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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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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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New rheumatology curricular milestones provide a standardized framework for fellowship training programs in the US. These milestones ensure consistent assessment of essential knowledge and skills for future rheumatologists.

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Area of Science:

  • Medical Education
  • Rheumatology Training
  • Competency-Based Assessment

Background:

  • US rheumatology fellowship programs lacked standardized assessment tools for trainee competency.
  • The Accreditation Council for Graduate Medical Education (ACGME) mandated milestone evaluations for all medicine subspecialties.
  • Existing ACGME milestones were not specific enough for rheumatology training.

Purpose of the Study:

  • To develop specific curricular milestones for rheumatology fellowship training.
  • To guide programs and fellows in achieving rheumatology competency.
  • To align training with the ACGME Next Accreditation System.

Main Methods:

  • Rheumatology curricular milestones were developed by expanding existing internal medicine milestones.
  • The process incorporated 6 ACGME core competencies.
  • The American College of Rheumatology core curriculum was updated to include these milestones.

Main Results:

  • Eighty rheumatology curricular milestones were created, detailing progressive learning.
  • Milestones emphasize patient care and medical knowledge acquisition.
  • The updated core curriculum integrates new milestones and rheumatology entrustable professional activities.

Conclusions:

  • Rheumatology curricular milestones offer a clear roadmap for fellowship training and assessment.
  • These milestones facilitate tracking of fellow progress over a 2-year period.
  • The comprehensive curriculum and milestones prepare fellows for independent rheumatology practice.