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We're currently focussing on encouraging others to join the specialty by providing more information and an insight into what it's like to have a career in rheumatology, please share these interviews with others to help us with this initiative. Next up in our Careers in rheumatology series, we caught up with a rheumatology podiatrist. Here's what David Warne from Salford Royal NHS Foundation Trust had to say about what his career journey has been like so far.

Why did you choose to be a rheumatology podiatrist?

Two years ago I was given the opportunity to rebuild the links between podiatry and the rheumatology team at Salford Royal. My manager was very supportive in allowing me to expand my role in order to specialise more.

This transition began with a trip to the excellent team at Leeds Teaching Hospital, where I shadowed consultant podiatrist Heidi Siddle for the day. Her use of ultrasound to aid diagnosis and monitor soft tissue and inflammatory conditions in a combined clinic with the rheumatologist set the tone of how I wanted the multidisciplinary team at Salford to work going forward.

Salford’s podiatry team is highly regarded for managing the high-risk foot in connection with diabetes and peripheral arterial disease. We felt a similar focus was needed for those patients with rheumatological conditions where early diagnosis, treatment and monitoring are essential to good outcomes.

What was your career journey like?

For nine years I was a steel worker in my home town of Scunthorpe. Knowing I didn’t want to stay in the steel industry, I studied A-level biology, as well as courses in counselling and reflexology, after which I set up a side business. In 2001 I decided to retrain as a podiatrist. I travelled to Salford University for an open day and immediately knew this was the place where I wanted to train. After qualifying in 2004, I got a job with the NHS in Salford and have been there ever since. I’ve also held a caseload of private patients who I travel to in my home area of Trafford for general nail and skin care.

For the majority of my time at Salford I’ve been a Band 6 podiatrist managing a broad range of patients. Most will have a medical condition that puts them at risk of foot health problems, so it’s important to get them the right treatment, at the right time, by the right person, to achieve the best outcomes.

I’ve completed a number of professional development courses and learning days. I’ve recently done an ultrasound taster day, corticosteroid injection course and the Rheumatology for Specialist Nurses course was excellent.

What are the challenges?

My own personal challenges relate to keeping up-to-date with current best practice in rheumatology. These don’t just involve the feet, but patient management as a whole, so understanding medications and wider disease management is important. Many patients in rheumatology have overlapping conditions, such as rheumatoid arthritis and fibromyalgia, and so coping strategies can change, with patients being encouraged to self-manage aspects of these long-term conditions.

I’ll soon be implementing corticosteroid injections in clinic to help avoid prolonged waiting times and unnecessary referrals. My next challenge is to utilise the ultrasound machine more to aid the diagnosis and help guidance of injections.

I’m lucky that I’ve had good support from both my podiatry manager and the rheumatology team, so if anyone has an interest in rheumatology and expanding their role, then do have that conversation. Both BSR and NICE guidelines recommend the need for a specialised podiatrist in a rheumatology multidisciplinary team.

What’s your advice for someone thinking about a career as a podiatrist?

Go for it! It’s a hugely rewarding job. Once qualified you have numerous options and areas to specialise in. The College of Podiatry website has some good information and videos explaining many of these options. If you're a caring person wanting a career in healthcare and like working autonomously as well as being a part of a team, you’d be hard pressed to find a more enjoyable career than podiatry.

Check out our Careers in Rheumatology section for more info on how to get into the specialty. 

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