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Differences and similarities in rheumatology specialty training programmes across European countries
  1. Francisca Sivera1,
  2. Sofia Ramiro2,3,
  3. Nada Cikes4,
  4. Maxime Dougados5,
  5. Laure Gossec6,7,
  6. Tore K Kvien8,
  7. Ingrid E Lundberg9,
  8. Peter Mandl10,
  9. Arumugam Moorthy11,
  10. Sonia Panchal11,
  11. José A P da Silva12,
  12. Johannes W Bijlsma1,13
  13. on behalf of the Working Group on Training in Rheumatology across Europe
    1. 1Rheumatology Department, Hospital General Universitario de Elda, Elda, Spain
    2. 2Amsterdam Rheumatology Center, Amsterdam, the Netherlands
    3. 3Hospital Garcia de Orta, Almada, Portugal
    4. 4University Hospital Centre Zagreb, Zagreb, Croatia
    5. 5Department of Rheumatology, Université Paris Descartes University, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris; INSERM (U1153); Epidemiologie Clinique et Biostatistiques, PRES Sorbonne Paris-Cité, Paris, France
    6. 6UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, Paris, France
    7. 7Department of Rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France
    8. 8Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
    9. 9Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institute, Stockholm, Sweden
    10. 10University of Vienna, Vienna, Austria
    11. 11University Hospitals of Leicester NHS Trust, Leicester, UK
    12. 12Centro Hospitalar e Universitário de Coimbra, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
    13. 13University Medical Center Utrecht, Utrecht, the Netherlands
    1. Correspondence to Dr Francisca Sivera, Rheumatology Department, Hospital General Universitario de Elda, ctra Sax s/n, Elda 03600, Spain; fransimas{at}


    Objectives To analyse the similarities and discrepancies between the official rheumatology specialty training programmes across Europe.

    Methods A steering committee defined the main aspects of training to be assessed. In 2013, the rheumatology official training programmes were reviewed for each of the European League Against Rheumatism (EULAR) countries and two local physicians independently extracted data on the structure of training, included competencies and assessments performed. Analyses were descriptive.

    Results 41 of the 45 EULAR countries currently provide specialist training in rheumatology; in the remaining four rheumatologists are trained abroad. 36 (88%) had a single national curriculum, one country had two national curricula and four had only local or university-specific curricula. The mean length of training programmes in rheumatology was 45 (SD 19) months, ranging between 3 and 72 months. General internal medicine training was mandatory in 40 (98%) countries, and was performed prior to and/or during the rheumatology training programme (mean length: 33 (19) months). 33 (80%) countries had a formal final examination.

    Conclusions Most European countries provide training in rheumatology, but the length, structure, contents and assessments of these training programmes are quite heterogeneous. In order to promote excellence in standards of care and to support physicians’ mobility, a certain degree of harmonisation should be encouraged.

    • Health services research
    • Qualitative research
    • Epidemiology

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