Kouranloo Koushan, Myall Nikki, Christie Jennifer
Department of Rheumatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
School of Medicine, University of Liverpool, Cedar House, Ashton St., Liverpool, Merseyside, L69 3GE, UK.
Clin Rheumatol. 2025 Feb;44(2):537-545. doi: 10.1007/s10067-024-07297-5. Epub 2025 Jan 8.
Data from the British Society of Rheumatology demonstrate a lack of exposure to rheumatology for medical students, potentially impacting career choice. We conducted a Systematic Literature Review (SLR) on quantity, type and quality of rheumatology teaching for undergraduate medical students. This SLR was registered on PROSPERO (CRD42023472169). Articles published in English-language until February 2024 were included. Information was extracted on demographics, method(s) and hours for rheumatology teaching, and students' and educators' feedback, where reported. Eight cross-sectional studies were included, published between 1981 and 2024. Studies were conducted in UK (3); USA (2); Australia (1); Pan-European (1) and Uganda (1). Year of rheumatology teaching at medical school was reported in four studies (three UK; one USA). The three UK studies taught rheumatology in the latter years of study; in the USA study, rheumatology was taught every year. Duration of exposure to rheumatology was 15-96 h per student. Reported teaching methods included lecture-based, rheumatology inpatient service, shadowing consultations and patient education. Student feedback was available in one (UK based) study- four students felt they had limited exposure to rheumatology; eight considered it "niche". Factors identified for poor exposure to rheumatology included lack of full-time rheumatologists on the school's faculty; lack of specialty training programmes in local hospitals; greater emphasis on acute specialties (e.g. emergency medicine). Exposure to and student awareness of clinical rheumatology has markedly decreased over time. Given the ageing population and increase in multimorbidity, there is a need to increase exposure and encourage entry to rheumatology training. Key Points • There are clear differences between the methods of rheumatology teaching between institutions and countries. • Teaching hours dedicated to undergraduate rheumatology education have overall markedly decreased over time, resulting in variable student awareness of the depth and breadth of this speciality. • The overall lack of exposure to rheumatology in undergraduate programmes has been associated with a lack of uptake of rheumatology as a career amongst medical students globally. • Our results indicate a need for a minimum required number of hours of teaching dedicated to rheumatology, delivered by specialists as well as a standardised undergraduate curriculum of competencies to better reflect the needs of our increasingly ageing and multimorbid population.
英国风湿病学会的数据表明，医学生接触风湿病学的机会不足，这可能会影响他们的职业选择。我们针对本科医学生的风湿病学教学数量、类型和质量进行了一项系统文献综述（SLR）。该SLR已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42023472169）登记。纳入截至2024年2月发表的英文文章。提取了有关人口统计学、风湿病学教学方法和时长以及学生和教育工作者反馈（如报告所述）的信息。纳入了8项横断面研究，发表时间为1981年至2024年。研究在英国（3项）、美国（2项）、澳大利亚（1项）、泛欧洲地区（1项）和乌干达（1项）开展。四项研究（三项在英国；一项在美国）报告了医学院校的风湿病学教学年份。英国的三项研究在学习后期教授风湿病学；在美国的研究中，每年都教授风湿病学。每名学生接触风湿病学的时长为15 - 96小时。报告的教学方法包括讲座式、风湿病科住院服务、见习会诊和患者教育。在一项（基于英国的）研究中有学生反馈——四名学生觉得他们接触风湿病学的机会有限；八名学生认为这是“小众领域”。确定的接触风湿病学机会少的因素包括学校教师中缺乏全职风湿病学家；当地医院缺乏专科培训项目；更侧重于急性病专科（如急诊医学）。随着时间推移，学生对临床风湿病学的接触和认识显著下降。鉴于人口老龄化和多种疾病并存情况增加，有必要增加接触机会并鼓励进入风湿病学培训领域。要点 • 不同机构和国家之间的风湿病学教学方法存在明显差异。 • 随着时间推移，本科风湿病学教育的教学时长总体显著减少，导致学生对该专业深度和广度的认识参差不齐。 • 本科课程中总体上缺乏接触风湿病学的机会，这与全球医学生中选择风湿病学作为职业的人数不足有关。 • 我们的结果表明，需要由专科医生提供专门用于风湿病学教学的最少课时数，以及标准化的本科能力课程，以更好地反映日益老龄化和多种疾病并存人群的需求。
