Rheumatology training in the United Kingdom: the trainees' perspective

Dubey, Shirish; Roberts, Chris; Adebajo, Adewale; Snaith, M. L.

doi:10.1093/rheumatology/keh192

Cited by 22 publications

(12 citation statements)

References 16 publications

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“…There were fewer doing so compared to two previous surveys where 43% had listed academic activity in 2006 and 34% in 2002. 5,7 These figures, however, were similar to those collected from the eighth RCP annual survey of all % Ͼ registrars, where 25% considered themselves currently in academic training. 8 However, there have been longstanding concerns about the falling number of academic trainees in all specialties due to a combination of the pressures of producing internationally competitive research, the difficulty of obtaining long-term funding, and the problem of reconciling academic training with the increased rigour of clinical training programmes.…”

Section: Discussionsupporting

confidence: 65%

“…This compared to response rates of 73% and 67.7% from previous surveys of rheumatology trainees. 5,7 A greater proportion of the respondents were female and more females aimed to accredit in rheumatology alone, but proportionately more male trainees were aiming for dual accreditation in rheumatology and general internal medicine (GIM). Less than half the trainees had either on-call commitments or participated in a dedicated on-call service.…”

Section: Resultsmentioning

confidence: 99%

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Academic training in rheumatology in 2009: a UK trainee survey

et al. 2011

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-Significant changes to the structure and entry into specialist training continue to be implemented. This is likely to have had a long-term impact on rheumatology service provision and the proportion of trainees undertaking academic medicine. An online questionnaire was sent to all trainees on the Joint Royal Colleges Postgraduate Training Board (JRCPTB) database. Out of 211 trainees, 141 responded (66.8%). Of these, 33 (23%) were registered for, or had been awarded, an MD or PhD with a wide variety of funding sources. Mainstream funding sources included Arthritis Research UK, the Medical Research Council, the National Institute for Health Research and the Wellcome Trust, but a substantial number of trainees (n‫؍‬ ‫,71؍‬ 51.5%) also utilised other sources of funding. The data from this study will be valuable in the planning of future rheumatology training and academic career pathways and provide useful comparative data for other medical specialties.

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Section: Discussionsupporting

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Academic training in rheumatology in 2009: a UK trainee survey

et al. 2011

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“…Delay in access to care for children with JIA is a major problem, likely a global issue with multifactorial aetiology [1][2][3][4] including poor self-rated confidence in musculoskeletal (MSK) clinical assessment in doctors to whom children may present [5,6] as a result of inadequate paediatric MSK clinical skills teaching at undergraduate and postgraduate level [7][8][9][10][11][12][13][14]. The GALS (Gait, Arms, Legs, Spine) adult MSK screening examination has been taught to medical students throughout the UK and has been shown to improve the assessment of the MSK system in adults with rheumatic disease [15,16].…”

Section: Introductionmentioning

confidence: 99%

Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children

et al. 2011

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The pGALS (paediatric Gait, Arms, Legs, Spine) Musculoskeletal (MSK) screen is validated in English-speaking school-aged children and has been shown to be useful in acute paediatric practice in the UK. The aim of this study is to evaluate the practicality and acceptability of pGALS in children in an acute hospital setting in Malawi. School-aged inpatients and children presenting to the Queen Elizabeth Hospital Blantyre, Malawi, participated. Practicality (time taken, degree of completion) and patient/parent assessed acceptability (time take, discomfort) were assessed using a 'smiley face' visual analogue scale. Fifty-one children (median age 8 years) were assessed; 23 out of 51 (45%) in the emergency department and the remainder were inpatients. Most presentations were infection or trauma related (n = 35, 69%). Practicality of pGALS was good [median time to complete pGALS--4 min (range 1.8-7.4)] and completed in 48 out of 51 children (94%). Acceptability was high; 98% of parents considered the time taken to be acceptable, 84% of children deemed little/no additional discomfort. Abnormalities using pGALS were found in 21 out of 51 (41%), mostly in the lower limbs. The pGALS MSK screen was practical and acceptable in this acute setting. Abnormal findings were common.

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“…Poor clinical skills are a significant barrier to care, with trainees in pediatrics and primary care reporting poor self-confidence in their ability to assess a child's musculoskeletal system (4,16 -19), poor documentation of musculoskeletal assessment (16), and inadequate training in pediatric rheumatology (4,20,21). These observations may be explained by the fact that teaching of musculoskeletal clinical skills involving children is not part of core training in UK medical schools (22), few standard pediatric textbooks describe musculoskeletal clinical examination techniques in children (23), and clinical skills are not reinforced in clinical practice because pediatricians themselves may not have received appropriate training.…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal screening examination (pGALS) for school‐age children based on the adult GALS screen

Foster

Kay

Friswell

et al. 2006

Arthritis & Rheumatism

129

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Objective. To develop and validate a musculoskeletal screening examination applicable to school-age children based on the adult Gait, Arms, Legs, Spine (GALS) screen.Methods. Adult GALS was tested in consecutive school-age children attending pediatric rheumatology clinics and was compared with an examination conducted, on the same day, by a pediatric rheumatologist who classified children as having abnormal or normal joints. Adult GALS was tested for validity compared with the pediatric rheumatologist's assessment and deficiencies in adult GALS were identified. Experts proposed amendments to adult GALS, achieving consensus by modified Delphi techniques. The resultant pediatric screening tool (pGALS) was tested (methodology identical to the testing of adult GALS) in an additional group of children.Results. Adult GALS was tested in 50 children (median age 11 years, range 4 -16), of whom 37 (74%) had juvenile idiopathic arthritis. Adult GALS missed important abnormalities in 18% of children, mostly at the ankle, foot, and temporomandibular joints. The pGALS was tested in 65 children (median age 13 years, range 5-17 years) and demonstrated excellent sensitivity (97-100%) and specificity (98 -100%) at all joints, with high acceptability scored by child and parent/guardian. The median time to perform pGALS was 2 minutes (range 1.5-3 minutes). Conclusion. The pGALS musculoskeletal screening tool has excellent validity, is quick to perform, and is acceptable to school-age children and parents/guardians. We propose that pGALS be incorporated into undergraduate and postgraduate medical training to improve pediatric musculoskeletal clinical skills and facilitate diagnosis and referral to specialists.

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Rheumatology training in the United Kingdom: the trainees' perspective

Cited by 22 publications

References 16 publications

Academic training in rheumatology in 2009: a UK trainee survey

Academic training in rheumatology in 2009: a UK trainee survey

Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children

Musculoskeletal screening examination (pGALS) for school‐age children based on the adult GALS screen

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