HAEMATOLOGY
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SUPERVISING COMMITTEE

Definition

GENERAL PRINCIPLES

Components of Training

Research

Project or Case Reports

TRAINING SITES

SPECIAL SOCIETY

 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.

General Principles
  1. Advanced training in paediatric rheumatology will be supervised by the SAC in Rheumatology, with major responsibility taken by the paediatric representatives (paediatric rheumatologist appointed by the BPC and a CPPT representative).
  2. Advanced training in paediatric rheumatology will be over at least 3 years to cover the full spectrum of the medical management of musculoskeletal disease - inflammatory and non inflammatory. This should also include the development of practical skills such as joint aspiration and intraarticular injection. This will be done following successful completion of basic paediatric training and the FRACP Examination in Paediatrics.
  3. The unique aspects of paediatric medicine must be incorporated into the training with the inherent emphasis of the optimal physical/emotional growth and development of the child and an awareness of how chronic illness impacts on the child and family.
  4. Trainees are encouraged to recognise the potential value of undertaking training in more than one institution. Training in any one institution should not be of more than 2 years duration under most circumstances.
  5. Continuing professional development (CPD) is an important aspect to develop. During advanced training you should ensure regular involvement in a variety of CPD activities such as hospital meetings, journal clubs as well as experience in teaching at undergraduate, graduate, nursing and lay organisations.
  6. Trainees are expected to develop a sophisticated understanding of child development, encompassing physical, cognitive, emotional, behavioural and social areas. This understanding can only be gained with the perspective of the child within the family and in the context of their community. Such understanding can be gained in a number of ways but should include experience in ambulatory and community care settings and child psychiatry and/or rehabilitation services.
  7. A general objective of advanced training is to develop attitudes, skills, and knowledge necessary for the prevention, assessment and management of impairment, disability and handicap in children, including adolescents, particularly as it relates to musculoskeletal disorders and connective tissue diseases.
  8. All subspecialty paediatric trainees must complete the community and child health requirements for paediatric training.
    Note that the guidelines differ between Australia and New Zealand.

Components of Training
At least 2 years experience in clinical paediatric rheumatology is necessary which could include a 3 months optional term in fields such as immunology, clinical pharmacology or pain management.

Trainees should establish formal links with an adult rheumatology training program either for a specified 3 to 6 months rotation and/or by regular attendance at clinics throughout the duration of training. This would enable trainees to experience the progression of paediatric into adult disease, the broader understanding of end stage inflammatory disease and greater exposure to procedural skills, in particular joint injections. It should also help trainees to develop awareness of the need for appropriate transition programs for patients rather than merely transfer to adult services.

The third or non core year of advanced training should be in a clinical or research discipline associated with or complementary to paediatric rheumatology, and will require prospective approval as a non core year by the SAC.

Research
Opportunities to engage in clinical and/or basic research are encouraged. It is recommended that you undertake a year of near full time research to develop an understanding of how to apply appropriate research methodologies to laboratory and clinical settings. Experience should be sought in study design, literature research and review, writing submissions for grants, data collection analysis, etc. Trainees should plan the research component well in advance with the paediatric rheumatology supervisor to ensure RACP requirements are met in addition to satisfying appropriate rheumatology training for membership of the Australian Rheumatology Association.

Project or Case Reports
Trainees will be expected to present or be a principal author of at least one paper to a meeting of a national or international society and/or prepare an article accepted by a peer reviewed journal during your training. Evidence of this will be required before progression to the third year of training can be approved by the SAC.

Training Sites
Training should only be undertaken in paediatric centre/s where the clinical load is of sufficient size to experience the full spectrum of clinical rheumatology at both inpatient and outpatient level. If in Australia, these sites will be accredited by the SAC in Rheumatology. A logbook audit of cases managed should be maintained, and an annual audit of 2 consecutive months of cases will need to be submitted to the SAC in Rheumatology by 1 October.

Centres at which programs of advanced training in paediatric rheumatology are undertaken should have the following:
  • Ideally, 2 paediatric rheumatologists, with at least one being full time or near full time equivalent;
  • appropriate allied health facilities with designated rheumatology physiotherapy, occupational therapy and orthotics;
  • access to full medical imaging and adequate laboratory services;
  • availability of all other subspecialties in particular orthopaedics, nephrology, neurology, endocrinology and haematology;
  • library facilities with ready access to major rheumatology journals and to literature search facilities such as Medline;
  • training posts will be evaluated at regular intervals and be designated as suitable for specific periods of training. When facilities fall short of these standards, training in institutions with complementary facilities becomes mandatory;
  • it would be essential for New Zealand trainees to work overseas for at least one year.

Special Society
Australian Rheumatology Association (ARA).

For further information regarding the requirements for registration with the society, please contact:

The Secretariat
Australian Rheumatology Association
145 Macquarie Street
Sydney NSW 2000
Tel: 61 2 9256 5458
Fax: 61 2 9251 8174
E-mail: robynm@racp.edu.au
Website: www.rheumatology.org.au

New Zealand Rheumatology Association
Honorary Secretary:
Dr Andrew Harrison FRACP
C/- Department of Rheumatology
Hutt Hospital
P O Box 31907
Lower Hutt
New Zealand


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This page was last edited: 5 November 2003