Rheumatology

The Rheumatology rotation combines seeing patients in the ambulatory care setting and on the inpatient consult service. We are clinic/consult split so if you are not scheduled to be in clinics please check in with other Residents and Staff on consult service.

There are both formal and informal teaching sessions scheduled throughout the rotation.

This rotation will also give you ample opportunity to learn the core knowledge of Rheumatology in depth. 

• Take a history and perform a physical examination, demonstrating the ability to adapt the assessment for patients with rheumatological complaints 

• Detect abnormalities of joints or tendons, and detect synovitis, effusions, and degeneration of major joints. 

• Differentiate inflammatory from degenerative causes, and outline the reasons for that conclusion. 

• Differentiate rheumatoid arthritis, psoriatic arthritis, reactive arthritis (Reiter’s syndrome), spondyloarthritis, gout and arthritis associated with inflammatory bowel disease. The resident will also be able to distinguish patients whose disease does not conform to these patterns. 

• Develop a systematic approach to the assessment, diagnosis and management of patients with the following issues 

a. Osteoarthritis 

b. Inflammatory arthritis 

c. Gout 

d. Septic arthritis 

e. Back pain 

f. Temporal arteritis 

g. Systemic Lupus Erythematosus 

h. NSAIDs, analgesics, steroids and Disease Modifying drugs 

i. Common forms of vasculitis 

j. Common forms of local pain syndromes (lower back pain, fibromyalgia, carpal tunnel, tendonitis, osteonecrosis) 

k. Urticaria and angioedema 

l. Osteoporosis 

i. Risk management and prevention 

m. Rheumatologic manifestations of common diseases of other systems, and the systemic manifestations of the more common rheumatologic diseases 

• Have an understanding of the clinical relevance of serologic investigations commonly ordered in rheumatology (e.g. ANA, ENA, ANCAs etc) 

• Knee aspiration and injection 

• Request the appropriate consultations for physio and occupational therapy in the treatment of rheumatologic disorders. 

• Radiologic features common to inflammatory or mechanical joint disease, and be able to recognize these on classic, clearly abnormal films.

Updated August 2025

Rheumatology Clinics

Rheumatology is mainly clinical based although we do usually schedule you for a week of consult service as well. Residents will be schedule for at least 4 clinics per week; this may include both AM/ PM.

Rheumatology Consults

On the consult service, after initial assessment, you will be expected to write progress notes, review tests and x-ray results, and make rounds on the consult service. The consults are split up if you have several in one day, or if consults come while you are scheduled to be in clinic. Consults will be reviewed with the staff as everyone’s clinic schedule allows.

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level,  PGY2 is Manager level, PGY3 is Educator level (See Program Information - Overall Goals and Objectives).

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centred manner.

• Documentation and Verbal Presentation: The resident appropriately documents and presents cases for new consults, progress notes, and handover of care (succinctly organized, prioritized, summarized) including answering the question asked by the referring service.

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with referring physician and other healthcare providers effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident addresses disease prevention, risk factor reduction, and health surveillance when indicated.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice: The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Assessment 

We use the following In-Training Evaluation Report (ITER):  

• Rheumatology

Entrustable Professional Activities (EPAs)

This rotation focuses on mainly Core of the Discipline EPAs. However, due to scheduling, a resident may do this rotation during Foundations. Residents are allowed to start Core of Discipline EPAs during the Foundations stage. This rotation is an ideal learning environment for the following EPAs:

• FD2: Managing patients admitted to acute care settings with common medical problems and advancing their care plans

• CD1: Assessing, diagnosing and managing patients with complex or atypical acute medical presentations

• CD2: Assessing, diagnosing, and managing patients with complex chronic diseases

• CD3: Providing internal medicine consultation to other clinical services

• CD5: Performing the procedures of Internal Medicine  -E.g. Joint arthrocentesis

• CD10: Implementing health promotion strategies in patients with or at risk for disease  (e.g. Counselling regarding immunocompromised state)

Program Director

Dr. Sarah Troster

troster@ualberta.ca

Medical Education Program Coordinator

mednrhe@ualberta.ca