P080 BSR national training survey results for rheumatology and GIM dual-accreditation
Authors: Khalid Sameena , Chakravorty Mithun , Godsave Cattleya , Yaqub Shahid , Davies Emma , Rutter Megan , Shabbir Shabnam , Reilly Elizabeth 
Published: April 2021

Background/Aims 

Following the Shape of Training Report, all Rheumatology registrars commencing training from August 2017 are required to obtain dual-accreditation with General Internal Medicine (GIM). Training time increased from 4 to 5 years. Current trainees have expressed concerns regarding the lack of clarity and standardisation of the structure and duration of GIM training, and the impact on Rheumatology experience. Surveys were developed and disseminated by the British Society for Rheumatology (BSR) Trainees' Committee to explore the national GIM experience and expectations of trainees and Training Programme Directors (TPDs).

Methods 

Two surveys were created by trainees, with support from the BSR. Web links were emailed to all UK Rheumatology trainees and TPDs in February 2020, and remained open for three weeks. The surveys covered: Duration of dedicated rheumatology trainingDuration of 'high intensity' GIM training (defined as night shifts with at least 1 in 8 on-calls)Weekly number of GIM clinics and ward roundsGuidance provided to trainees and TPDs on the expected duration and structure of GIM training.

Results 

73 responses were analysed from dual-accrediting trainees across the UK. 73% of trainees expected 1.5-3 years of dedicated rheumatology training however, 12% of trainees did not expect any dedicated rheumatology years. Similarly, the expected duration of ‘high intensity’ GIM training varied widely from up to 1 year (10%) to 2.5-3 years (30%). 37% of trainees expected to do more than 3.5 years of 'high intensity' GIM training.

During a ‘high intensity’ GIM year, 58% of trainees did not do any GIM clinics (some Deaneries count general rheumatology clinics towards GIM), 34% had one GIM clinic and 8% of trainees had three or more GIM clinics per week. Similarly, the number of average weekly GIM ward rounds varied from none (11%) to 3 or more (55%). Only 62% of trainees confirmed they were aware of the number and 'intensity' of GIM years required during their training.

Twelve TPDs completed the survey. 72% of TPDs were able to provide specific guidance on the expected duration and structure of GIM training for ST3 applicants in 2020. Despite this, 83% of TPDs felt that further guidance is required on the length of dedicated rheumatology and GIM training. Free-text comments suggested a move away from describing GIM training as ‘low', 'medium' or 'high intensity’.

Conclusion 

The surveys identified a wide national variation in GIM training structure and duration, and dedicated Rheumatology training for dual-accrediting trainees. This inequality has proved concerning for many trainees. TPDs and trainees felt that further information and standardisation is needed regarding the dedicated time required in Rheumatology and GIM. The results will be discussed at the next Joint Royal College of Physician’s Board (JRCPTB) Specialty Advisory Committee meeting.

Disclosure 

S. Khalid: None. M. Chakravorty: None. C. Godsave: None. S. Yaqub: None. E. Davies: None. M. Rutter: None. S. Shabbir: None. E. Reilly: None.