General Internal Medicine.

Most Endocrine SpRs are trained both in Endocrinology and General Internal Medicine, so-called 'Dual Accreditation'. The Hammersmith and Charing Cross sites provide excellent training in General Internal Medicine and are approved by the North Thames Postgraduate Dean.


The SpR is responsible for the day-to-day management of the general medical patients. There are two Consultant-led ward rounds per week, allowing a balance between sufficient senior support and registrar autonomy. The SpR looks after the patients from the time they are admitted to their discharge home, ensuring that continuity of care and recognising fitness for discharge is learned. The SpR is responsible for the supervision of the junior staff, in terms of practical management problems, and has a commitment to undergraduate and postgraduate bedside teaching.


The SpR sees both new referrals and discharge follow ups (if there are specific ongoing medical problems) in clinic. The Endocrinology Department is one of the few specialities within The Trust which has retained its general medical component as a major part of its' clinical work and hence patients referred by General Practitioners to the 'General Physician' are often targeted to the Endocrinology Clinic. This allows the SpR to investigate patients whose diagnosis may be unclear, and provides good training in ordering the correct investigations from the outset of a clinical problem.

Accident and Emergency

The Hammersmith Hospital has over 300 emergency admissions per year and Charing Cross has between 450 and 500. The case mix of the admissions to the two hospitals is similar, and the diverse ethnicity of the population at both sites ensures a wide range of pathology.

The SpR supervises the Senior House Officer and House Officer and is resident on-call. There is plenty of opportunity to master all the practical emergency procedures required by the Deanery, and there is on-site cover by the relevant speciality for those patients urgently requiring dialysis, endoscopy or pacing wire insertion if there are specific difficulties with the case. The SpR is responsible for contacting the radiologist and anaesthetist for relevant clinical situations.

DIABETES (page 3)