GOALS AND OBJECTIVES FOR
To further develop clinical skills, ability to analyzeanalyse patients’ problems and
formulate a management/treatment plan through exposure to a wide variety of patients
with rheumatological disease.
CanMEDS 2000 ROLE/SPECIFIC OBJECTIVES
Medical Expert/Clinical Decision Maker
1. Formulate an appropriate differential diagnosis and management strategy
Basedbased on an appropriate and thorough history,history and a
comprehensive physical examination,an appropriate differential diagnosis and
management strategy examination. be formulated.
2. Describe the common signs and symptoms of the following rheumatic conditions:
a) infectious diseases involving the musculo-skeletal system (MSK)
b) diffuse inflammatory connective tissue disorders (i.e. lupus, scleroderma,
inflammatory arthritis, vasculitis, myositis, Sjogrens Syndrome)
c) crystal related arthritis
d) degenerative diseases of the MSK (including osteoarthritis)
e) metabolic bone disease and
f) stress related MSK disorders
3. Develop a broad knowledge of the epidemiology of MSK disorders in society and
the impact on the individuals and their families.
4. Be aware of the indications and limitations of imaging studies in rheumatic
disease; develop an approach to the interpretation of laboratory investigations in
light of the clinical data.
5. Be aware of the indications and contra-indications of joint aspiration, and be able
to perform aspiration/injection of a shoulder, knee, elbow, wrist if indicated.
1. Be able to communicate in an effective manner, verbally and in written form, with
other members of the healthcare team.
2. Appreciate the importance of effective and clear communication with patients
and involved family members.
1. Recognize and integrate into case management the roles of other health care
providers including orthopedic, physiotherapists, occupational therapists,
pharmacists, nurses, and social workers.
2. Foster respect for and appreciation of the importance of communication with
Educational Goals and Objectives …/ 2
allied health care workers and referring physicians in the care of patients.
1. Based on the differential diagnosis, be able to propose an appropriate
investigative approach that would aid in establishing a diagnosis.
2. Utilize other health care organizations and allied health care professionals in the
efficient management of ambulatory Rheumatologyrheumatologic problems and
delivery of services in an out-patient environment.
1. Recognize the role played by physicians in the health care system.
2. Appreciate patient autonomy and the religious, ethnic, and psychosocial factors
which influence the doctor-patient relationship and to take such factors into
account when pursuing problems and understanding patient decisions.
1. Use patient encounters as a stimulus to further reading and review of the current
2. Further develop and enhance skills in critical appraisal and the application of the
literature in patient care.
1. To demonstrate effective ethical medical care in a professional manner.
2. To demonstrate appropriate professional behavior and interpersonal skills.
Educational Goals and Objectives …/ 3
SPECIFIC LEARNING OBJECTIVES
1. Describe clinical and extra-articular features of common musculoskeletal
- osteoarthritis - rheumatoid arthritis
- fibromyalgia - spondyloarthropathies
- septic arthritis - crystal induced arthritis (gout, CPPD)
- polymyalgia rheumatica/giant cell arteritis
- systemic lupus erithematosus
- antiphospholipid antibody syndrome
- Raynaud’s phenomenaphenomenon
2. Describe the indications, utility and interpretation of laboratory tests.
- ESR - complement
- Rheumatoid Factor - uric acid
- C-reactive protein - synovial fluid analysis
- ANA - HCA-B27
- Anti DNA antibodies
- Antibodies to Sm, RNP, RO/SSA and La/SSB
- AnticordiolipinAnticardiolipin antibodies and lupus anticoagulant
3. Be aware of the indications/contra-indications and identification of patients
at risk for toxicity with ASA, non steroidal anti-inflammatory drugs.
a) and potential toxicities of steroids – both intra-articular and
b) and toxicity and monitoring of slow acting antirheumatic drugs in
Rheumatoid arthritis with particular emphasis on antimalarial
agents, gold and methotrexate.