One contributor commented that immunology is an area that
particularly interests her, and that this is expressed clinically in
various rheumatic syndromes. The specialty is an exciting and
progressive field, with new biological therapies likely to have a
major impact on disease management in the near future.
You need to possess strong clinical ability since patients may
present with complex histories and a multitude of physical signs and
symptoms. Skill and empathy are required for identifying and
managing pain syndromes in particular. You also need to have some
level of technical skill for performing procedures such as joint
injections.
For a hospital-based specialist a typical day would involve a
morning outpatient clinic with associated dictation and
administration. The rest of the day might be spent on a combination
of ward rounds, consultation, teaching and research.
The increasing use of biological agents in treatments requires that
specialists update their knowledge of underlying disease mechanisms
on a regular basis.
Many opportunities exist in this field. Although there is limited
scope in the public sector for practice solely devoted to
rheumatology, there are many combined rheumatology and general
physician positions. Private practice is attracting burgeoning
numbers of patients.
One female contributor commented that it is definitely possible to
manage raising a family after completion of training in
rheumatology: there is very little on-call work and part time
private practice is an option.
While employment arrangements may be flexible, there will inevitably
be some degree of impact on family life since hours of work can be
long and there are occasionally on-call responsibilities.
The specialty offers little exposure to acute general medicine
(unless you hold a combined position) and the financial rewards are
not as great as for procedural specialties.
The advanced training programme in rheumatology recognises
that rheumatologists may practice in a number of different ways in
New Zealand. Some may hold ‘pure’ rheumatology positions within
large metropolitan hospitals or academic institutions or in private
practice, while others will work in a more general setting. To an
extent, these needs can be catered for in the structure of the
training programme.
