Metabolic medicine - Royal College of Physicians

Specialty reports
Census of consultant physicians in the UK, 2011
Metabolic medicine
The speciality of chemical pathology with metabolic medicine (chemical pathology) has shown a decline
since 2010 and there is an ongoing apparent decrease in vacant consultant posts being advertised. This
is mostly due to impending changes to pathology service provision across England with the ongoing
planned merger of laboratories.
The clinical workload is growing due to:
• the increasing number of patients with inherited metabolic diseases (IMD) now
reaching adulthood
• certain diseases such as osteoporosis now being part of the GP Quality Outcomes
Framework
• increased general awareness of the other aspects of metabolic medicine.
There may be a future paradigm shift where metabolic physicians are appointed with a larger clinical
workload and, to a lesser extent, involved in the laboratory. More recently there has been an increase in
metabolic medicine CCT holders who practise predominantly as physicians, and without any laboratory
sessions (currently seven in total). There are suggestions that these posts will need to expand in number
by as many as 6‒10 posts during the next 10 years to maintain service provision for IMD patients.
Current trainee numbers for metabolic medicine and chemical pathology (without metabolic medicine)
and projected CCT date are as follows:
Table 1. Expected CCT dates of trainees
Expected CCT date
‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒ Number of trainees ‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒‒
With metabolic medicine
Without metabolic medicine
2012 4 6
2013 8 3
2014 6 3
2015 8 4
2016 12 2
2017 6 ‒
2018 6 ‒
>2018 ‒ 1
Summary 50 19
The potential impact on the future of the workforce of the privatisation of laboratory services, or hub
and spoke models, is unclear but it is unlikely that there will be an increase in posts (with a potential for
decline).
October 2012
Dr Peter Prinsloo
Consultant in chemical pathology and metabolic medicine
© Royal College of Physicians 2013 177