Skills and attitudes of medical registrars towards patients with rheumatic diseases – a cross-sectional study from a tertiary center


Dr Anuelmagd Abdalla Prof. Douglas Veale


St. Vincent's University Hospital - Dublin


Musculoskeletal diseases are a leading cause of disability worldwide and make up to 20% of GP visits. A pilot study in the west of Ireland indicated a prevalence of 40% of rheumatic or musculoskeletal diseases among acutely admitted medical patients. Lack of adequate rheumatology exposure had been cited as the main factor for low skill level among internal medicine and GP trainees


This study aims to identify skill levels and core generic skills gaps for common conditions and therapeutics in rheumatology among a heterogenous group of medical registrars training in various medical specialties at a tertiary center.


Online survey format was sent to all medical registrars in SVUH for a period of 1 month during Oct 2018. Rheumatology specialist registrars were assigned as a control group in order to provide a reference for the skill level. Consent was gained by all participants upon voluntary inclusion


The survey comprised 23 questions with an average completion time of 2 mins at a response rate of 50% by medical registrars and 70% by rheumatology registrars/ SpRs. Total of 19 medical registrars & 17 rheumatology SpR participated. See table 1 for demographics and self-reported skill levels. The questions covered common areas such as dealing with a flare of RA, SLE, Gout or dealing with anti-TNF drugs during acute illness or starting crucial treatment out of hours when no rheumatology cover available.


The study identified poor rheumatology skill level among senior medical trainees due to lack of post-grad experience/ exposure. Rheumatology currently is not regarded as a key specialty for basic training by RCPI. As the prevalence of rheumatic diseases such as osteoarthritis and gout is expected to increase given the changing demographics, next-generation physicians are likely to encounter more populations with such conditions or on newer immunomodulatory therapies, therefore a period of training in rheumatology needs to be encouraged