08 FYi • Career


GETTING PATIENTS BACK ON THEIR


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HEUMATOLOGISTS are doctors who investigate, diagnose, manage and rehabilitate patients with disorders of the musculoskeletal system. This diverse range of more than 200 conditions includes arthritis,


inflammatory spinal disorders such as ankylosing spondylitis, and multisystem autoimmune rheumatic disorders such as lupus, myositis, and systemic vasculitis. Rheumatologists are also trained in recognition and management of the breadth of regional musculoskeletal conditions including tendinopathies and osteoarthritis, as well as metabolic bone disease. Rheumatology requires interdisciplinary


knowledge and awareness of new developments in internal medicine, immunology, orthopaedics, neurology/pain management, rehabilitation, psychiatry, nursing and professions allied to medicine. Rheumatologists practising in adult medicine must also have knowledge of childhood and adolescent rheumatological disease to facilitate an effective transition to adult care. Many rheumatologists practise the


specialty exclusively but there are opportunities to subspecialise in a variety of areas such as rehabilitation or sports medicine.


A career in the rapidly evolving specialty of rheumatology offers doctors many exciting opportunities


Rheumatology is a very research-active specialty, and in recent years a great many novel treatments have been developed, trialled and introduced across the range of rheumatic disorders.


Entry and training Following successful completion of foundation training, doctors must undertake two or three years of core training before sitting the membership exam of the Royal College of Physicians (MRCP UK). This is then followed by a further four years of specialty training, as well as completion of the specialty certificate examination (SCE) in rheumatology. Increasingly, rheumatology training is being


offered in conjunction with the opportunity to train for a dual certificate of completion of training (CCT) with general internal medicine.


The job Most patients are treated in an outpatient department, but many also need to attend day treatment units to be administered novel biologic treatments by infusion. “Shared care” arrangements are increasingly common, where specialists and GPs, and homecare nursing teams jointly look after people with conditions such as inflammatory arthritis. Practical skills, including a range of joint and soft-tissue injections and increasingly ultrasound assessment, are invaluable to the rheumatologist.


As this specialty looks after patients with


long-term conditions, there is a considerable amount of administration and liaison with the multidisciplinary team and other agencies. In most areas, there is active participation in continuing medical education, audit and research. As a consultant, on-call and shift work in


rheumatology is usually relatively light, although rheumatologists may contribute to the general medical on-call rota. The British Society for Rheumatology (BSR)


is the UK’s leading specialist medical society for rheumatology and musculoskeletal professionals. Membership provides access to a range of courses, eLearning and conferences as well as other advice and support.


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