Postgraduate School of Rheumatology

Integrated (i.e., core) training objectives
The trainee must have acquired satisfactory theoretical knowledge and professional competence in the clinical and instrumental diagnosis and treatment, including emergency and urgent conditions, of the most common internal medicine diseases. The trainee must acquire fundamental knowledge of the pathophysiology of various organs and systems, the theoretical and practical knowledge necessary to recognize diseases affecting the various body systems, the theoretical and practical knowledge of the main areas of instrumental and laboratory diagnostics related to the aforementioned diseases, and the ability to evaluate the connections and influences of internal medicine and specialists. Therefore, the trainee must be able to recognize the clinical and functional symptoms and signs of diseases affecting various organs and systems, having acquired the fundamental diagnostic, therapeutic, psychological, and ethical knowledge necessary for a comprehensive patient perspective. To this end, the trainee must develop the ability to clinically assess the patient based on the medical history and physical examination; develop critical and analytical diagnostic skills; Become familiar with the main diagnostic procedures and laboratory and instrumental investigations; recognize and be able to address major medical emergencies; familiarize themselves with therapeutic resources to plan their optimal use and recognize their indications and contraindications, as well as the effects of interactions and potential iatrogenic effects; acquire fundamental knowledge of clinical research methodologies and pharmacological trials; and understand the fundamental issues related to prevention, public health, and social medicine. The trainee must have acquired satisfactory theoretical knowledge and professional competence in the recognition and treatment, in emergency situations, of the most common pathologies. Finally, the trainee must also have clinical and therapeutic knowledge of the most common pathologies covered by other categories of the class.

Basic Educational Objectives
Acquisition of fundamental knowledge of the morphology and pathophysiology of connective tissues and the musculoskeletal and joint system, in order to understand the biological basis of the pathophysiology and clinical aspects of rheumatic diseases.

General Educational Objectives
The trainee must acquire the correct statistical approach and the methodological foundations of laboratory, clinical, and therapeutic practice, as well as the ability to continuously update their professional knowledge, including through the use of up-to-date information technology.

Specific Educational Objectives for the School Type
Acquisition of theoretical knowledge and clinical (diagnostic, therapeutic, and rehabilitative) and instrumental-laboratory skills (including flow cytometric techniques) for the treatment of connective tissue and musculoskeletal and joint system diseases, including for rheumatological emergencies. Acquisition of clinical skills mainly concern the physical and instrumental semeiotics of rheumatic diseases, the immunopathology of rheumatic diseases, rheumatological imaging diagnostics (ultrasound, capillaroscopy, bone densitometry, scintigraphy), clinical pharmacology, pharmacotherapy and hydropinotherapy of rheumatic diseases, physical medicine, orthopedic therapy, rehabilitation and occupational therapy of rheumatic diseases; acquisition of knowledge of Medical Statistics and Epidemiology adequate to recognize the social implications of rheumatic diseases.


Mandatory professional development activities to achieve the following educational objectives:
- Acquisition of general technical skills for clinical rheumatological diseases, personally following at least 400 rheumatological cases.
Within these cases, the resident will:
- Follow at least 100 systemic cases, actively participating in the collection of anamnestic data, performing the physical examination, proposing the planning of rational diagnostic and therapeutic interventions, and critically evaluating clinical data;
- Conduct clinical activity in the Rheumatology inpatient ward, completing at least 40 active on-call shifts and completing at least 20 discharge letters (co-signed);
- Conduct clinical activity in the Rheumatology outpatient clinic, performing at least 300 visits;
- Conduct clinical activity related to the admission and monitoring procedures of at least 20 patients undergoing treatment with biological drugs, followed for at least one year;
- acquire the ability to discuss clinical cases in a documented and analytical manner, presenting at least 5 cases of rheumatic diseases;
- directly perform at least 20 arthrocenteses with related synovial fluid analysis and at least 40 joint and periarticular infiltrations for therapeutic purposes, at least 10 of which must be ultrasound-guided;
- critically evaluate the results of at least 400 laboratory tests related to rheumatic diseases, including at least 100 autoantibody profiles;
- acquire the ability to recognize the most common histological patterns related to rheumatic diseases through participation in at least 5 clinical-pathological conferences and direct involvement in the presentation of at least 1 case;
- Perform musculotendinous and joint ultrasounds and periungual capillaroscopies, attending at least 100 ultrasound examinations and personally performing at least 40 in multiple areas, and attending at least 50 capillaroscopies and personally performing at least 20, demonstrating and therefore knowing how to correctly interpret the results of each of the two techniques;
- Acquire the ability to analytically and critically interpret bone densitometry results, including knowledge of the technical procedures used;
- Acquire the ability to correctly recognize and interpret X-rays, scintigraphies, CT scans, MRI scans, and all other diagnostic imaging techniques relevant to rheumatological disease.
- Acquire and interpret key clinimetric data, primarily regarding patients with chronic inflammatory joint diseases.

The trainee may apply for the diploma after completing the professional development activities.

As part of their training, the trainee will be expected to learn the scientific foundations of the School's curriculum in order to achieve full maturity and professional competence, including an adequate ability to interpret scientific innovations and a critical understanding that allows them to consciously manage both their healthcare and their own development. This training may include participation in meetings, conferences, the production of scientific publications, and periods of attendance at qualified Italian and foreign institutions useful for their training.