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Alunno A, Avcin T, Haines C, Ramiro S, Sivera F, Badreh S, Baraliakos X, Bijlsma JWJ, Buttgereit F, Chaudhuri K, Da Silva JAP, Dudler J, Ferreira RJO, Gudu T, Hachulla E, Holland-Fischer M, Iagnocco A, Kragstrup TW, Nagy G, Romão VC, Stones SR, van Onna M, Edwards CJ. Points to consider: EULAR-UEMS standards for the training of European rheumatologists. Ann Rheum Dis 2023; 82:1107-1113. [PMID: 37188497 DOI: 10.1136/ard-2023-223941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
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.
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Affiliation(s)
- Alessia Alunno
- Internal Medicine and Nephrology Division, Department of Clinical Medicine Life Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Tadej Avcin
- Unit of Allergy, Rheumatology and Clinical Immunology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | - Catherine Haines
- Education Committee, EULAR, Zurich, Switzerland
- Clinical Education, King's College London, London, UK
| | - Sofia Ramiro
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
| | - Francisca Sivera
- Faculty of Medicine, Miguel Hernandez University of Elche, Sant Joan D'Alacant, Spain
- Rheumatology, Hospital General Universitario Elda, Elda, Spain
| | - Sara Badreh
- EULAR Patient Research Partner, Stockholm, Sweden
| | | | - Johannes W J Bijlsma
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank Buttgereit
- Department of Rheumatology and Immunology, Charité University, Berlin, Germany
| | - Kaushik Chaudhuri
- Rheumatology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Jose A P Da Silva
- Reumatologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Jean Dudler
- Service de Rhumatologie, Médecine Physique et Rééducation, HFR Fribourg, Hôpital Cantonal, Fribourg, Switzerland
| | - Ricardo J O Ferreira
- Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Health Sciences Research Unit, Nursing School of Coimbra, Coimbra, Portugal
| | - Tania Gudu
- Rheumatology, Sf Maria Hospital, Universitatea de Medicina si Farmacie Carol Davila, Bucuresti, Romania
| | - Eric Hachulla
- Internal Medicine, Univ. Lille & Lille Inflammation Research International Center, Hôpital Claude Huriez, Lille, France
| | | | - Annamaria Iagnocco
- Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy
| | - Tue Wenzel Kragstrup
- Department of Biomedicine, Aarhus University, Aarhus C, Denmark
- Department of Rheumatology, Aarhus Universitetshospital, Aarhus, Denmark
| | - György Nagy
- Immunology and Medicine, Semmelweis University Medical School, Budapest, Hungary
| | - Vasco C Romão
- Rheumatology Research Unit, Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisbon, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | | | - Marloes van Onna
- Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Christopher J Edwards
- Musculoskeletal Research Unit, NIHR Southampton Clinical Research Facility, University Hospital Southampton, Southampton, UK
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Díez J, Ortiz A. The need for a cardionephrology subspecialty. Clin Kidney J 2021; 14:1491-1494. [PMID: 34276973 PMCID: PMC8280941 DOI: 10.1093/ckj/sfab054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 12/11/2022] Open
Abstract
Chronic kidney disease (CKD) has structural and functional repercussions for the cardiovascular system that facilitate the development of cardiovascular disease (CVD). In fact, cardiovascular complications are frequent in the CKD population and thus cause a great clinical, public health and economic burden. Despite this challenge, the prevention and management of cardiovascular complications is one among several aspects of CKD that meets the criteria of an unmet medical need. This probably has to do with the misperception by the nephrologist of the global relevance of CVD in the CKD patient which, in turn, may be due to insufficient cardiovascular training during nephrology specialization. Therefore a change in approach is necessary to understand CKD as a disease in which the manifestations and complications related to CVD become so frequent and important that they require dedicated multidisciplinary clinical management. From this perspective, it makes sense to consider training in the subspecialty of cardionephrology to provide adequate cardiovascular care for CKD patients by the nephrologist. In addition, the cardionephrology subspecialist would be better able to interact with other specialists in multidisciplinary care settings created to achieve a deeper understanding and more effective clinical handling of the interactions between CKD and CVD.
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Affiliation(s)
- Javier Díez
- Departments of Nephrology and Cardiology, University of Navarra Clinic, Pamplona, Spain.,Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Pamplona, Spain
| | - Alberto Ortiz
- Red de Investigación Renal, Madrid, Spain.,Division of Nephrology IIS-Fundación Jiménez Díaz, University Autonoma of Madrid, Madrid, Spain
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