6th Early Career Clinical Endocrinologists Meeting in Antalya, Turkey

6th Early Career Clinical Endocrinologists Meeting

20 October 2022, Antalya, Turkey

The 6th Early Career Clinical Endocrinologists (ECCE) Meeting took place on 20 October 2022, during this year’s EndoBridge meeting. The main topic at the ECCE Meeting was ‘Training and continuous education for endocrinologists in medical nutrition therapy and physical exercise’. The event was attended by 23 early career participants representing 17 countries.

The participants’ perspective

The meeting’s scope included discussion of the aims, expectations, challenges, threats and obstacles, from the perspective of early career clinical endocrinologists. ECAS (the ESE Council of Affiliated Societies) conducted a survey to record the views of the participants and the support they would like to receive from their National Societies.

Not surprisingly, the main pillars of education, clinical training and research were at the top of the list. Education must be complemented by unrestricted access to evidence-based guidelines and position papers. Clinical training must include rare diseases and special conditions, such as the critically ill patient. Experienced tutors and mentors who are willing to help are often needed. Finally, research must be supported by national and international funds, travel grants and exchange programmes. Further requests included amendment of the endocrinology curriculum to incorporate skills such as problem-solving, decision-making, research methodology and critical appraisal of the literature.

Keynote lectures

The keynote lectures were delivered by Hermann Toplak (Professor of Medicine at the University of Graz, Austria) and Konstantina Dipla (Clinical Exercise Physiologist and Professor at the Aristotle University of Thessaloniki, Greece).

Professor Toplak’s lecture, ‘Medical nutrition therapy: sine qua non for metabolic disease therapy’, was an elegant overview of our current understanding of how obesity can affect endocrine and metabolic diseases. He also explained how specific medical nutrition therapies could improve or completely alleviate these conditions.

Professor Dipla, in her lecture ‘Exercise is medicine: the integration of physical exercise into endocrinology and metabolism treatment plans’, comprehensively and informatively examined how physical exercise improves glycaemic control, insulin sensitivity, and mitochondrial, vascular and autonomic nervous system function. In addition, she gave practical advice on how to prescribe exercise to individuals with metabolic disturbances following the FITT principle (frequency, intensity, type and time).

Networking and discussion

After a coffee break, during which the early career endocrinologists had the opportunity to meet one other, there was a vivid discussion. All clinical, administrative and educational procedures were discussed. One major objective was to identify the similarities and differences among European countries.

In addition, the opportunities and difficulties associated with putting ‘medical nutrition therapy’ and ‘physical exercise in endocrinology and metabolism’ into practice were discussed, as well as the things that need to be changed in the coming years, and how these changes can be applied.

Outcomes

The main outcomes of the meeting, as identified by the early career endocrinologists, were as follows:

  • Medical nutrition therapy (MNT): Training is suboptimal in many European countries at both under- and postgraduate levels. Consequently, its application into everyday practice does not cover clinical needs. Dieticians and nutritionists provide assistance, but on many occasions, the clinical needs are not covered.
  • Physical exercise therapies (PET): Things are more problematic as the exercise training is, almost universally, suboptimal. For successful implementation of exercise training programmes in individuals with metabolic/endocrine-related disease, patients should follow a centre-based, multidisciplinary programme (with the collaboration of endocrinologists, clinical exercise physiologists, psychologists, physiotherapists and clinical nutritionists). These specialised centres are currently lacking in most countries. In addition, exercise programmes are not covered by healthcare/medical insurance programmes in most of the countries.
  • Strengths: With their holistic approach to human health, endocrinologists are in a central position to apply MNT and PET. Their background knowledge of physiology and biochemistry, and their involvement with the topics of diabetes mellitus and obesity, strengthen their role even more.
  • Weaknesses: Given the suboptimal training, there are obvious obstacles to applying MNT and PET in clinical practice. As MNT and PET are time-consuming and long term (even lifetime) approaches, endocrinologists must find the necessary time to apply them.
  • Proposals:
    • The establishment of interdisciplinary teams in the fields of MNT and PET (indicatively: endocrinologists, dieticians, ergophysiologists, mental health professionals, specialised nurses) is an obvious necessity.
    • MNT and PET consulting centres should be established, where the members of the interdisciplinary teams mentioned above will collaborate among themselves and with the patients. These centres must be established in tertiary and, possibly, primary healthcare centres.
    • The national health systems must reimburse the prescription of MNT and PET.
    • The endocrinology curriculum must be reinforced concerning the fields of MNT and PET.

The National Societies and ESE could collaborate toward confronting these challenges.

Organisation

The ECCE Meeting is organised annually by ECAS. In 2022, it was moderated by Anton Luger (Austria), Bulent Yildiz (Turkey), Djuro Macut (Serbia), Mirjam Christ-Crain (Switzerland) and Dimitrios G Goulis (Greece).

The 7th ECCE Meeting will take place in October 2023 during the EndoBridge meeting. The main topic will be ‘Challenges for endocrinologists in the hormone laboratory’. The hormone lab is an essential part of endocrinology training. As some hormone labs are not directly associated with endocrinology departments, the exposure of the trainees to the rationale, methodology and interpretation of the endocrine tests could be impaired. All challenges, opportunities and differences among European countries will be discussed.