Background Structured rheumatology training and curriculum exists in G8 countries including UK and Canada 1.Trainees from various countries may immigrate to these countries because of socio-economic reasons or better job opportunities. This study has compared current rheumatology training between UK and Canada.
Objectives 1. To compare the rheumatology training in UK and Canada.
2. To identify the strength and weakness of training curriculum in these two countries.
Methods After piloting a survey of 39 questions and redesigning the questionnaire, electronic circulation was sent to the rheumatology trainees via the training programme directors in UK and the Canadian Rheumatology Association in Canada. Our survey was directed to explore different aspects of rheumatology training including curriculum content, training facilities, research opportunities and job prospects. The results were analysed using Smart survey®
Results Total respondents were n=62 including 16% (40/240) of UK trainees and 44% (22/50) of Canadian trainees, with a female predominance (64% of respondents). 63% of UK respondents were enrolled in 5 year combined training in rheumatology and internal medicine (IM). Canadian trainees had 3 years of mandatory training in IM followed by 2 years in rheumatology. A national training curriculum designed by JRCPTB is followed in UK, whereas multiple curricula exist across various training sites in Canada.
Trainees from both countries had regular weekly teaching.UK trainees had more regular supervised training for large joint, small joint and soft tissue injections. Musculoskeletal ultrasound (US) training was available in 52% of respondents in Canada compared to 36% in UK.
Trainees from both countries had comparable experience with combined and speciality clinics, whereas Canadian trainees had more exposure to immunology and sports medicine (the latter as an elective rotation). Completion of training in Paediatric rheumatology is strongly recommended in Canada. Training for generic skills including leadership and management was mandatory in UK, whereas Canadian trainees had Royal College evaluations for competencies including advocate, manager, scholar and professional.
More than 75% trainees from both countries were involved in research projects. However only 28% of UK and 4% of Canadian trainees were enrolled for research degrees eg masters, or PhD. In UK Speciality Certificate Examination is mandatory before training completion.In Canada,although successful completion of rheumatology exams are expected, candidates with successful oral and written IM certification exams are allowed to review rheumatology patients
UK trainees (73%) believed it could be difficult to obtain a consultant job. Although academic consultant jobs are available at most medical schools in Canada, 80% of Canadian trainees believed it is easier to obtain community employment in rheumatology.
– This is the first study comparing rheumatology training in UK and Canada.
– UK training is more structured with a clear national curriculum,whereas multiple training curricula exist in Canada.
– Canadian trainees have more exposure to ultrasound,speciality and combined subspeciality clinics. Employment opportunity was felt to be better in Canada.
Speciality training curriculum for rheumatology. August 2010. Joint Royal College of Physicians Training Board.
Disclosure of Interest None declared