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Vocational Training
Rheumatology
Supervising Committee
Specialist Advisory Committee (SAC) in Rheumatology.
Definition of Specialty
The diagnosis and management of rheumatic disorders, including all forms
of arthritis; connective tissue disease; spinal and soft tissue disorders;
chronic musculoskeletal pain syndromes; and certain metabolic bone disorders,
particularly osteoporosis.
General Principles
Rheumatologists practise in a number of different ways in Australia and
New Zealand. Some practise ‘pure’ rheumatology within a large
metropolitan hospital, an academic post, or in private practice, while
others practise rheumatology in a more general setting. They are all expected
to be competent in the diagnosis and management of inflammatory rheumatic
diseases as well as non inflammatory conditions, spinal and soft-tissue
disorders and chronic musculoskeletal pain-syndromes.
Components of Training
Core Training
A minimum of 2 years’ core training is required. During this
time, the trainee must have direct and supervised responsibility for inpatient
and outpatient care in a rheumatology unit.
Specific Objectives of Core Training
- Acquisition of knowledge of aspects of basic and applied medical sciences
relevant to rheumatic and connective-tissue disease. This should include
appropriate aspects of morbid anatomy, chemical pathology, pathophysiology,
immunology and microbiology.
- Training in statistical methods, research techniques and critical
evaluation of the results of investigation, and of the published literature.
- Competence in diagnostic and therapeutic procedures appropriate to
rheumatology including:
- knowledge of the indications for, and interpretation of, various
imaging techniques used in rheumatology, including skeletal and
soft-tissue plain radiographs, nuclear medicine, ultrasound, CT
scanning and MRI
- physical methods used in the treatment of patients with musculoskeletal
disorders, and an awareness of the value of and indications for
physiotherapy, occupational therapy, podiatry and allied forms of
management
- techniques of synovial, bone and muscle biopsy and interpretation
of pathology
- the application of electrophysiological diagnostic tests
- the indications for, and an outline of, the operative and perioperative
techniques in the surgery of the rheumatic diseases.
- A detailed knowledge of, and practical experience in, clinical pharmacology
in relation to therapy of the rheumatic diseases.
- Assessment and management of chronic musculoskeletal pain, including
cognitive, behavioural, and biopsychosocial components.
Non Core Training
In Australia, in general, it is recommended that the non core year
be spent working as a rheumatology registrar. However, enrolment as a full
time PhD, MD or MPH student will be accepted as a non core year. A non
core year in which 50% or more time is spent in rheumatology and up to
a maximum of 50% time is spent in one of the following optional areas may
be considered for approval on a case by case basis:
- general medicine, geriatric medicine or paediatrics;
- a medical specialty (e.g. immunology, haematology, gastroenterology,
nephrology or neurology);
- orthopaedic surgery;
- a pain management service;
- laboratory medicine particularly immunology;
- rehabilitation medicine;
- epidemiology;
- radiology and/or nuclear medicine;
- clinical pharmacology;
- regional/rural training.
Applications for non core training should be submitted to the SAC for prospective
approval before June in the year prior to commencement of the proposed training.
In New Zealand, time spent in one of the following areas may be approved
as non core training:
- a medical specialty e.g. immunology, haematology, gastroenterology,
nephrology, neurology or geriatrics;
- orthopaedic surgery;
- pain management service;
- laboratory medicine, particularly immunology;
- rehabilitation medicine;
- epidemiology;
- radiology and/or nuclear medicine;
- clinical pharmacology;
- general medicine;
- PhD or MD studies.
Trainees who are contemplating other types of non core training should
submit a proposal to the SAC Chair at least six months prior to the commencement
of the proposed training.
Rheumatology
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