What steps it is taking to support rheumatic and musculoskeletal disease specific training for medical students at (a) undergraduate and (b…

The Scottish Government is funding record numbers of undergraduate medical places and postgraduate training posts in Scotland, as well as providing the resources that NHS Education for Scotland(NES), Health Boards and GP practices require to deliver medical education and training in Scotland.
Rheumatic and musculoskeletal disease is a core part of the undergraduate teaching curriculum taught by each of the Scottish Medical Schools. In all the teaching programmes, the teaching and clinical experience of Rheumatic and musculoskeletal disease spirals throughout the curriculum; it is revisited across multiple years with the relevant underpinning science, clinical experience and multiple points of assessment.
Postgraduate medical training comprises 2 or 3 distinct phases of training; each phase has its own curriculum and learning outcomes. For those pursuing training towards being a General Practitioner the 2 phases are Foundation training (2 year programme) and GP Specialty Training (typically a 3 year programme). For those training to be physicians there are 3 phases – Foundation Training (2 year programme), Core Medical Training (2 year programme) and Higher Medical Training (typically 5 years’ duration and covering dual training combining a specialty with training in General Medicine); some physicians will train specifically in Rheumatology as one of the dual Higher Training specialties.
Foundation training is designed to be generic and to achieve competence to meet curricular outcomes across 20 professional capabilities for all entering postgraduate medical training in Scotland and the UK; examples of these capabilities are the ability to recognise, assess and manage patients with long-term conditions, how to take a history and examine a patient and formulate a differential diagnosis. The expectation is that the generic capabilities apply across disease areas including rheumatological and musculoskeletal conditions. Foundation trainees are placed in GP practices in Foundation Year 2.
General Practice Specialty Training (GPST) is based on the Royal College of Practitioners (RCGP) curriculum which is approved by the GMC. Rheumatology awareness training is covered in the Curriculum Statement 3.20 Care of People with Musculoskeletal Problems. NES also supports Continuous Professional Development (CPD) activities for all GPs through a variety of means. Specific educational support of GPs to improve their awareness of rheumatology includes (a) Practice Based Small Group Learning (PBSGL) modules and (b) Taught courses on arthritis (along with Arthritis Care Scotland), joint injections and musculoskeletal medicine.
Core Medical Training ensures trainees gain competence in describing and eliciting the examination features of musculoskeletal disease, recognise when specialist rheumatology opinion is indicated, outline the indications, contraindications and side effects of major immunosuppressive drugs including corticosteroids, recognise the need for long-term review in many cases of rheumatological disease and their treatments, recognise the importance of a multidisciplinary approach and use national and local guidelines appropriately.
The GMC-approved Higher Medical Training curriculum develops competences around recognition, assessment, diagnosis and management including therapeutics and multidisciplinary team working around themes such as ‘back pain’, joint pain’ and musculoskeletal diseases with requirements specifically in relation to a list of conditions.