Challenges and opportunities to diabetes and endocrinology training during and beyond the COVID‐19 pandemic

The COVID‐19 pandemic posed unprecedented new challenges to diabetes and endocrinology (D&E) training. We reflect from our local experience on its impact and lessons we can learn.Necessary restructuring of clinical services resulted in more general medicine and less inpatient specialty exposure. Outpatient clinic opportunities were reduced as clinics were postponed and virtual consultations became more frequent. Training opportunities such as local teaching and conferences were cancelled, and academic training often put on hold. Together these had a significant impact on training in D&E.However, the necessary restructuring can also be used to change D&E training for the better. Virtual consultations could improve opportunities for clinic attendance as physical space is a lesser issue. Remote access to clinical systems should be more widely available, thus promoting flexible working for trainees. The necessity for virtual teaching has seen the emergence of on‐demand services and the option of online attendance. Barriers to attending teaching, such as travel time and leave, are a lesser issue than ever before, particularly for conferences. The wellbeing of doctors is also being supported increasingly after the pandemic.The lessons we learn from this pandemic should be used to transform the face of D&E training and improve flexibility and job satisfaction. Such solutions can be applied to other current and future demands on specialty training. Copyright © 2022 John Wiley & Sons.

Clinical characteristics and pregnancy outcomes of women diagnosed with SARS-CoV-2 in London's most ethnically diverse borough: A cross-sectional study.

INTRODUCTION: It is unclear whether pregnant women from ethnic minority groups and with metabolic disorders are disproportionately affected by SARS-CoV-2 infection within deprived areas. No previous studies have compared pregnancy outcomes with an appropriate comparator group. METHODS: Cross-sectional study of 32 women with SARS-CoV-2 compared to background departmental figures from the three months prior to the outbreak. Clinical characteristics were compared to the UK Obstetric Surveillance System report. RESULTS: Estimated incidence was 10 times the national average (50.3 vs 4.9 per 1000 maternities). Women from Black (OR, 95% CI: 3.01, 1.08-7.38) and Asian (OR, 95% CI: 2.68, 1.23-6.05) ethnic groups were over-represented; however, there was no association with metabolic disorders. Babies born to women diagnosed with coronavirus were more likely to be born premature, or by caesarean delivery, however there was no difference in birthweight centile for gestational age. CONCLUSION: Women from Black and Asian backgrounds are disproportionately affected, even within an area of high ethnic diversity. Mothers do not appear more severely affected than women nationally; however, babies are more likely to be born preterm, or by caesarean delivery, compared to usual departmental figures. It is unclear whether this is due to increased intervention or a direct result of coronavirus infection.