Endocrinology MSc

Aims of the module:
Analyse and evaluate the complex physiological principles governing hypothalamic-pituitary axes, and critically examine common disorders affecting these structures, synthesising current research to inform advanced clinical practice.

Module Content:
Students will examine the physiology of hypothalamic-anterior pituitary-end organ axes and posterior pituitary function, with detailed study of anterior and posterior pituitary hormones and hypothalamic signals. The curriculum encompasses hormonal signaling mechanisms including intracrine, paracrine, and endocrine effects, alongside second messenger pathways. Clinical aspects cover non-functional pituitary tumours (presentation, diagnosis, investigation, management, and surveillance) and functional pituitary disorders including acromegaly, Cushing's disease, prolactinomas, TSHomas, and various forms of hypopituitarism. The module also addresses congenital hypopituitarism and associated genetic disorders, integrating medical and surgical management approaches for these complex neuroendocrine conditions.

Learning outcomes:

1. Synthesise complex physiological principles of the hypothalamic-pituitary-end organ axis to analyse and interpret a range of endocrine disorders.
2. Critically evaluate the presentation, diagnosis, and management of patients with hypothalamic and pituitary disorders, proposing evidence-based treatment strategies.

Aims of the module:

Integrate advanced understanding of thyroid physiology and hormone function to critically assess and develop strategies for the diagnosis and management of thyroid disorders, considering emerging treatments and patient-specific factors.

Module Content:
This module examines thyroid gland physiology, hormonal regulation, and thyroid hormone effects. Students will master thyroid function test interpretation, including complex presentations like sick euthyroidism and thyroiditis. The curriculum covers hypothyroidism and hyperthyroidism pathophysiology, diagnosis, and management, critically evaluating treatment options including hormone replacement therapy, thionamides, radioiodine, and surgery. Thyroid nodule assessment, fine needle aspiration techniques, and cytological classification may also be focused upon.

Learning outcomes:

1. Critically appraise thyroid disorders, integrating advanced knowledge of underlying physiological mechanisms.
2. Exhibit advanced clinical decision-making skills in the diagnosis and management of patients with thyroid disorders, justifying chosen approaches.

Aims of the module:
Synthesise advanced knowledge of adrenal gland physiology and pathophysiology to critically analyse endocrine disorders affecting these glands, evaluating current diagnostic approaches and treatment modalities.

Module Content:
The module examines the pathophysiology, diagnosis, and management of adrenal gland disorders. Students will explore adrenal anatomy and physiology, steroid hormone biosynthesis, and regulatory pathways of the hypothalamic-pituitary-adrenal axis. The curriculum covers primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency, adrenal crisis management, Cushing's syndrome, primary hyperaldosteronism, pheochromocytoma, adrenal incidentalomas, and congenital adrenal hyperplasia. Advanced diagnostic approaches including biochemical testing, imaging techniques, and genetic analysis will be examined. Treatment modalities encompassing pharmacological interventions, surgical approaches, and lifestyle modifications will be critically evaluated.

Learning outcomes:

1. Analyse and interpret the complex pathophysiology of various conditions affecting the adrenal glands, relating findings to clinical presentations.
2. Formulate and defend critical clinical decisions for the management of diverse adrenal gland conditions, considering potential complications and outcomes.

Aims of the module:
Critically appraise the interrelationships between parathyroid, calcium, and bone physiology and pathophysiology, and apply this advanced understanding to formulate and justify complex clinical management strategies for related endocrine disorders.

Module Content:
Students will examine hypercalcaemia and hypocalcaemia, including investigation protocols and management strategies, with a focus on Familial Hypocalciuric Hypercalcaemia and acute severe hypercalcaemia. The curriculum covers primary hyperparathyroidism (presentation, diagnosis, and evidence-based management including surgical referral criteria and calcium receptor mimetics) and secondary/tertiary hyperparathyroidism (addressing vitamin D deficiency and renal failure contexts). Bone health assessment is addressed through DEXA interpretation and osteoporosis management, with critical evaluation of pharmacological interventions including bisphosphonates, SERMs, strontium ranelate, vitamin D/calcium supplementation, and calcitonin, emphasising mechanism of action and adherence to current clinical guidelines.

Learning outcomes:

1. Devise and justify complex management strategies for patients with disorders of calcium metabolism and parathyroid function, integrating current research findings.
2. Critically appraise and synthesise evidence-based approaches for the investigation and management of patients presenting with osteoporosis.

Aims of the module:
Critically evaluate and synthesise current evidence on the presentation, investigation, diagnosis, and management of reproductive endocrine disorders, developing advanced skills in clinical decision-making and patient care strategies.

Module Content:
This module examines gonadal physiology, sex hormone profiles, and reproductive disorders. Students will explore genetic conditions (e.g. Turner, Klinefelter, Kallmann syndromes), polycystic ovarian syndrome management, and infertility investigations. The curriculum addresses female hypogonadism (premature ovarian failure, menopause) with critical evaluation of hormone replacement therapies and their safety profiles. Male hypogonadism is covered through diagnostic approaches and treatment modalities, including testosterone replacement options and emerging therapies. The module concludes with erectile dysfunction management, preparing students to provide evidence-based care for patients with reproductive endocrine disorders.

Learning outcomes:

1. Critically evaluate the evidence base and design comprehensive strategies for the investigation, diagnosis, and management of patients with endocrine disorders of the gonads.
2. Analyse and critique current approaches to the investigation, diagnosis, and management of endocrine-related fertility issues, proposing innovative solutions where appropriate.

Aims of the module:
Conduct in-depth analysis of the presentation, investigation, diagnosis, and management of endocrine-related cancers, critically appraising current research to propose and justify innovative approaches to patient care and treatment.

Module Content:
Students will explore thyroid cancer variants (follicular, medullary, anaplastic), including epidemiology, evidence-based treatment approaches, radioiodine ablation, surveillance protocols, and long-term hormone replacement strategies. The curriculum addresses adrenal cancer presentation, investigation, management, and adjunctive therapies including chemotherapeutic principles. Neuroendocrine tumour components cover classification systems, diagnostic approaches (including chromogranin assays and somatostatin scintigraphy), management strategies featuring somatostatin analogues, carcinoid syndrome manifestations and treatment, and the relationship between NETs and hereditary conditions such as Multiple Endocrine Neoplasia. Throughout, emphasis is placed on multidisciplinary management and current research in endocrine oncology.

Learning outcomes:

1. Synthesise and critically appraise evidence relating to the diagnosis and management of patients with endocrine-related cancers, identifying gaps in current knowledge.
2. Develop and justify evidence-based recommendations for improving the investigation and management of patients with neuroendocrine tumours, grounded in critical analysis of current research.

Module Aims
To prepare students for an independent research-based project by developing skills in selecting, appraising, discriminating, using evidence and appropriate research/investigative methods to address relevant topics for investigation.

Module Content

• Basic terminology used in epidemiology and research studies such as prevalence, incidence, sensitivity, specificity, false positive and false negatives.
• Interpreting graphical representation of epidemiological and statistical data such as Kaplan-Meier Curves, Forrest Plots and Meta-analyses.
• Calculations used in the assessment of research data such as relative risk, absolute risk, number needed to treat.
• Basic statistical tests and their applications including T-Tests, ANOVA, Chi-Squared Tests.
• Methodologies used in endocrine research such as insulin tolerance testing, short synacthen testing, OGTT, measures of insulin resistance and GH testing.
• Research on issues such as health outcomes and quality of life using bespoke questionnaires such as the SF-36 as well as other modes of assessment.
• Fundamentals of evidence-based practice and its application into the clinical setting.
• Establishing patient registers and the value of disease specific registers.
• Research into educational principles for both doctor and patient. Understanding what may work for the patient as well as the educator.

Learning Outcomes

1. Critically analyse and interpret research to assess its application to delivery/service development.
2. Evaluate and synthesise diverse methodological approaches and research tools to formulate and investigate complex questions within your field of practice.

Module Aims

• To formulate the research question that you seek to answer.
• To develop an ability to critically evaluate areas of professional practice.
• To critically appraise specific areas of clinical, research and organisational practice.
• To develop skills in independent research and study.
• To develop skills relevant to scientific publications.

Module Content
The professional project must be endocrinology-related and relevant to the person's practice. This project may comprise of:

• Literature review and appraisal of the evidence.
• Audit of practice including organisational or clinical.
• Review and implementation of evidence-based practice.
• Qualitative or quantitative research (formal research involving human subjects is not anticipated).
• Case-based and quality of service review with critical appraisal.
• Case report, review of literature and organisational assessment.

Learning Outcomes

1. Synthesise advanced knowledge of endocrinology research to conceptualise, plan, and execute an original investigation that contributes significant insights to the field.
2. Critically evaluate practice and suggest improvements or change in an endocrinology setting.
3. Incorporate knowledge of the research process in developing endocrinology services appropriately.