I agree with Hosie1 that each group in primary care “has different needs at different times and educational activities must be sufficiently flexible to deliver what is needed at the appropriate time.”

Over the past decade I have been teaching rheumatology to trainees in general practice in a district general hospital and over the past four years in a teaching hospital in the east end of London.

Trainees find it more useful if musculoskeletal problems are discussed by region as they present in real life rather than as individual diseases. For example, the differential diagnosis of pain in the elbow includes medial and lateral epicondylitis, olecranon bursitis (traumatic, inflammatory, or crystal induced, but is not to be confused with tophi, …