Many roles for this tool have been suggested, ranging from delivering a self-study tool for IM housestaff to providing a structure for a guided tutorial led by rheumatology faculty or fellows in a small-group learning environment. The hope is that Rheum2Learn can provide a platform for teaching IM residents during the short exposure they have while rotating on a rheumatology elective, and it can be implemented outside of the rheumatology rotation to provide a useful resource throughout the remainder of the IM training period. Importantly, it will be valuable to track the use of the tool and to develop a method for assessing outcomes from its implementation. One such outcome measure might include IM resident performance on the medicine in-service examination.
Rheumatologists have a narrow window of time during which to expose IM house staff to the evaluation of the patient with rheumatic disease, including demonstrating the key portions of the history, the nuances of the physical exam, the breadth of the differential diagnosis, the efficient use of resources to evaluate the differential diagnostic considerations, and the selection of medications, with awareness demonstrated of potential adverse effects. Lack of study time during a rheumatology elective, or even exposure to a rheumatologist during a three-year IM residency, can make learning rheumatology during a single specified period challenging. Thus, the provision of a structured and interactive tool, easily accessible for self-study or more formalized teaching, should enhance rheumatology learning during IM residency training.
Increased education in training will have many obvious positive results. We recognize the shortfalls of the rheumatology workforce, the needs for recruitment of more capable physicians into our field, and the link of possible solutions to our needs with improved IM residency education in rheumatology. In addition to the goal of increasing the passion for internists seeking subspecialty training, we hope to fill the room to learn more rheumatology!
Dr. Bolster is associate physician and director of the rheumatology fellowship training program at Massachusetts General Hospital in Boston.
