27 May 2025
BSR has voiced the concerns and frustrations of rheumatology trainees and proposed solutions in its response to NHS England’s review of postgraduate medical training.
In our response, led by our trainees committee, we reiterated our position that the number of rheumatology specialty training posts must expand to ensure we have the consultants we need to meet service demands, as we set out in our Rheumatology workforce: a crisis in numbers report. We highlighted the lack of join-up in the way training is currently organised and the importance of taking a UK-wide view on postgraduate medical training.
We also described the impact that dual-accreditation in rheumatology and general internal medicine (GIM) has had on trainees’ experience.
GIM requirements risk reducing trainees’ ability to develop competencies in the specialty, and mean they are often called on to cover workforce gaps in general medicine. We are clear that rheumatology trainees - and other specialty trainees - should not be the solution to general medicine workforce issues.
The general medicine requirements and pressure to contribute to the on-call rota reduces time trainees can spend in rheumatology clinics, where they develop the knowledge and skills they require to become consultants. There is also significant variability in trainees’ exposure to tertiary rheumatology, which is important for gaining experience in managing more complex cases.
We also highlighted trainees’ concerns about the lack of protected time for non-clinical commitments, such as research, leadership roles, and teaching, even though these are essential for training completion, and the particular challenges facing trainees who want to go into clinical academic roles.
Anastasia Madenidou, chair of BSR’s trainees committee said:
“Rheumatology is a rewarding and fascinating specialty with a wealth of opportunity in clinical practice, quality improvement, and research. But the issues we have described in our response to this review are currently hindering trainees’ career development and learning.
It is vital that, as the next generation of rheumatology specialists, we are given the best possible opportunity to develop the expertise and skills we need to meet the needs of patients.”
At BSR, we will continue to make the case for improving rheumatology trainees’ learning and training experience as the NHS England review progresses.