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Medical specialties

Rheumatology Diploma

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A live online diploma in adult clinical rheumatology, built around the decisions you make in clinic: assessment and tests, inflammatory arthritis, connective tissue disease and vasculitis, bone, soft tissue and pain, and the special situations that test judgement, from pregnancy to immunosuppression.

Teaching is anchored on current UK and European guidance from BSR, EULAR and NICE, with US differences flagged where they change practice. Twenty-five weekly sessions across five modules, taught live by practising rheumatologists you can question.

Course director
To be announced
Format
25 live weekly sessions on Zoom, in 5 modules
Dates
Confirmed when enrolment opens

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You are registering for Rheumatology. We email you first when it opens for enrolment, and we will not pass your details to anyone outside PMI.

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Radiograph of both hands affected by rheumatoid arthritis, with eroded and narrowed wrist and finger joints.
Image: hand radiographs in rheumatoid arthritis by Jojo at Polish Wikipedia via Wikimedia Commons, public domain.

Who it is for

Senior trainees, fellows and early-career consultants in rheumatology, and physicians, GPs and allied specialists who manage rheumatic disease, worldwide.

The programme

25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.

Module 1 · Sessions 1 to 5Assessment, tests and safe prescribing

  1. 1. The rheumatological assessment

    • Distinguish inflammatory from mechanical musculoskeletal pain using history and examination
    • Recognise joint distribution patterns that point to a diagnosis
    • Identify red flags that need same-day or urgent assessment
    • Write a referral or advice letter that lets a rheumatology service triage safely

  2. 2. Laboratory tests: autoantibodies and inflammatory markers

    • Interpret CRP and ESR in context, including discordant results
    • Choose autoantibody tests by pre-test probability rather than as a screen
    • Explain a positive ANA in a well patient without causing alarm
    • Recognise results that need urgent action, such as a positive ANCA with renal involvement

  3. 3. Imaging in rheumatology

    • Select the imaging test that answers the clinical question
    • Recognise erosive, crystal and inflammatory changes on plain films and ultrasound
    • Interpret sacroiliac joint MRI reports in suspected axial spondyloarthritis
    • Explain when vascular ultrasound or PET-CT is used in suspected large-vessel vasculitis

  4. 4. The hot joint and crystal arthritis

    • Manage an acute monoarthritis as septic until proven otherwise, including aspiration and antibiotics
    • Interpret synovial fluid microscopy, culture and crystals
    • Treat an acute gout flare and start urate-lowering therapy to a target, following NICE NG219
    • Recognise calcium pyrophosphate deposition disease and its common presentations

  5. 5. Prescribing and monitoring DMARDs safely

    • Start methotrexate, sulfasalazine, leflunomide or hydroxychloroquine with the right baseline checks
    • Apply a monitoring schedule and act on abnormal blood results
    • Minimise glucocorticoid exposure and manage its harms
    • Screen and vaccinate before immunosuppressive treatment
Module 2 · Sessions 6 to 10Inflammatory arthritis

  1. 6. Early rheumatoid arthritis

    • Diagnose early rheumatoid arthritis and explain the role and limits of classification criteria
    • Start treat-to-target therapy with a conventional DMARD strategy
    • Measure disease activity with DAS28 and act on the result
    • Agree a treatment plan with the patient, including bridging steroids

  2. 7. Established rheumatoid arthritis: biologics and targeted therapies

    • Decide when a patient meets criteria for biologic or targeted synthetic therapy
    • Choose between drug classes using comorbidity, safety and patient preference
    • Apply current regulatory safety advice on JAK inhibitors
    • Plan tapering for a patient in sustained remission

  3. 8. Axial spondyloarthritis

    • Recognise inflammatory back pain and refer suspected axial spondyloarthritis promptly
    • Use MRI and HLA-B27 appropriately in diagnosis
    • Plan first-line treatment with NSAIDs and exercise
    • Select patients for biologic therapy and assess response

  4. 9. Psoriatic arthritis and the spondyloarthritis family

    • Recognise the domains of psoriatic disease and their impact on treatment choice
    • Choose treatment by dominant domain using EULAR and GRAPPA recommendations
    • Coordinate care with dermatology, ophthalmology and gastroenterology
    • Identify reactive arthritis and enteropathic arthritis

  5. 10. The whole patient with inflammatory arthritis

    • Assess and reduce cardiovascular risk in inflammatory arthritis
    • Recognise interstitial lung disease and other extra-articular disease
    • Address fatigue, mood and work disability as part of routine care
    • Use the multidisciplinary team, including nurse specialists, physiotherapy and occupational therapy
Module 3 · Sessions 11 to 15Connective tissue disease and vasculitis

  1. 11. Systemic lupus erythematosus

    • Diagnose lupus using clinical features and serology
    • Identify organ-threatening lupus, including nephritis, that needs urgent escalation
    • Prescribe hydroxychloroquine and steroid-sparing treatment in line with EULAR recommendations
    • Plan monitoring for disease activity and drug toxicity

  2. 12. Sjögren's disease, myositis and overlap syndromes

    • Assess sicca symptoms and recognise systemic Sjögren's disease
    • Identify the features that raise lymphoma risk
    • Investigate suspected inflammatory myositis, including antibodies and cancer screening
    • Recognise overlap syndromes and their lung involvement

  3. 13. Systemic sclerosis and Raynaud's phenomenon

    • Distinguish primary from secondary Raynaud's phenomenon
    • Recognise early diffuse systemic sclerosis that needs urgent referral
    • Screen for interstitial lung disease and pulmonary arterial hypertension
    • Recognise and manage scleroderma renal crisis

  4. 14. Giant cell arteritis and polymyalgia rheumatica

    • Recognise suspected giant cell arteritis and start treatment the same day
    • Use a fast-track pathway with ultrasound or biopsy to confirm the diagnosis
    • Diagnose polymyalgia rheumatica and exclude its mimics
    • Plan glucocorticoid tapering and steroid-sparing therapy in relapsing disease

  5. 15. ANCA-associated and other small-vessel vasculitis

    • Recognise the presentations of ANCA-associated vasculitis, including rapidly progressive renal disease
    • Plan induction treatment and know when to involve renal and respiratory teams
    • Choose maintenance therapy and duration
    • Monitor for relapse, infection and long-term damage
Module 4 · Sessions 16 to 20Bone, soft tissue and pain

  1. 16. Osteoporosis

    • Assess fracture risk using FRAX and national thresholds
    • Choose first-line and anabolic treatment for patients at high and very high risk
    • Plan treatment duration, drug holidays and safe denosumab discontinuation
    • Investigate secondary causes of osteoporosis

  2. 17. Osteoarthritis in the rheumatology clinic

    • Diagnose osteoarthritis clinically and know when imaging adds value
    • Build a core treatment plan of exercise, weight management and education
    • Use analgesia and joint injections in line with the evidence
    • Refer for joint replacement at the right time

  3. 18. Fibromyalgia and chronic widespread pain

    • Diagnose fibromyalgia confidently and explain it to the patient
    • Lead with exercise and psychological approaches before medicines
    • Avoid escalating treatment of inflammatory disease for fibromyalgic pain
    • Agree realistic goals and a self-management plan

  4. 19. Regional pain and soft-tissue conditions

    • Assess common regional pain syndromes and identify inflammatory causes
    • Decide when a steroid injection is appropriate and when it is not
    • Describe safe injection technique and aftercare
    • Refer to physiotherapy or surgery appropriately

  5. 20. Metabolic bone disease beyond osteoporosis

    • Investigate osteomalacia and treat vitamin D deficiency
    • Recognise Paget's disease of bone and decide on treatment
    • Identify hyperparathyroidism and other endocrine causes of bone disease
    • Recognise atypical femoral fractures and manage antiresorptive therapy afterwards
Module 5 · Sessions 21 to 25Special situations and practice

  1. 21. Pregnancy and reproductive health in rheumatic disease

    • Plan pregnancy with women who have rheumatic disease, including disease control first
    • Choose medicines that are compatible with pregnancy and breastfeeding
    • Manage antiphospholipid syndrome in pregnancy with the obstetric team
    • Counsel on the risks associated with anti-Ro antibodies

  2. 22. Infection and immunosuppression

    • Screen for latent tuberculosis and viral hepatitis before biologic therapy
    • Plan vaccination, including which live vaccines to avoid
    • Recognise serious and opportunistic infections in immunosuppressed patients
    • Decide when to pause and restart immunosuppression around infection and surgery

  3. 23. From paediatric to adult rheumatology

    • Recognise the subtypes of juvenile idiopathic arthritis seen in adult clinics
    • Run a transition consultation that keeps the young person engaged
    • Address adherence, mental health and lifestyle in adolescents
    • Plan long-term follow-up for growth, eyes and fertility

  4. 24. Immune-related adverse events and emerging issues

    • Recognise rheumatic immune-related adverse events of checkpoint inhibitors
    • Treat them while protecting the patient's cancer treatment, with oncology
    • Describe the new treatment approaches in development for rheumatic disease
    • Judge early evidence for new therapies critically

  5. 25. Complex case decisions and running a rheumatology service

    • Apply the course to complex cases in a panel discussion
    • Design an early inflammatory arthritis pathway that meets national standards
    • Use advice and guidance and virtual clinics safely
    • Build a personal plan for continuing development in rheumatology

What the diploma includes

  • 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
  • Practising specialists teaching live, so you can put your questions to them.
  • Weekly MCQs and a final written assessment.
  • A digital certificate carrying your final classification.

Lead or teach the Rheumatology Diploma

We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.

Apply to teach