Current level of rheumatology teaching amongst undergraduate medical students: a systematic literature review

Data from the British Society of Rheumatology demonstrate a lack of exposure to rheumatology for medical students, potentially impacting career choice. We conducted a Systematic Literature Review (SLR) on quantity, type and quality of rheumatology teaching for undergraduate medical students. This SLR was registered on PROSPERO (CRD42023472169). Articles published in English-language until February 2024 were included. Information was extracted on demographics, method(s) and hours for rheumatology teaching, and students' and educators' feedback, where reported. Eight cross-sectional studies were included, published between 1981 and 2024. Studies were conducted in UK (3); USA (2); Australia (1); Pan-European (1) and Uganda (1). Year of rheumatology teaching at medical school was reported in four studies (three UK; one USA). The three UK studies taught rheumatology in the latter years of study; in the USA study, rheumatology was taught every year. Duration of exposure to rheumatology was 15-96 h per student. Reported teaching methods included lecture-based, rheumatology inpatient service, shadowing consultations and patient education. Student feedback was available in one (UK based) study- four students felt they had limited exposure to rheumatology; eight considered it "niche". Factors identified for poor exposure to rheumatology included lack of full-time rheumatologists on the school's faculty; lack of specialty training programmes in local hospitals; greater emphasis on acute specialties (e.g. emergency medicine). Exposure to and student awareness of clinical rheumatology has markedly decreased over time. Given the ageing population and increase in multimorbidity, there is a need to increase exposure and encourage entry to rheumatology training. Key Points • There are clear differences between the methods of rheumatology teaching between institutions and countries. • Teaching hours dedicated to undergraduate rheumatology education have overall markedly decreased over time, resulting in variable student awareness of the depth and breadth of this speciality. • The overall lack of exposure to rheumatology in undergraduate programmes has been associated with a lack of uptake of rheumatology as a career amongst medical students globally. • Our results indicate a need for a minimum required number of hours of teaching dedicated to rheumatology, delivered by specialists as well as a standardised undergraduate curriculum of competencies to better reflect the needs of our increasingly ageing and multimorbid population.