in Metabolic Medicine will undertake a period of laboratory training in which they will become familiar with the laboratory techniques used in the investigation and monitoring of the various disease states included in the curriculum. They are required to undertake a project which would normally be laboratory based to acquire appropriate analytical skill.
Competence Based Curricula and Assessment - StRs (for trainees who commenced training from 1 August 2007 to present)
There are two versions of curricula for this training period:
StRs who commenced training between 1st August 2007 and 3rd August 2010 will follow the 2007 version of their specialty curriculum and the 2007 Generic curriculum. Please see the 2007 Curriculum section of this webpage.
StRs who commenced training from 4th August 2010 onwards will use the 2010 version of their specialty curriculum. There is no need to follow the previously known ‘Generic curriculum' as this has now been embedded into the specialty curriculum. Please see the 2010 Curriculum section of this webpage.
The Joint Royal Colleges of Physicians Training Board (JRCPTB) is pleased to announce the 2010 Metabolic Medicine curriculum which has been reviewed and rewritten to:
meet the GMC's 6 new standards as detailed in their Standards for Curricula and Assessment systems
keep up to date with medical advances and changes in the service and training
incorporate the framework documents produced by the Academy of Medical Royal Colleges (AoMRC) detailing Common, Medical Leadership and Health Inequality competencies
include 5 new assessment methods (Acute Care Assessment Tool, Case based Discussion, Patient Survey, Teaching Observation and Audit Assessment).
This new curriculum has improved content, design and usability compared to its predecessors, and reflects a great deal of hard work and time expended by specialty curriculum groups. This curriculum will become the training manual for all trainees entering ST3 from 4th August 2010.
For further information on the 2010 curriculum it is recommended that you read the Quick Start Curriculum Guide.
If you have any queries or problems regarding the 2010 curriculum please email ptb@jrcptb.org.uk.
Core Training Programmes
Entry into the sub-specialty of Metabolic Medicine is possible following successful completion of both a foundation programme and a core training programme.
There are 2 core training programmes for Metabolic Medicine training:
Metabolic Medicine is a subspecialty of either GIM or CP and trainees will be National Training Number (NTN) holders in GIM or CP. The award of Certificate of Completion of Training (CCT) is in either GIM or CP and will require evidence of satisfactory completion of the GIM or CP curriculum. Trainees will receive sub-specialty recognition of Metabolic Medicine on the specialist register.
Assessment
The following method is used as part of the integrated assessment system:
The assessment blueprint, which is embedded in the clinical syllabus, shows the possible methods that can be used to assess each of the competencies in the curriculum. Trainees and trainers should refer to the blueprint for guidance on the appropriate assessment methods for each aspect of the curriculum, and so plan the training programme according to the criteria set by the ARCP Decision Aid. It is not expected that all competencies will be assessed by all methods, rather that there will be a sampling of competencies within a variety of settings, both within formal and workplace-based assessment, from which overall competence acquisition has to be determined.
The diagrams below describes the possible training pathways:
Please view the 2010 curriculum for Metabolic Medicine for full details on the training routes and selection criteria.
Entry into Metabolic Medicine training is possible following successful completion of both a Foundation Programme and a core training programme.
Please view the 2007 curriculum for Metabolic Medicine for full details on the training routes and selection criteria.
Assessment
The assessment blueprints show the possible methods that can be used to assess each of the competencies in the curriculum. Trainees and trainers should refer to the blueprints for guidance on the appropriate assessment methods for each aspect of the curriculum, and so plan the training programme according to the criteria set by the ARCP/RITA Decision Aid. It is not expected that all competencies will be assessed by all methods, rather that there will be a sampling of competencies within a variety of settings, both within formal and workplace-based assessment, from which overall competence acquisition has to be determined.
Further information on the various methods of assessment can be viewed in the Assessment section of this website.
The diagram below describes the training pathways in general terms.
Competence Based Curricula - SpR (for trainees who commenced training between 1 Jan 2003 and 31 July 2007)
The JCHMT introduced revised curricula for all the medical specialties together with a generic curriculum that applied to all trainees back in 2003. These are competence-based and set out the knowledge, skills and attitudes to be acquired by trainees before they may be awarded a CCT.
Curricula - SpR (for trainees who commenced training before 1 Jan 2003)
The curricula for trainees enrolling pre 01/01/03 are no longer available on the website but can be obtained by request to ptb@jrcptb.org.uk.