Why study rheumatology

Only rheumatologists are experts in this field of medicine. Rheumatologists also advocate for the patient in all aspects of health care and in the community. As a group, these doctors support laws that promote patient rights and patient-centered care.

The rheumatologist teaches the patient, family and community about health information and how to live with a chronic long-term rheumatic disease. Topics can include medications, coping mechanisms, techniques for preventing disability or regaining function, and ways to improve quality of life. Rheumatologists receive years of education and training beyond college.

After they earn a medical degree four years of medical school , they complete a residency program in internal medicine or pediatrics.

They have another two to three years in specialized rheumatology training. After completing their rheumatology fellowship training, they must pass a rigorous national exam. For adult rheumatologists, the subspecialty exam is conducted by the American Board of Internal Medicine. For pediatric rheumatologists, the American Board of Pediatrics conducts the exam.

As a rheumatologist, you can look forward to developing genuine long-term friendships with your patients, take part exciting research opportunities and enjoy time with your family and loved ones. Read why others chose rheumatology as their specialty. Mapping out your career can be very daunting and nerve-racking period of your life. To make things easier, we mapped out the many career opportunities in rheumatology to give you a better idea what a life in rheumatology looks like.

The top T articles were divided into several categories: clinical study, review, meta-analysis, clinical guidelines, and basic science. The content of these articles also fell into several categories, including classification criteria, evaluation of drug therapy, disease activity evaluation, pathogenesis, risk factor, and description of epidemiology.

Articles focused on clinical guidelines revealed rheumatoid arthritis classification criteria, management recommendations with different drug types, advice on evaluating disease activity pre- and post-treatment, and cardiovascular risk management. The review did have some limitations, investigators said. The analysis was limited to articles pulled from Web of Science, and no studies published in non-English languages were included.

In addition, self-citations were not taken into consideration. Although this article examines the growth of rheumatoid arthritis publications over the past 30 years, researchers said, it likely does not cite all of the most influential articles. The American Rheumatism Association revised criteria for the classification of rheumatoid arthritis 2. Modified disease activity scores that include joint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritis 3.

Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patietns with rheumatoid arthritis 4. Infliximab and methotrexate in the treatment of rheumatoid arthritis 5. Gastrointestinal toxicity with celecoxib vs.

American College of Rheumatology. Although supervised, the PhD trainee is expected to develop their research in a more original and independent manner than for MDs. After completing the PhD they should be able to plan future research effectively and be in a position to obtain further grant funding.

As with MD projects, the success of a PhD training programme depends on the personality, ability and commitment of the individual, as well as that of the supervisor and others in the research institution or elsewhere, who act as collaborators and advisors. These factors are usually more important than the details of the research project. The problems often lie in the difficulty of deciding whether 3 yr dedicated research in a fairly specialized area is what the trainee wants and needs for their future career, and whether the trainee is going to be suitable for the research work and training.

The amount of research experience prior to a planned PhD is often very limited and neither the trainee nor the trainer may be sure at the outset. Moving between a PhD and MD, or vice versa, has become increasingly difficult, although some universities require a qualifying MPhil short research thesis at the end of the first year before allowing someone to register for a PhD, as a way of ensuring that they have the relevant skills. The timing of the PhD in the career structure is debatable but may be critical for the individual see below.

This is sufficient to maintain clinical skills and may allow some exposure to different types of clinical practice than the trainee has experienced previously. This may promote increased awareness of the important questions in clinical medicine that require integration of basic and clinical science to answer. This is a more structured postgraduate degree with less emphasis on doing research. The courses are very variable, some generic to a variety of medical specialities and some more specific for rheumatology.

The courses are often modular, allowing some choice of subject matter, and include formal teaching and some independent course work for the trainees. This may include short research projects or dissertations. MSc courses are often undertaken part-time and are usually equivalent to a 1 yr postgraduate degree course. The emphasis of many of the MSc courses is to provide some background in research methodology and application of statistics, as well as more traditional topic teaching in specific diseases or the provision of health services.

Some are designed to supplement the new Calman training schemes and others are more for doctors from abroad than for British graduates.

Many have been set up recently as the new Calman training schemes for rheumatology have not included time for research thesis work MD or PhD , and it appears that many future rheumatologists will have gone from general medical training at senior house officer SHO level, to rheumatology specialist registrar SpR posts and then consultant posts without obtaining any postgraduate degrees.

The value of the MSc schemes is very debatable and has yet to be evaluated not that formal evaluation of MD or PhD training has been undertaken, and there is known to be considerable variation in the quantity and quality of both as there are no standards.

This has been proposed for PhDs only, particularly for candidates who look like potential high-flying academics of the future. Most universities operate a system of combined BSc with medical studies for selected candidates all at Oxford and Cambridge and this is used to provide some introduction to more detailed study and research than a normal medical degree provides.

Some universities offer a PhD place to those that do well in their BSc but some have now introduced PhD research programmes directly into the medical undergraduate course for selected individuals. Early introduction to detailed research study: 1. Individuals at this stage have too little experience to know what subject they will want to study long term and whether a PhD will be of any use to them in a medical career and the value of a PhD in a different subject to that studied later is debatable.

Without at least a BSc or equivalent first it may be very hard to tell if they are really suitable for this training, are likely to enjoy it and will put in the necessary commitment to make it a success in the short and long term. Even if they do well, they then have to go back to general medical training. There is a risk that either they will not complete undergraduate or postgraduate medical training, or they will not come back to research. This applies equally to MD or PhD funded by a fellowship grant or departmental funds as in the past and could be a time for a full-time MSc, if funding was available but this is unlikely so savings would have to be used or a fellowship obtained for study abroad.

The individual is likely to have decided what branch of medicine interests them, thus to become involved in research at this stage may be very rewarding after a lot of general training. This is similar to the old tradition of doing an MD before a senior registrar post. The individuals may still not be clear about what subject will interest them for long-term study.

Importantly, they will not know what the really interesting and important topics to study are, or who would be best to work with, in order to get the most out of the research training. This applies to MD and PhD studies predominantly. After a PhD or MD at this stage, there is still a need to complete SpR training in the chosen speciality if the individuals want to continue with clinical work.

It is hard to combine continued research at postdoctoral level with clinical training, although attempts are being made to facilitate this in some places. However, both activities may suffer from not being done full-time.

It is very difficult to obtain research funding if you are not fully active in research, although the recently introduced clinician scientist schemes are designed to help these individuals continue their academic careers at this stage or, more likely, on completion of Calman training. It can be difficult to do general medical on-call at SpR level after a period of time out of medicine, but this is now frequently required in the first year of rheumatology SpR training.

Trainees have more experience and can decide better what to study, who with, and can contribute to initial discussions on how to study the subject of interest. They are also more likely to get funding at this stage as a result, and are more likely to be sufficiently committed to the subject to put in the time required to do it and be successful.

Individuals are more likely to remain active in the field and therefore to continue to get grant funding as required in the future particularly relevant to individuals who obtain a PhD and wish to continue in academic posts.

SpR training still has to be completed with the above problems for clinical and research activities in general, worse the earlier in the training programme the research is done, with the exception of medical on-call if that is no longer required on return to the SpR scheme in rheumatology—the problem will persist if dual accreditation in medicine and rheumatology is sought, but this is unusual in academic rheumatologists.

Two or 3 yr out of a clinical training programme may cause problems with rotations, and return to an individual's original scheme may not be guaranteed. This option avoids problems with remaining active in research while finishing clinical training. The individual should have less problems obtaining further research funds after completion of the research degree, providing that the project goes well and results in publications. Individuals might find this a useful way of filling in time while waiting for a consultant post and the research should enhance their CV.

The question of whether or not to continue with research, and how much, in the future is left open and may depend on the post finally obtained. The post sought by an individual may itself depend on the research experience obtained. As individuals will have the most background in the subject by this stage, they should be able to get the most out of the research opportunity.

This option will reduce clinical work experience immediately prior to taking up consultant responsibilities which might be seen as a disadvantage by some.