Abstract
The past decade has witnessed a remarkable transformation in the field of rheumatology. The progress has been startling, with major advances in patient treatment attributed to the impressive array of new biologic therapies and the development of new treatment approaches which dramatically improved patient outcomes. However, while the situation has engendered optimism for the future, concerns have been raised about sustaining the momentum. Over recent years, there has been increasing concern among rheumatologists that fewer trainee doctors have been choosing rheumatology as a career. In some regions, training posts have remained unappointed. This unexpected contrast warrants a thorough look at the reasons behind such attitude. This chapter will discuss why do we need to revise ways rheumatology is being taught and its impact on attracting, rather than deterring, junior doctors to the speciality.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Al Maini M, Adelowo F, Al Saleh J, Al Weshahi Y, Burmester G, Cutolo M, Flood J, March L, McDonald-Blumer H, Pile K, Pineda C, Thorne C, Kvien T. The global challenges and opportunities in the practice of rheumatology: white paper by the world forum on rheumatic and musculoskeletal diseases. Clin Rheumatol. 2015;34:819–29.
Key components of a well-functioning health system. World Health Organization, 2010. http://www.whoint/healthsystems/EN_HSSkeycomponentspdf?ua=1. Accessed 15 Dec 2017.
Putrik P, Ramiro S, Kvien TK, Sokka T, Pavlova M, Uhlig T, Boonen A, Tafaj A, Harutyunyan R, Radner H. Inequities in access to biologic and synthetic DMARDs across 46 European countries. Ann Rheum Dis. 2014;73(1):198–206.
Fiehn C, Hajjar Y, Mueller K, Waldherr R, Ho A, Andrassy K. Improved clinical outcome of lupus nephritis during the past decade: importance of early diagnosis and treatment. Ann Rheum Dis. 2003;62(5):435–9.
Nell V, Machold K, Eberl G, Stamm T, Uffmann M, Smolen J. Benefit of very early referral and very early therapy with disease modifying anti-rheumatic drugs in patients with early rheumatoid arthritis. Rheumatology. 2004;43(7):906–14.
Day CS, Yeh AC. Evidence of educational inadequacies in region-specific musculoskeletal medicine. Clin Orthop Relat Res. 2008;466:2542–7.
Alonso J, Ferrer M, Gandek B, Ware JE Jr, Aaronson NK, Mosconi P, Rasmussen NK, Bullinger M, Fukuhara S, Kaasa S, Leplege A. Health-related quality of life associated with chronic conditions in eight countries: results from the international quality of life assessment (IQOLA) project. Qual Life Res. 2004;13:283–98.
Almoallim H, Bukhari E, Amasaib W, Zaini R. How to avoid delay in SLE diagnosis and management. In: Almoallim H, editor. Systemic lupus erythematosus. Croatia: InTech; 2012. p. 219–42. https://doi.org/10.5772/26498.
Almoallim H, Khojah E, Allehebi R, Noorwali A. Delayed diagnosis of systemic lupus erythematosus due to lack of competency skills in musculoskeletal examination. Clin Rheumatol. 2007;26:131–3.
Beattie KA, Bobba R, Bayoumi I, Chan D, Schabort I, Boulos P, Kean W, Obeid J, Mccallum R, Ioannidis G, Papaioanno A, Cividino A. Validation of the GALS musculoskeletal screening exam for use in primary care: a pilot study. BMC Musculoskelet Disord. 2008;9:115.
Akesson K, Dreinhöfer KE, Woolf AD. Improved education in musculoskeletal conditions is necessary for all doctors. Bull World Health Organ. 2003;81:677–83.
Abou-Raya A, Abou-Raya S. The inadequacies of musculoskeletal education. Clin Rheumatol. 2010;29:1121–6.
Matzkin E, Smith MEL, Freccero CD, Richardson AB. Adequacy of education in musculoskeletal medicine. J Bone Joint Surg Am. 2005;87:310–4.
Freedman KB, Bernstein J. The adequacy of medical school education in musculoskeletal medicine. J Bone Jt Surg. 1998;80:1421–7.
Skelley NW, Tanaka MJ, Skelley LM, Laporte DM. Medical student musculoskeletal education: an institutional survey. J Bone Joint Surg Am. 2012;94:e146.
Beran MC, Awan H, Rowley D, Samora JB, Griesser MJ, Bishop JY. Assessment of musculoskeletal physical examination skills and attitudes of orthopaedic residents. J Bone Jt Surg. 2012;94:e36.
Comer GC, Liang E, Bishop JA. Lack of proficiency in musculoskeletal medicine among emergency medicine physicians. J Orthop Trauma. 2014;28:e85–7.
Ramani S, Ring BN, Lowe R, Hunter D. A pilot study assessing knowledge of clinical signs and physical examination skills in incoming medicine residents. J Grad Med Educ. 2010;2:232–5.
Di Caprio MR, Covey A, Bernstein J. Curricular requirements for musculoskeletal medicine. J Bone Joint Surg Am. 2003;85:565–7.
Day CS, Yeh AC, Franko O, Ramirez M, Krupat E. Musculoskeletal medicine: an assessment of the attitudes and knowledge of medical students at Harvard Medical School. Acad Med. 2007;82:452–7.
Craton N, Matheson GO. Training and clinical competency in musculoskeletal medicine. Identifying the Problem. Sports Med. 1993;15:328–37.
Curriculum 2020. King’s College school of Medicine. (https://www.kcl.ac.uk/lsm/education/meded/mbbs/index.aspx).
AAMC. Report VII contemporary issues in medicine: musculoskeletal medicine education, medical school objectives project no. VII. Washington, DC: Association of American Medical Colleges; 2005.
Wise EM, Walker DJ, Coady DA. Musculoskeletal education in general practice: a questionnaire survey. Clin Rheumatol. 2014;33:989–94.
Queally JM, Kiely PD, O’Daly BJ, O’Byrne JM. Design and implementation of a system-based course in musculoskeletal medicine for medical students. J Bone Joint Surg Am. 2009;91:1276–7.
Bilderback K, Eggerstedt J, Sadasivan KK, Seelig L, Wolf R, Barton S, Mccall R, Chesson AL Jr, Marino AA. Design and implementation of a system-based course in musculoskeletal medicine for medical students. J Bone Joint Surg. 2008;90:2292–300.
Al-Nammari SS, James BK, Ramachandran M. The inadequacy of musculoskeletal knowledge after foundation training in the United Kingdom. Bone Joint J. 2009;19:1413–8.
Nottidge TE, Ekrikpo U, Ifesanya AO, Nnabuko RE, Dim EM, Udoinyang CI. Pre-internship Nigerian medical graduates lack basic musculoskeletal competency. Int Orthop. 2012;36:853–6.
Goldenberg DL, Dehoratius JK, Mason J, Meenan R, Perlman SG, Winfield JB. Rheumatology training at internal medicine and family practice residency programs. Arthritis Rheum. 1985;28:471–6.
Clawson DK, Jackson DW, Ostergaard DJ. It’s past to reform the musculoskeletal curriculum. Acad Med. 2001;76:709–10.
Katz SJ, Oswald AE. How confident are internal medicine residents in rheumatology versus other common internal medicine clinical skills: an issue of training time or exposure? Clin Rheumatol. 2011;30:1081–93. Matzkin E, Smith MEL, Freccero CD, Richardson AB. (2005). Adequacy of education in musculoskeletal medicine. J Bone Joint Surg Am. 87:310–4.
Freedman KB, Bernstein J. Educational deficiencies in musculoskeletal medicine. J Bone Joint Surg. 2002;84(4):604–8.
Oswald AE, Bell MJ, Snell L, Wiseman J. The current state of musculoskeletal clinical skills teaching for preclerkship medical students. J Rheumatol. 2008;35(12):2419–26.
Thompson AE. Improving undergraduate musculoskeletal education: a continuing challenge. J Rheumatol. 2008;35(12):2298–9.
Garneau KL, Iversen MD, Tsao H, Solomon DH. Primary care physicians’ perspectives towards managing rheumatoid arthritis: room for improvement. Arthritis Res Ther. 2011;13(6):R189.
Harrold LR, Mazor KM, Negron A, Ogarek J, Firneno C, Yood RA. Primary care providers’ knowledge, beliefs and treatment practices for gout: results of a physician questionnaire. Rheumatology. 2013;52(9):1623–9.
Almeida C, Clarke B, O’Brien A, Hammond A, Ryan S, Kay L, Hewlett S. Current provision of rheumatology education for undergraduate nursing, occupational therapy and physiotherapy students in the UK. Rheumatology. 2006;45(7):868–73.
Hewlett S, Clarke B, O’Brien A, Hammond A, Ryan S, Kay L, Richards P, Almeida C. Rheumatology education for undergraduate nursing, physiotherapy and occupational therapy students in the UK: standards, challenges and solution s. Rheumatology. 2008;47(7):1025–30.
Henrickson M. Policy challenges for the pediatric rheumatology workforce: part I. Educ Econ Pediatr Rheumatol Online J. 2011;9:23. https://doi.org/10.1186/1546-0096-9-24.
Louthrenoo W. An insight into rheumatology in Thailand. Nat Rev Rheumatol. 2014. https://doi.org/10.1038/nrrheum2014142.
Gibson T. Rheumatology in India and Pakistan today. Rheumatology. 2014;keu306.
Li Z, Yang Y. Rheumatology in China: challenges and development. Rheumatology. 2012;51(10):1733–4.
Lau C, Feng P. Rheumatology without borders. Nat Clin Pract Rheumatol. 2007;3(6):305.
Chipeta J, Njobvu P, McGill PE, Bucala R. Progress made towards enhancement of rheumatology education and practice in Zambia: review of an ILAR-supported project. Clin Rheumatol. 2014:1–6.
Pinney SJ, Regan WD. Educating medical students about musculoskeletal problems. Are community needs reflected in the curricula of Canadian medical schools? J Bone Joint Surg Am. 2001;83:1317–20.
Williams JR. The teaching of trauma and orthopaedic surgery to the undergraduate in the United Kingdom. J Bone Joint Surg Br. 2000;82:627–8.
Rasker JJ. Rheumatology in general practice. Br J Rheumatol. 1995;34:494–7.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
El Miedany, Y. (2019). Rheumatology Teaching: The Need to Review. In: Rheumatology Teaching. Springer, Cham. https://doi.org/10.1007/978-3-319-98213-7_2
Download citation
DOI: https://doi.org/10.1007/978-3-319-98213-7_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98212-0
Online ISBN: 978-3-319-98213-7
eBook Packages: MedicineMedicine (R0)