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Why study rheumatology?

This area provides information for those considering applying for a training post in rheumatology and answers some of the questions that trainees may have.

Please explore the content to learn more about what rheumatology entails and how best to prepare for the specialty training application process.

Why would this interest me?

Rheumatologists make happy doctors

Rheumatology is a fun, friendly and rewarding specialty. Their work involves interaction with many different medical specialities in managing multi-system diseases. There is a strong focus on teamwork and cohesiveness, as they collaborate regularly with an extensive team of allied health professionals. Repeated surveys about doctor happiness have confirmed that rheumatologists are amongst the happiest medical specialists.

Variety of opportunity

Rheumatologists can often develop a sub-specialty interest such as connective tissue disease, paediatrics and sports medicine. We can work closely with other specialities such as renal, respiratory and dermatology. Combined speciality clinics with other specialities ensure shared expertise. Rheumatologists may have an active role in research and there are plenty of opportunities for trainees to get involved also. They often take the lead outside rheumatology with roles in education, clinical governance and management.

Rheumatologists are innovators

The scientific understanding and treatment of rheumatological disorders has undergone revolutionary change thanks to innovative research in the past two decades. The development of a vast array of biological drugs has lead to highly effective treatment for many conditions. There are still many advances that can be made but many patients may now lead normal lives thanks to modern rheumatology.

Rheumatologists are practical

Many rheumatologists continue to practice in General Internal Medicine as well as rheumatology; and are often the specialists to whom others turn to help in solving those difficult diagnostic conundrums. While they have access to many specialist lab and radiological tests, a large part of the diagnostic process still relies on astute clinical judgement and examination skills.

All rheumatologists are trained to perform a variety of joint and soft tissue injections, which can be helpful in ameliorating patient symptoms. The development of musculoskeletal ultrasound as a clinic-based tool for the rheumatologist has lead to vast improvements in diagnosis and treatment of a variety of disorders.

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A week in the life

As a registrar you undertake a combination of pure rheumatology and combined rheumatology/general medical postings. On call commitments will vary with the post. Each week you will get the chance to experience variety of sub-speciality clinics, allowing you develop your own specialty interests.

Many trainees take time out of programme (OOP) for research or other clinical experiences and this is highly encouraged.

An example of an average rheumatology trainee's week is shown below (N.B. these vary from hospital to hospital):

Morning

Afternoon

Monday

Connective Tissue Disease clinic 

Transitional Care clinic

Tuesday

Rapid Access 'emergency' clinic

ACU Cover postgraduate education

Wednesday 

Early arthritis clinic

General/specialty clinic

Thursday

Ward round

Radiology/MDT meeting

Friday

Combined Specialty clinic

Injection/Ultrasound clinic

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How to apply

Candidates applying for ST3 in Rheumatology are eligible if they have completed Core Medical Training and obtained Membership of the Royal College of Physicians (MRCP). More information on the application process can be found here.

All successful candidates then enter a five year training programme to dual accredit in rheumatology and General Internal Medicine, which allows us to maintain our general skills and knowledge.

If you are looking to find out more, approach your friendly local rheumatologist who would be more than happy to help arrange some hands-on experience, talk to the registrars about the training and interview process, or come along to one of our events or our Annual Conference.

Alternatively, contact our Trainees committee via email.

How training is assessed

There are five years on the training programme. By the time you reach ST5 you need to have attempted the Specialty Certificate Examination (SCE) in Rheumatology, with successful completion expected by the end of ST6.

At the end of each year you will attend an Annual Review of Competency Progression (ARCP) to ensure you are acquiring the skills necessary for your stage of training. At each ARCP the previous years’ ePortfolio and assessments will be reviewed.

Trainees are required to complete a number of Case Based Discussions (CBDs), Mini-CEXs, multi-source feedback (MSF), multiple consultant reports (MCRs) and directly observed procedural skills (DOPS). Further information including ARCP decision aids can be found on the JRCPTB website.

This is the formal method by which a trainee's progression through their training programme is monitored and recorded.