Endocrine Medicine

Endocrine disorders are commonly encountered in general practice⁽¹⁾. Conditions such as diabetes, thyroid dysfunction, and obesity are frequently managed in primary care, while more complex or less common disorders (such as adrenal, pituitary, or parathyroid disease) may require shared care with specialists. GPs are well-placed to detect endocrine issues early, interpret relevant investigations, initiate treatment, and provide long-term follow-up and lifestyle support. Endocrine conditions often present with subtle or non-specific symptoms, making clinical vigilance and a structured approach to diagnosis essential. With the growing burden of chronic endocrine conditions and increasing use of shared care models, general practitioners play a key role in delivering holistic, evidence-based endocrine care that is responsive to patients’ needs and closely integrated with secondary services. 

• EM1. Demonstrate competence in recognising endocrine emergencies in the primary care setting including Diabetic Ketoacidosis (DKA), Euglycemic Diabetic Ketoacidosis, Hyperosmolar Hyperglycaemic State (HONK), Thyrotoxicosis and Addisonian crisis, ensuring timely intervention, referral and patient safety.
• EM2. Effectively diagnose and manage endocrine disorders through appropriate investigations, clear clinical reasoning, and effective communication with patients.
• EM3. Effectively diagnose and manage Type 2 Diabetes Mellitus through appropriate investigations, clear clinical reasoning and effective communication with patients.
• EM4. Recognise obesity as a chronic disease and apply evidence-based strategies for its assessment, management, and prevention (including lifestyle changes, medications and surgery).
• EM5. Apply principles of chronic disease management that focus on overall health rather than weight alone or any single metric.
• EM6. Recognise the importance of lifestyle interventions, patient empowerment, and public health initiatives in the prevention and management of endocrine disorders.
• EM7. Adopt a holistic approach to endocrine care, recognising the potential for comorbid mental health conditions and addressing the stigma associated with obesity, diabetes and other endocrine disorders.
• EM8. Coordinate care effectively for endocrine disorders, collaborating with multidisciplinary teams and making timely referrals to secondary care.
• EM9. Understand the challenges and limitations of managing endocrine disorders in primary care and advocate for improved resources and support for both patients and healthcare providers.
• EM10. Demonstrate competence in the pharmacological management of Type 2 Diabetes Mellitus and other endocrine disorders, ensuring the safe and evidence-based use of treatments while addressing:
• - Polypharmacy and medication interactions
• - Patient adherence to treatment regimens
• - Financial implications of healthcare for patients with chronic conditions
• - Awareness of the Long-Term Illness Scheme
• EM11. Commit to evidence-based practice and actively participate in national screening programmes for endocrine disorders to enhance early detection and prevention strategies.

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed Endocrine Learning

Blended Learning Resources (Education Platform)

Diabetes Management in General Practice

Diabetes and Multimorbidity (not created yet)

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

EPA 10: Manage the care of adults, including older people with chronic conditions and complex multimorbidity

For EPA 10, managing a patient with poorly controlled Type 2 Diabetes demonstrates competence in chronic disease management, including medication review, addressing comorbidities, and coordinating care with endocrinology services. Reflection could cover strategies to support lifestyle modification, address stigma, and promote patient empowerment in self-management.

Core Knowledge Test (CKT)

• Assessment of hypercalcaemia

• Management of Type 2 Diabetes Mellitus

• Diagnosis of Addisons Disease

Clinical Competency Test (CCT)

• A patient presenting for help managing obesity.
• Chronic Disease Management of Diabetes.
• Management of a patient presenting with symptoms suggestive of hypothyroidism.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.

1.    Harrison C, Britt H, Miller G, Henderson J. Prevalence of Chronic Conditions in Australia. PLOS ONE. 2013 July 23;8(7):e67494.