Clinical Immunology & Allergy Residency Program

Rotation-Specific Goals and Objectives for Rheumatology

The following sections outline the rotation expectations in CanMEDS roles within the domains of medical expert, communicator, collaborator, manager, health advocate, scholar and professional.

Medical Expert

As Medical Experts, Clinical Immunologists and Allergists integrate all of the CanMEDS Roles, applying medical knowledge, clinical skills and professional attitudes in their provision of patient-centered care.

Key Competencies:
Physicians are able to:

  1. Function effectively as consultants, integrating all the CanMEDS Roles to provide optimal, ethical and patient centered medical care
  2. Perform a consultation, including the presentation of well-documented assessments and recommendations in written and/or verbal form in response to a request from another health care professional
  3. Demonstrate use of all CanMEDS competencies relevant to Rheumatology
  4. Demonstrate ability to prioritize professional duties when faced with multiple patients and problems

Apply fundamental knowledge, skills and attitudes:

  1. Basic Science
  2. Overview of the immune system as pertaining to rheumatology
  3. effector mechanisms (chemokines/ cytokines/ adhesion molecules)
  4. B cell mediated immunity
  5. T cell mediate immunity
  6. Immune functions of cellular elements of immune system (platelets, T cells, B cells, granulocytes)

Pharmacology:

  • steroids, IVIG, DMARDs, biologics

Therapeutics:

  • cytokine, cytokine receptor mediated therapy
  • recombinant molecules and humanized monoclonal antibodies
  • monitoring for therapeutics agents and managing complications

Specific Diagnostics:

  • Laboratory tests for inflammation and autoimmune diseases
  • Autoantibody testing
  • Diagnostic imaging techniques in assessment of rheumatic disease that overlap immunological conditions

Clinical Sciences - demonstrate knowledge of etiology, pathophysiology, diagnostic methods, assessment and practical management of the following:

  • Vasculitides (small, medium , large vessels)
  • Sarcoidosis
  • Immune rheumatic disorders (including but not limited to SLE, Sjogrens)
  • Inflammatory myositis

Principles and Methodology of lab techniques in Rheumatology related to Allergy:

  • Measurement of immunoglobulins
  • Serum protein electrophoresis and immunoelectrophoresis
  • Measurement of immune complexes , cryoprecipitable proteins, complement
  • Monoclonal antibody technology

Communicator

Key Competencies:

  1. develop rapport, trust, and ethical therapeutic relationships with patients
  2. accurately elicit and synthesize relevant information and perspectives of patients, colleagues and other professionals
  3. accurately convey relevant information and explanations to patients, colleagues and other professionals
  4. develop a common understanding on issues, problems, and plans with patients and families, colleagues, and other professionals to develop a shared plan of care
  5. Convey effective oral and written information about medical encounter

Specific Requirements:

  1. communicate effectively with all staff, allied health professionals and discuss appropriate information with patients and team
  2. establish effective relationships with patients, family members and caregivers to obtain meaningful history, conduct relevant physical exams and properly manage a patient’s medical problem
  3. understand the psychosocial aspects of caring for patients with acute, chronic and life threatening disorders
  4. understand the biomedical ethics involved in the investigation and care of patients with rheumatological disorders
  5. demonstrate effective communication skills by presenting concise, informative overviews on topics in the diagnosis of rheumatologic disorders

Collaborator
Key Competencies:

  1. Participate effectively and appropriately in an interprofessional healthcare team
  2. effectively work with other health care professionals to prevent, negotiate and resolve interprofessional conflict

Specific Requirements:

  1. Contribute clinically useful rheumatological opinions on patients referred for consultation, including ordering and arranging for specific testing, administering required therapy, and conveying results of the rheumatological opinion to referring physicians. This may require integrating results of clinical, laboratory, EMG, and radiological data
  2. Consult and collaborate with physicians, lab staff, clinic staff and other health care professionals and contribute effectively to interdisciplinary team activities held within hospital (rounds, journal clubs, etc.)

Manager
Key Competencies:

  1. participate in activities that contribute to the effectiveness of their healthcare organizations and systems
  2. allocate finite healthcare resources appropriately
    • specific Requirements
    • appropriate use of IVIG
    • appropriate use of biologics given in hospital setting

Health Advocate
Key Competencies:

  1. Respond to individual patient health needs and issues as part of patient care
  2. respond to health needs of the communities that they serve
  3. identify the determinants of health of the populations that they serve
  4. promote the health of individual patients, communities and populations

Specific Requirements:

  1. demonstrate an appreciation of the health care needs of patients with all serious rheumatological conditions that necessitates admission to hospital
  2. encourage promotion of active family involvement in decision making and continuing management
  3. understand the ways effective laboratory support is important to patients with rheumatological and medical problems
  4. advocate for patients if there are delays in diagnosis and management as a result of limited resources

Scholar
Key Competencies:

  1. maintain and enhance professional activities through ongoing learning
  2. critically evaluate information and its sources and apply this appropriately to practice decisions
  3. Facilitate the learning of patients, families, students, residents and other health professionals, the public and others as appropriate
  4. contribute to the creation, dissemination, application, and translation of new medical knowledge and practices

Specific Requirements:

  1. Provide evidence in the material that they present during their presentations of cases to rheumatology attendings that they are acquiring an appropriate level of in depth knowledge pertaining to rheumatology diagnostics and a current understanding of the pathophysiology of the disorder
  2. develop critical appraisal skills specific to rheumatological literature, particularly as it applies to the physiology and pathophysiology of the particular rheumatological disorder being treated

Professional
Key Competencies:

  1. demonstrate a commitment to their patients, profession and society through ethical practice
  2. demonstrate commitment to their patients, profession, society thought participation in profession led regulation
  3. demonstrate a commitment to physician health and sustainable practice

Specific Requirements

  1. deliver highest quality care with integrity, honesty and compassion
  2. exhibit appropriate personal and interpersonal professional behaviour
  3. practice medicine ethically consistent with obligations of a physician
  4. be courteous and punctual
  5. follow up on patients evaluated
  6. arrange additional laboratory investigations as appropriate