Training needs in adolescent and young adult health and transition in UK paediatric and adult higher specialist trainees in endocrinology and diabetes

Abstract

Background: There is a concern that medical training contains insufficient emphasis on adolescent and young adult health and transition. Clinicians working in diabetes and endocrinology across paediatric and adult services need to have the skills to work effectively with this age group. The aim of the present survey was to ascertain the current state of training of paediatric and adult trainees in endocrinology and diabetes in the UK. Methods: A questionnaire assessing training in adolescent and young adult health was developed using existing questionnaire formats. An online survey was disseminated to UK trainees in paediatric and adult endocrinology and diabetes through the Young Diabetologists and Endocrinologists Forum (YDEF), the British Society of Paediatric Endocrinology and Diabetes (BSPED), and the Society for Endocrinology (SfE) to assess access and quality of adolescent and young adult health and transition training. Results: 146 responses were received from 97 adult trainees, 38 paediatric trainees with a special interest and 11 paediatric sub-specialty trainees. All grades were represented from across the UK. Training in adolescent and young adult health and transition was rated as minimal or non-existent (65%); this was more marked in endocrinology (76%) than in diabetes (42%). The major barriers to achieving this experience and training were perceived to be limited clinic time and lack of training. Trainees reported unmet training needs, with paediatric trainees reporting higher learning needs despite reporting more exposure and training. Both seniority and number of clinics attended positively impacted on reported training experience. Conclusions: This survey has highlighted the need for improvements in training in adolescent and young adult health. Trainees from paediatric and adult backgrounds feel under-trained and under-prepared to deliver this care. Given the importance of improving outcomes in adolescents and emerging adults with long-term conditions, this issue merits urgent attention.