Education and training

The GMC-approved rheumatology curriculum defines the training for the specialty. Trainees now train over a 5-year period in rheumatology and general internal medicine. The curriculum is regularly reviewed and updated by the rheumatology specialty advisory committee (SAC) for the Joint Royal College of Physicians training board (JRCPTB). Each training region of the UK is represented on the SAC and there is an elected curriculum lead who updates and advises the committee. Trainee representatives sit on each regional training board, with elected members on the SAC. The curriculum defines the core training requirements for rheumatologists and the methods of assessment. Trainees can choose to take time out of training to pursue research interests or subspecialty clinical training.

All trainees have both clinical and educational supervisors who provide clinical supervision and educational mentorship. Training programmes are designed to ensure training in all aspects of the curriculum. All trainees must document evidence of their training and competences on a national e-portfolio. Progress is formally reviewed annually at the ARCP.

Locally and nationally, physicians contribute to specialist and primary care meetings (eg RCP meetings), and educational opportunities for other healthcare professionals. Rheumatologists train foundation, GP and core trainees as well as GPs with a specialist interest. Rheumatology is a multidisciplinary specialty and strongly supports the development of specialist nurses and allied health professionals with training and education.

Historically, approximately 65% of rheumatology trainees in the UK dual trained with internal medicine on a 5-year programme, with the remaining 35% training over 4 years in rheumatology alone. Concerns about regional inconsistencies and the current need for more doctors with general medical knowledge and skills to help manage acute medical care, have led to an agreement by the British Society for Rheumatology (BSR), SAC and JRCPTB that all rheumatology training programmes will now comprise dual training with internal medicine. Trainees who have already started on single training programmes will not be required to convert to dual training unless they choose to do so. The training requirements for internal medicine are outlined in the GIM curriculum. Following recommendations from the Shape of Training report, a new model for medical training was approved by the GMC in 2017, and will be implemented from 2019. This will see changes to the structure of core medical training (Internal Medicine Stage 1, 3 years) and subsequent specialty training in rheumatology (4 years). 

The Academy of Medical Royal Colleges (AoMRC) has produced a cost of training document setting out the mandatory costs of training involved in college enrolment fees, examination costs and GMC fees. Published in October 2017, it has been compiled to help pre-specialty doctors make fully informed career selections, with a clear understanding of the mandatory costs of their future training pathway. 

The BSR website has details of national conferences, the BSR journal Rheumatology, as well as access to online educational modules and lectures. In addition, the BSR has a dedicated trainee committee (British Rheumatologists in Training, BRiTS) made up of regional trainee representatives, with representation on all of the councils within BSR, including the executive committee, to enable the trainees’ voice to be heard across the organisation. Priorities for the group include developing educational resources for trainees, facilitating mentoring and fellowship initiatives and championing rheumatology as a career.