Specialty specific changes for CESR in Rheumatology

The new Rheumatology curriculum was published in January 2022. For a transition period you can make your CESR application in either the new curriculum or the previous version of the curriculum.

This option is available until the transition deadline of 31 August 2024.

Specialty specific guidance

We’ve produced guidance documents for each version of the curriculum with the Joint Royal Colleges of Physicians Training Board.

How to apply

You can apply through your GMC Online account. There is one application form which includes sections for both versions of the curricula. You should declare which curriculum version you wish to be assessed against in sequence one and only provide evidence in the sections of the application relevant to your curriculum.

2022 curriculum

Our standards for postgraduate medical curricula are Excellence by design and the framework for Generic professional capabilities. These help postgraduate medical training programmes focus trainee assessment away from an exhaustive list of individual competencies, towards fewer broad capabilities needed to practise safely from your first day as a consultant.

As a result, the 2022 physicianly curricula are outcomes based. This means trainees will be assessed against the fundamental capabilities required of consultants in the working week. These include the general skills which all doctors need to have as well as those needed to carry out all the specific day to day tasks undertaken by a consultant physician (Capabilities in Practice – CiPs). The Rheumatology curriculum is made up of six Generic CiPs which are common to all physicianly specialties, eight clinical internal medicine CiPs and seven Specialty CiPs unique to Rheumatology.

In demonstrating these capabilities a successful applicant will be awarded a dual CESR in Rheumatology and General internal medicine.

Completion of three years Internal Medicine Training replaces Core Medical Training as the core training programme.

Content shared between all physicianly specialties

There are six CiPs which are shared between all physicianly specialties:

  • CiP 1 - Able to function successfully within NHS organisational and management systems
  • CiP 2 - Able to deal with ethical and legal issues related to clinical practice
  • CiP 3 - Communicates effectively and is able to share decision making, while maintaining appropriate situational awareness, professional behaviour and professional judgement
  • CiP 4 - Is focused on patient safety and delivers effective quality improvement in patient care
  • CiP 5 - Carrying out research and managing data appropriately
  • CiP 6 - Acting as a clinical teacher and clinical supervisor.

Clinical internal medicine content

  • CiP 1 - Managing an acute unselected take
  • CiP 2 - Managing the acute care of patients within a medical specialty service
  • CiP 3 - Providing continuity of care to medical inpatients, including management of comorbidities and cognitive impairment
  • CiP 4 - Managing patients in an outpatient clinic, ambulatory or community setting, including management of long-term conditions
  • CiP 5 - Managing medical problems in patients in other specialties and special cases
  • CiP 6 - Managing multidisciplinary team including effective discharge planning
  • CiP 7 - Delivering effective resuscitation and managing the acutely deteriorating patient
  • CiP 8 - Managing end of life and applying palliative care skills.

Specialty specific content

  • CiP 1 - Managing common rheumatological disorders across multiple care settings
  • CiP 2 - Managing rheumatologic emergencies
  • CiP 3 - Managing complex rheumatologic disorders across multiple care settings
  • CiP 4 - Managing transitional care, chronic pain, metabolic bone disease and rarer rheumatologic disorders
  • CiP 5 - Competent in all practical procedures for rheumatologic conditions as defined by the curriculum
  • CiP 6 - Managing and leading a musculoskeletal multidisciplinary team and Coordination of care with other specialties
  • CiP 7 - Ability to manage the interface with primary care and demonstrate effective relationships with primary care teams and patient groups.

Changes in assessment tools

There has been no change to the workplace-based assessment methodology.

Changes in knowledge and skills

All JRCPTB specialties identified as group 1 will dual train in internal medicine (IM) and the IM learning outcomes have been embedded in the Rheumatology curriculum. This curriculum will train doctors that are specialists with generalist skills to manage the acute unselected take and care of acutely ill patients.

There is an increased interface with primary care and a requirement to demonstrate effective relationships with primary care teams, patients and patient groups.