The HEE KSS training programme in Rheumatology is, at present, a five-year programme, although this will change after the implementation of IMT3 when it will become four years, leading to dual accreditation in the specialty together with General (Internal) Medicine. This is a new and evolving training programme that took its first trainees in 2012 and separated from the South London group of hospitals to set up HEE KSS rotations.

The programme is led by Nik Patel, Head of School, and Dr Rod Hughes, Training Programme Director. To find out more about their roles visit the Meet the Team webpage.

By choosing to train in KSS, you will have the opportunity to develop a broad base of specialty experience within the friendly and supportive units within the region, and then also deepen your sub-specialty knowledge in the world-class centres of expertise within London teaching hospitals or the Brighton teaching hospital group. At some time within your programme you will have access to placements within a pure Rheumatology post to experience more complex connective tissue diseases, including complex lupus.

By combining experience in HEE KSS trusts along with teaching hospital posts you can gain the experience and skills to become a well-rounded and confident Rheumatologist with all the experience you will need to obtain a high quality consultant post or alternatively go on to pursue a more academic career.  Within the wealth of district general hospital (DGH) posts within HEE KSS there are many fantastic training opportunities within the region. Within your DGH placements you will be involved in a full complement of Rheumatology clinical experience, including:

  • Inflammatory joint disease
  • Spondyloarthropathies
  • Joint and soft tissue injections
  • Musculoskeletal radiology
  • Metabolic and osteoporotic medicine
  • Osteoarthritis and crystal arthropathy (gout and pseudogout)
  • Hypermobility
  • Chronic pain management
  • Renal and vasculitic complications of inflammatory disease
  • Autoimmune connective tissue diseases
  • Transitional and young person’s clinics
  • Many hospitals within HEE KSS also provide expertise in sub-specialist areas and over the course of the programme you will have access to more specialised services including paediatric rheumatology and ultrasound imaging of inflammatory arthritis

Structured training and education across HEE KSS and South London

In the past, HEE KSS trainees have joined South London trainees in being encouraged to enrol in the Rheumatology MSc, which is administered and run through Kings College Hospital. This  two-year programme is curriculum-mapped to cover all the Rheumatology needed to pass both the MSc exam and the SCE. It has introduced students to research methodology and how to conduct a literature search and write a topic review. Several HEE KSS supervisors teach on the MSc programme. This covers the first two years of regional teaching and is open to those not enrolled on the MSc who will be expected to pay a nominal charge through their study leave budget to attend the training days. With changes in academic costs and programme organisation this course will not function as a full MSc in the future and a new training programme for junior trainees is being developed.

As trainees get more senior they will attend six regional study days organised through South London/HEE KSS. These cover a wide range of subject matter both within the Rheumatology curriculum and within the sphere of more generic skills such as interview techniques and time management. These take place every two months.

HEE KSS/South London run three extra training courses – one on ultrasound technique through Kings College hospital and two study days at Brighton Medical School on joint injection technique (upper and lower limb). These are unique in their design and content and have been very highly rated by trainees. The joint injection days involve introduction to theory, practice through videos and models and then sessions within the Department of Anatomy with study of basic anatomy and joint injection geography using cadaver specimens. All three of these courses are free to trainees.

Where do trainees train?

Our posts are offered across HEE KSS, and we try to accommodate trainees who express geographical preference by offering a flexible system of placement based both on the trainees’ needs and their preferred placement choice annually. With only a small number of trainees within the programme, trainees have been pleased with their rotation choice.

National Training Numbers (NTNs) will be advertised with flexibility. So far trainees have expressed a preference not to be allocated to East or West sub-rotations, but this may change with time if trainees prefer to know exactly where they will spend their five years.

East rotation

Queen Elizabeth and Queen Mother Hospital, Margate – East Kent Hospitals University Foundation Trust

Maidstone Hospital, Maidstone – Maidstone and Tunbridge Wells NHS Trust

Tunbridge Wells Hospital, Pembury – Maidstone and Tunbridge Wells NHS Trust

Medway Maritime Hospital, Medway – Medway NHS Foundation Trust

Eastbourne District General Hospital, Eastbourne – East Sussex Healthcare NHS Foundation Trust

West rotation

Ashford and St Peter’s Hospital, Chertsey – Ashford and St. Peter’s Hospitals NHS Foundation Trust

Royal Surrey County Hospital, Guildford – Royal Surrey NHS Foundation Trust 

East Surrey Hospital, Redhill – Surrey and Sussex Healthcare NHS Trust

Princess Royal Hospital, Haywards Heath – Brighton and Sussex University Hospitals NHS Trust

St Richard’s Hospital, Chichester – Western Sussex Hospitals NHS Foundation Trust

East or West Rotation example

Royal Sussex County Hospital (Brighton)

Princess Royal Hospital (Hayward Heath)

Further details about the East or West sub-rotations can be seen below. To find out more about each training location, please visit the Local Education Provide webpage.

Within this framework, we aim where possible for placements to be family-friendly, and to minimise the need for travel or relocation during the programme. Typically, you can expect to spend the first two years (ST3, ST4, ST5) in geographically close DGHs within your sub-rotation, before gaining tertiary centre experience in either Brighton or London with pure Rheumatology placements (ST6, ST7), according to your training needs. If you have had the opportunity to experience a London placement within ST6 then the final year (ST7) is an opportunity to consolidate experience leading up to CCT within a DGH.

New recruits will be offered a choice of vacant placements, and as your training progresses you will be invited to give your annual preferences for placements at your interim review in the spring. However, the programme directors will need to ensure, above all, that placements meet your individual training needs while at the same time maintaining overall programme balance.

London placements

Within your rotation you will be offered, if you wish, a year within a London teaching hospital. Each year the three pure Rheumatology teaching hospitals in London offer three placements within the HEE KSS programme as below to our ST6-7 trainees.

North West London
North Central London:

University College Hospital, University College London Hospitals NHS Foundation Trust.

The Royal London Hospital, Barts Health NHS Trust.

South London

Training pathway

To understand how the training pathway for Rheumatology is structured please visit the Training Pathway webpage.

Other opportunities

There are opportunities for out-of-programme research experience within many KSS centres or within our linked London and Brighton teaching units. The desire to progress along these lines is usually stimulated via the trainees themselves but OOP experience will be encouraged by the Rheumatology STC.

Recent developments in the organisation of research nationally and regionally, with the establishment of the HEE KSS Clinical Research Network (HEE KSS CRN) in April 2014, mean that this is now an exciting time for developing and participating in clinical research in Kent, Surrey & Sussex. There is a focus on developing research capacity, capability and infrastructure within the region, and opportunities for involvement in research within the region are already increasing.

Specialist trainees are encouraged to attend national meetings, including the British Society for Rheumatology (BSR) and international meetings within Europe (EULAR) and USA (ACR), especially if they have submitted cases or research work to these meetings. There are also several clinical updates in Rheumatology, run by the Royal College of Physicians, the Royal Society for Medicine Rheumatology section, and national clinical updates such as Ten Topics in Rheumatology. We would normally expect our trainees to become members of the BSR and BSR trainees group. Study leave bursaries are provided for approved meetings.