AB1354-HPR CURRENT SITUATION OF TRAINING IN RHEUMATOLOGY IN THE POSTGRADUATE CURRICULUMS OF INTERNAL MEDICINE, FAMILY MEDICINE, GERIATRICS, PAIN MEDICINE AND, PHYSICAL AND REHABILITATION MEDICINE ACROSS COLOMBIA
Authors: D. G. Fernández-Ávila, L. Patino, J. Gutiérrez
Journal: Annals of the Rheumatic Diseases (2020)

Background: Rheumatic diseases are an important complaint in patients, although the incidence is low, they cause disability and impact on the health system. Currently, in Colombia, there are 198 rheumatologist, so it’s important to know how is rheumatology training in specialties related to rheumatology, which are the specialties that the patient with a suspected rheumatic disease will visit at first. Objectives: To describe the training status in rheumatology in the postgraduate curriculums of internal medicine, family medicine, geriatrics, pain medicine and, physical and rehabilitation medicine across Colombia. Methods: This is a descriptive cross-sectional study. A survey was applied in each participating medical school using the RedCap® platform. The questionnaire included multiple-choice responses and a textbox to complete. The survey was done to the 29 registered medical schools which offer the specializations already mentioned. The program director or an assistant professor was asked to fill the survey out between April 2019 and January 2020. The sample was described through means and standard deviations or frequency and percentages according to the type of variable. Results: Data was obtained from all the programs of specialization in internal medicine (n = 29), family medicine (n= 9), pain medicine (n= 8), physical and rehabilitation medicine (n= 6), geriatrics (n= 4). All the programs of internal medicine, geriatrics, and physical/rehabilitation medicine have rheumatology as a mandatory subject within the curriculum, while in family medicine and pain medicine programs: 33% (n= 3), and 57% (n= 4) respectively, does not have a rheumatology training. In internal medicine the average duration of rheumatology training is 56 days (28 to 90 days), in geriatrics, it is 56 days (45-60 days), in family medicine 26.1 days (3 to 30), in medicine physical and rehabilitation medicine 35 days (30 to 60) and in pain medicine 40 days (30 to 60). 93.8% (n= 45) of the programs surveyed have a rheumatologist as a teacher in charge of both, the academic activities and the external rheumatology consultation and in the rest of the programs these activities are done by an specialist in internal medicine, family medicine or pain medicine. The theoretical components most frequently offered in seminars or master classes are: rheumatoid arthritis, lupus, vasculitis, spondyloarthritis, gout, osteoarthritis, sjogren’s syndrome and osteoporosis. The specialization programs have an average of 3 rheumatologists as professors (range 1 to 8). 43.8% of the programs use some virtual resources to complement the teaching in rheumatology such as video conferencing in virtual platform or YouTube (8.3%), online course (6.3%), mobile application (16.7%), others such as moodle and webcast platform (12.5%). 92.9% (n = 52) offer their students an elective rotation in the rheumatology service, in addition to the mandatory one. Finally, 89.6% (n = 43) of the interviewees agree with the way in which the curriculum is structured in their programs, to approach initial diagnostic and therapeutic in patients with suspected or established rheumatic disease. However, 23.2% (n = 13) of the professors of the surveyed programs (6 of internal medicine, 4 of family medicine, 2 of pain medicine and 1 of physical/rehabilitation medicine), consider that the rheumatology subject should not be mandatory within their programs. Conclusion: All physicians need to be familiar with rheumatological conditions since the rate of rheumatologists in Colombia is low. Knowing rheumatology is an increasingly important role in a clinical scenario in many postgraduate curriculums as we explain in this study. References: [1]Sivera F, et al; Working Group on Training in Rheumatology across Europe. Differences and similarities in rheumatology specialty training programmes across European countries. Ann Rheum Dis. 2015 Jun;74(6):1183-7 Disclosure of Interests: None declared