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Points to consider: EULAR–UEMS standards for the training of European rheumatologists
  1. Alessia Alunno1,
  2. Tadej Avcin2,
  3. Catherine Haines3,4,
  4. Sofia Ramiro5,6,
  5. Francisca Sivera7,8,
  6. Sara Badreh9,
  7. Xenofon Baraliakos10,
  8. Johannes W J Bijlsma11,
  9. Frank Buttgereit12,
  10. Kaushik Chaudhuri13,
  11. Jose A P Da Silva14,
  12. Jean Dudler15,
  13. Ricardo J O Ferreira16,17,
  14. Tania Gudu18,
  15. Eric Hachulla19,
  16. Mette Holland-Fischer20,
  17. Annamaria Iagnocco21,
  18. Tue Wenzel Kragstrup22,23,
  19. György Nagy24,
  20. Vasco C Romão25,26,
  21. Simon R Stones27,
  22. Marloes van Onna28,
  23. Christopher J Edwards29
  1. 1 Internal Medicine and Nephrology Division, Department of Clinical Medicine Life Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
  2. 2 Unit of Allergy, Rheumatology and Clinical Immunology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
  3. 3 Education Committee, EULAR, Zurich, Switzerland
  4. 4 Clinical Education, King's College London, London, UK
  5. 5 Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  6. 6 Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
  7. 7 Faculty of Medicine, Miguel Hernandez University of Elche, Sant Joan D'Alacant, Spain
  8. 8 Rheumatology, Hospital General Universitario Elda, Elda, Spain
  9. 9 EULAR Patient Research Partner, Stockholm, Sweden
  10. 10 Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
  11. 11 Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
  12. 12 Department of Rheumatology and Immunology, Charité University, Berlin, Germany
  13. 13 Rheumatology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
  14. 14 Reumatologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  15. 15 Service de Rhumatologie, Médecine Physique et Rééducation, HFR Fribourg, Hôpital Cantonal, Fribourg, Switzerland
  16. 16 Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  17. 17 Health Sciences Research Unit, Nursing School of Coimbra, Coimbra, Portugal
  18. 18 Rheumatology, Sf Maria Hospital, Universitatea de Medicina si Farmacie Carol Davila, Bucuresti, Romania
  19. 19 Internal Medicine, Univ. Lille & Lille Inflammation Research International Center, Hôpital Claude Huriez, Lille, France
  20. 20 Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
  21. 21 Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy
  22. 22 Department of Biomedicine, Aarhus University, Aarhus C, Denmark
  23. 23 Department of Rheumatology, Aarhus Universitetshospital, Aarhus, Denmark
  24. 24 Immunology and Medicine, Semmelweis University Medical School, Budapest, Hungary
  25. 25 Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
  26. 26 Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
  27. 27 PARE, EULAR Patient Research Partner, Manchester, UK
  28. 28 Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
  29. 29 Musculoskeletal Research Unit, NIHR Southampton Clinical Research Facility, University Hospital Southampton, Southampton, UK
  1. Correspondence to Professor Christopher J Edwards, Musculoskeletal Research Unit, NIHR Southampton Clinical Rsearch Facility, University Hospital Southampton, Southampton, UK; cedwards{at}


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.

  • outcome and process assessment, health care
  • patient care team
  • qualitative research

Data availability statement

Data sharing is not applicable as no datasets are generated and/or analysed for this study.

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Data availability statement

Data sharing is not applicable as no datasets are generated and/or analysed for this study.

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  • Handling editor Josef S Smolen

  • Twitter @sofiaramiro82, @FranciscaSivera, @FerreiraRJO, @KragstrupTW

  • Contributors All authors contributed to this work and approved the final version of the manuscript. CJE acts as guarantor and is responsible for the overall content.

  • Funding The project was funded by the European Alliance of Associations for Rheumatology (grant number EDU049).

  • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient and public involvement Patients and the public were involved in the design, conduct, reporting or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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