Rheumatology is one of the specialities within medicine and retains a very strong reliance on sound clinical skills despite considerable advance in the understanding of the molecular basis of rheumatological disease.
There is considerable demand for rheumatology expertise. Currently there are over 470 consultants and 210 trainees working in the speciality, approximating to one consultant per 165,000 of the UK population.
Rheumatology incorporates the investigation, holistic management and rehabilitation of patients with a wide spectrum of disorders of the muskuloskeletal system encompassing the locomotor apparatus, bone and connective tissues and blood vessels. Rheumatic disorders include inflammatory arthritis, complex auto immune rheumatic and multi-system disease, soft tissue conditions including injuries, osteoarthritis, spinal pain, chronic pain syndromes and metabolic bone disease. The optimum investigation and management of such conditions is therefore quite often challenging and rewarding and requires a multi-disciplinary approach linking the application of principles of pathophysiology of disease and advanced therapeutics with sound principles of rehabilitation.
The rheumatology curriculum is oriented around achieving competency in a number of domains including:
Rheumatology provides an excellent opportunity to practice clinical medicine in its broadest sense with principles of acute and chronic disease management at its core. This may often result in the building of satisfying and rewarding long term therapeutic and educational relationships with patients.
The speciality may be linked with duties in GIM, particularly in DGH settings and there are ample opportunities to develop sub-speciality interests and research with a developing academic career pathway which followed the Walport proposals. Increasingly strong links with primary care are also being forged through work at the primary/secondary interface. This may prove to be a developing area of focus for the future.