Background Rheumatological disorders are very common in primary¹ and secondary care.² Each year, 20% of the general population consult their General Practitioner (GP) due to a musculoskeletal problem.³ With demands on musculoskeletal service likely to rise further, there is a growing concern that new doctors of tomorrow may not be equipped with necessary competencies to deal with this burden.^{4, 5}

Objectives To explore the effectiveness of rheumatology departmental induction training. To explore the confidence of post-graduate trainees in assessing and managing patients with rheumatological conditions. To evaluate the confidence of post-graduate trainees to do knee aspiration and injection. To explore the satisfaction of post-graduate trainees and trainers with various teaching activities in the department. To make recommendation for further improvement of the quality of on-the-job teaching of junior doctors posted in the department of rheumatology.

Methods An online questionnaire survey was administered to all current and previous four years’ rheumatology trainees. Subsequently trainees were interviewed divided in to two focus groups for Specialty Trainees and non-specialist (General Practice and Foundation Year 2) trainees. Consultants, Allied Health Professionals and nurses were also interviewed divided in to two focus groups. The data from questionnaire survey and qualitative data from focus group interviews was then analysed and collated.

Results Induction was suboptimal with only two-thirds of trainees rating its quality as excellent or good. Most trainees were confident in the assessment and management of rheumatological conditions but felt less confident in prescribing rheumatological drugs. Most trainees were confident in performing knee injection and aspiration. The trainees were satisfied with educational and clinical supervision, learning environment and availability of training opportunities. However both trainees and trainers were dissatisfied with inadequate formal teaching and underutilisation of specialty and multidisciplinary clinics. Rota gaps and excessive workload were thought to be the main barriers.

Conclusions In a climate of increasing service demands, limited time and manpower shortage, training junior doctors effectively has become more challenging. An effective induction, supportive learning environment, structured training with incorporated formal teaching would help optimise the learning opportunities.

References [1] Arthritis Research UK National Primary Care Centre, Keele University. Musculoskeletal Matters: what do general practitioners see? Bulletin 1, October 2009. www.keele.ac.uk/media/keeleuniversity/ri/primarycare/bulletins/MusculoskeletalMatters1.pdf

[2] General Medical Council (2016). Promoting excellence: standards for medical education and training. www.gmc-uk.org/education/standards.asp (accessed 31 Oct 2017).

[3] Creswell JW, Plano Clark, VL. Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage, 2007.

[4] Braun, V. & Clarke, V. Using thematic analysis in psychology. Qualitative Research in Psychology 2006;3(2): 77–101.

[5] Dubey SG, Roberts C, Adebajo AO, Snaith ML (2004). Rheumatology training in the United Kingdom: the trainees’ perspective. Rheumatology;43:896–900

[6] General Medical Council. National Training Surveys. 2017 National training survey results live reporting tool. October 2017. https://webcache.gmc-uk.org/analyticsrep/saw.dll?Dashboard. (accessed 31 Oct 2017).

[7] General Medical Council National Training Survey. 2017 http://www.gmc-uk.org/education/surveys.asp https://webcache.gmc-uk.org/analyticsrep/saw.dll?Dashboard (accessed 31 Oct 2017).

Disclosure of Interest None declared