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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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What Is a Rheumatologist and How Do We Make One?

Calvin R Brown1, Lisa Criscione-Schreiber2, Kenneth S O'Rourke3

  • 1Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

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Summary
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New reporting milestones and entrustable professional activities (EPAs) define rheumatologist training expectations. These tools enhance fellow accountability and clarify the expertise of practicing rheumatologists.

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Area of Science:

  • Medical Education
  • Rheumatology Training
  • Professional Competency Assessment

Background:

  • Graduate medical education requires robust evaluation for rheumatologist training.
  • Standardized milestones and entrustable professional activities (EPAs) are crucial for assessing trainee competency.
  • Rheumatology previously lacked defined EPAs, hindering clear articulation of specialist abilities.

Purpose of the Study:

  • To describe the collaborative development of rheumatology reporting milestones and EPAs.
  • To establish clear assessment tools for rheumatologist trainees.
  • To define the core competencies of practicing rheumatologists for all stakeholders.

Main Methods:

  • Collaborative development involving multiple professional organizations and working groups.
  • Iterative refinement of milestones and EPAs through dedicated summits and meetings.
  • Utilized input from the Association of Specialty Professors, Alliance for Academic Internal Medicine, American Board of Internal Medicine, and Accreditation Council for Graduate Medical Education.

Main Results:

  • Twenty-three subspecialty reporting milestones were established.
  • Fourteen rheumatology entrustable professional activities (EPAs) were developed and refined.
  • These tools emerged from 3 development summits and 3 working group meetings.

Conclusions:

  • The developed milestones and EPAs set measurable expectations for rheumatologist trainees.
  • These tools promote enhanced accountability and enrichment in fellowship training.
  • EPAs clearly define the expertise of a practicing rheumatologist to stakeholders.