Endocrine Abstracts

Background: Disorders of sexual development (DSD) are estimated to occur in every 1 in 4500 births. This project builds upon previous work by the authors to explore the knowledge and management of paediatric junior doctors in a single deanery. The majority of junior doctors stated that they would seek the advice and explanation of paediatric consultant. We therefore attempted to qualify the knowledge and management strategies of the region-wide consultant body with regards to DSD.

Methods: We used an online survey which was distributed to all general paediatric and neonatal consultants in a single deanery. The survey comprised of 10 questions designed to investigate the knowledge of history taking, examination, investigations and management.

Results: A total of 15 consultants completed the questionnaire. 93% of respondents were general paediatricians and 7% neonatologists. Knowledge of key points to record in history and examination findings was high at 80% compliance with national standards. Management of a patient with suspected DSD (eg., hypospadias with unilateral testicle) was highly variable with 74% referral to urology, 13% referral to DSD co-ordinator of the DSD service based at tertiary centre and 13% organising follow-up in the clinic in 2–3 months. Knowledge of ordering investigations in cases of suspected DSD was good with 100% of respondents ordering chromosomal studies, abdominal ultrasound and serial electrolyte samples. However, only 75% of respondents would order 17-OH progesterone. Only 27% of respondents were aware of the regional DSD pathway and co-ordinator. Most (87%) recognised they would appreciate further training on DSD with an online module being the most preferable form of delivery.

Conclusion: This work builds upon previous a previous study which highlighted a lack of knowledge and management in junior doctors with regards to DSD. Given that all respondents in the original study indicated they would involve senior colleagues, this study demonstrates that even at consultant level the management of DSD is still suboptimal. Most professionals indicated that further training would be beneficial to their knowledge and suggested an online module to be the most convenient method of delivering this.