Rheumatology is the subspecialty of internal medicine that focuses on the diagnosis and treatment of medical diseases of the joints, muscles, and connective tissues. Although traditionally thought of as dealing primarily with joint diseases such as arthritis, physicians trained in rheumatology (“rheumatologists”) possess expertise in evaluating and managing a wide spectrum of disorders related to the musculoskeletal system, including systemic inflammatory and autoimmune diseases that may also involve other organ systems. Although many musculoskeletal and related soft tissue diseases are treated by general internists and other specialty physicians, rheumatologists are frequently called upon to help in diagnosing and managing more complex and systemic disease.
Examples of conditions cared for by rheumatologists include rheumatoid arthritis, osteoarthritis, crystalline diseases (such as gout), the spondyloarthropathies, vasculitis (such as giant cell arteritis or polyarteritis nodosa), polymyalgia rheumatica, systemic lupus erythematosus, inflammatory muscle diseases (such as polymyositis and dermatomyositis), systemic sclerosis (scleroderma), Sjögren disease, polychondritis, osteoporosis, fibromyalgia, and common musculoskeletal and sports injuries.
There are many different models of rheumatology practice. Rheumatologists may have their own practice, seeing patients in consultation for other physicians and longitudinally for management of their rheumatic disease. Rheumatologists also frequently serve as hospital consultants for patients admitted with rheumatological disorders. Some rheumatologists maintain practices seeing a mix of patients with rheumatological issues and those with general medical problems. In academic settings, rheumatologists provide consultative and ongoing care in ambulatory and inpatient settings, perform basic science and clinical research in rheumatological diseases, and teach medical students and residents.
Fellowship training in rheumatology is two years following completion of a three year basic internal medicine residency. Following completion of a rheumatology fellowship, board certification is available through the American Board of Internal Medicine.
Dual certification in both rheumatology and allergy and immunology is also available and requires a minimum of three years of training beyond the three year basic internal medicine residency. Completion of this combined fellowship allows for board certification in both rheumatology and allergy and immunology.
In the 2018-2019 academic year, there are 119 Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs in rheumatology with 486 trainees. There are 36 ACGME-accredited combined training programs in pediatric rheumatology with 90 trainees.
Major Professional Society
- American College of Rheumatology
- American College of Allergy, Asthma, & Immunology
Back to the October 2018 issue of ACP IMpact