Points to consider: EULAR-UEMS standards for the training of European rheumatologists.

BACKGROUND: Postgraduate rheumatology training programmes are already established at a national level in most European countries. However, previous work has highlighted a substantial level of heterogeneity in the organisation and, in part, content of programmes. OBJECTIVE: To define competences and standards of knowledge, skills and professional behaviours required for the training of rheumatologists. METHODS: A European Alliance of Associations for Rheumatology (EULAR) task force (TF) of 23 experts, including two members of the European Union of Medical Specialists (UEMS) section of rheumatology, was convened. The mapping phase consisted of the retrieval of key documents on specialty training in rheumatology and other related specialties across a broad set of international sources. The content of these documents was extracted and represented the foundation for the document draft that underwent several rounds of online discussion within the TF, and afterwards was also distributed to a broad group of stakeholders for collecting feedback. The list of generated competences was voted on during the TF meetings, while the level of agreement (LoA) with each statement was established by anonymous online voting. RESULTS: A total of 132 international training curricula were retrieved and extracted. In addition to the TF members, 253 stakeholders commented and voted on the competences through an online anonymous survey. The TF developed (1) an overarching framework indicating the areas that should be addressed during training, (2) 7 domains defining broad areas that rheumatology trainees should master by the end of the training programme, (3) 8 core themes defining the nuances of each domain and (4) 28 competences that trainees should acquire to cover each of the areas outlined in the overarching framework. A high LoA was achieved for all competences. CONCLUSION: These points to consider for EULAR-UEMS standards for the training of European rheumatologists are now defined. Their dissemination and use can hopefully contribute to harmonising training across European countries.

Capacity building for the provision of rheumatological services in sub-Saharan Africa.

INTRODUCTION: A project aimed to develop and deliver a clinical training course in Accra, Ghana, to increase patient access to physicians trained in the diagnosis, treatment and management of rheumatological conditions. METHODS: We started with a scoping exercise followed by collaborative course curriculum development, co-delivered training course facilitated by both locally based rheumatologists and international faculty members. Evaluation data gathered from application forms, participant feedback forms and multiple-choice tests completed at the beginning and end of training and the test scores compared to evaluate a change in knowledge. RESULTS: A 4-day clinical training course developed and delivered to twenty medical professionals based across Ghana. Test scores suggest a 15.83% increase in clinical knowledge. CONCLUSIONS: The training model with the curriculum design and delivery teams drawing expertise from both locally based rheumatologists and internationally based faculty has guaranteed both world-class approach and content while ensuring contextual relevance. The inclusion of leadership and Training of Trainer (ToT) elements into the model of training has maximised reach and increased teaching capacity. The programme has been well-received by participating medical professionals and faculty and has been demonstrated to be effective within this multinational programme and the methodology may be applicable to similar needs in other countries. Key Points • The growing burden of musculoskeletal disease in West Africa means that strengthening capacity in the specialty of rheumatology is more important than ever. • A pilot workshop to strengthen capacity in rheumatology care in Ghana with the curriculum design and delivery teams drawing expertise from both the UK and West Africa has guaranteed both world-class approach and content while ensuring contextual relevance. • The programme has been well-received by participating medical professionals and faculty and may be applicable to similar needs in other countries across sub-Saharan Africa.