Department of Rheumatology, 4th Floor Thomas Guy House, Guy's Hospital, St Thomas Street, London SE1 9RT, UK
E-mail: amistl{at}aol.com
SIR, I thank Dr Kay and colleagues for their comments and interest regarding our report [1]. They reinforce many important points from our report. I agree that the problem of poor confidence in musculoskeletal examination skills is more widespread than just rheumatology specialist registrars (SpRs) and affects all tiers of the medical education system. The fact that this is starting to be addressed with a revision of Introduction to the locomotor system, which is the foundation for the building blocks for postgraduate training, is important. As medical education receives a higher profile it is hoped that rheumatology SpRs will be able to discuss training and education shortcomings more openly without taking it as a personal failure.
Increased specific teaching and training is only one possible solution proposed. The proposals were from individual responders to the survey and were their personal views. Rheumatology SpRs are, however, a special case when it comes to musculoskelatal examination skills as they are the ones often involved in the education and training of medical students, junior doctors and general practitioners.
It is important that musculoskeletal examination training is under systematic review. The study performed does highlight current deficiencies in training which need addressing.
The author has declared no conflict of interest.
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