Harmonizing rheumatology training across Europe

Postgraduate rheumatology training programs define the knowledge, skills, and behaviors needed for physicians to become specialists in rheumatology. In some countries there is a standardized approach, but in others the program content and delivery can vary between different regions and training providers. There are also differences between countries. Since specialists frequently move and work internationally, there is a need for a European standard that defines key aspects.

The new EULAR points-to-consider were developed by a multidisciplinary task force of 23 health professionals and patient representatives from EULAR and UEMS, and completed in line with EULAR standardized operating procedures. The group looked at 132 different training courses to see where there were similarities and differences, and used these to develop suggestions for a common set of expected knowledge, skills, and behaviors for trainee rheumatologists.

The paper—published in the Annals of the Rheumatic Diseases—is split into three key areas. First, an overarching framework lays out the need for medical expertise as the main goal and foundation of any training program. This is followed by 28 competencies split across seven domains. The domains define broad areas that rheumatology trainees should master, from basic activities such as how to physically examine a patient in a routine examination to dealing with medical emergencies.

The competencies also include diagnosis and management of individual rheumatic diseases, plus specific situations and patient characteristics that may affect management, such as pregnancy or the presence of comorbidities. The paper also sets out the need for training in how to establish relationships with both patients and colleagues, with the aim of fostering effective communication and interdisciplinary cooperation.

Finally, the last domain includes research and training—both for an individual's ongoing learning plan and continuing medical education throughout their career, and to ensure that they can critically appraise research and share relevant knowledge with patients and colleagues.

EULAR and the UEMS hope that these new points will contribute to harmonizing training across Europe, and ultimately to a common level of knowledge, skills, and professional behaviors for the next generation of rheumatologists.