The Centers for Disease Control and Prevention (CDC) reported that between 2019 and 2021, about 53.2 million U.S. adults had been diagnosed with some type of arthritis, rheumatoid arthritis, lupus, gout, or fibromyalgia. These autoimmune and musculoskeletal disorders can hinder one’s quality of life; therefore, rheumatologists are vital in managing these diseases and allowing patients to take life by storm. The high number of people with rheumatoid diseases, coupled with an aging population and rheumatology shortages, has increased the demand for rheumatologists in healthcare. 

If you’re interested in learning more about this field of medicine and are considering a career in rheumatology, join us as we explore how to become a rheumatologist, delve into rheumatology subspecialties, and more.  

What Is a Rheumatologist?

Rheumatologists are internists who have pursued further training to diagnose and treat musculoskeletal diseases and systemic autoimmune conditions, known as rheumatic diseases. These conditions can cause pain, swelling, and deformities in the joints, bones, supporting muscles, and even internal organs including the lungs, kidneys, and the brain. 

A rheumatologist can diagnose, treat, and manage a broad range of conditions including:

  • Inflammatory disorders that can affect the muscles, joints, and bones, such as rheumatoid arthritis and gout 
  • Connective tissue diseases, such as tendonitis and bursitis, which can affect ligaments and tendons and may also involve the skin and other organs
  • Autoimmune diseases, such as lupus, scleroderma, and myositis which occur when the immune system attacks healthy tissue.

What Does a Rheumatologist Do?

Rheumatologists are critical in treating and rehabilitating patients of all ages suffering from a wide range of rheumatic diseases. Typical responsibilities of rheumatologists include:

  • Running tests to find the underlying cause of the condition and formulate a diagnosis
  • Developing a treatment plan
  • Following up to ensure the treatment is working and adjusting when needed. 

The most common treatment methods include punctures and operations, medication, pain therapy, physiotherapy and ergotherapy, and nutrition therapy. 

As autoimmune diseases aren’t specific to one area of the body, rheumatologists often have to take a multidisciplinary approach to ensure better outcomes by collaborating with physical therapists, nurses, rehabilitation specialists, podiatrists, dieticians, orthopedic surgeons, and more.  

How to Become a Rheumatologist?

The journey to becoming a rheumatologist involves the completion of educational and training steps, such as: 

Step 1: Complete a bachelor’s degree

The first milestone on becoming a rheumatologist is earning a bachelor’s degree from an accredited college or university. While there aren’t set major requirements, majoring in a science-related field helps you to build a strong foundation in biological sciences, which is necessary for medical school. Therefore, we recommend considering a degree in biology, chemistry, or pre-medicine. 

During or after your undergraduate studies (before you enroll in a medical school), you’ll have to pass and get a good score on the MCAT. 

Step 2: Obtain a medical degree

Next, you must obtain a medical degree from either an allopathic school (M.D.) or an osteopathic school (D.O.). Generally, medical schools follow a similar curriculum, which involves two years of focused coursework and two years of coursework and clinical rotations.

For example, AUAMED’s M.D. program follows a similar curriculum, with two pivotal phases: Preclinical Sciences and Clinical Sciences, both offering a robust foundation for your medical career. In the Preclinical Sciences phase, you’ll gain foundational anatomy, physiology, biochemistry, pathophysiology, pharmacology, and microbiology knowledge in the eight organ systems.

On the other hand, during the Clinical Sciences phase, you’ll gain a profound understanding of medical principles and engage in clinical rotations, where you’ll develop the knowledge, skills, and professionalism essential to patient care. 

Step 3: Complete a residency

Rheumatology is an internal medicine subspecialty, so to become a rheumatologist, you must first complete an internal medicine or pediatrics residency. Both residencies last three years and include hands-on medical training under the supervision of an attending. During residency, you’ll engage in residency rotations, including inpatient, outpatient, and consult rotations, during which you’ll get exposure to rheumatology. 

Step 4: Obtain licensure

Obtaining licensure is an essential step for practicing medicine as a rheumatologist. To become a licensed physician, you must pass the U.S. Medical Licensing Examination (USMLE) for M.D.s or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) for D.O.s.

The USMLE is a three-step examination which you’ll have to take:

  • Step 1: Typically taken at the end of the second year of medical school. 
  • Step 2: Taken in the fourth year of medical school.
  • Step 3: Usually taken after the first year of residency.

The COMLEX also has three levels you’ll have to take in the same order as the USMLE exams. 

Remember that state licensure requirements vary, so double-check if there’s any specific requirement in the state you want to practice in. 

Step 5: Complete a fellowship in rheumatology

Perhaps the most critical step in becoming a rheumatologist is fellowship training in a specialized area of rheumatology. Typically, these fellowships last two years, during which you’ll gain additional experience and advanced training in diagnosing and managing inflammatory, autoimmune, and rheumatic diseases.

Clinical training during the rheumatology fellowship offers exposure to the full spectrum of rheumatic conditions. Moreover, it provides you with opportunities for scholarly work by engaging in laboratory research. 

Step 6: Become board certified

Your educational and training journey to becoming a rheumatologist concludes with becoming board-certified by passing the board examination administered by the American Board of Internal Medicine (ABIM) or the American Osteopathic Board of Internal Medicine.

Keep in mind that to maintain certification and continue to practice rheumatology, you must take the recertification exam every ten years, which ensures you’re up-to-date with advancements in rheumatology knowledge and practice. 

Step 7: Apply for rheumatologist positions

Lastly, after completing all educational and training requirements, you can apply for rheumatologist positions. To increase your chances of employment, you can:

  • Explore the CareerConnection service by the American College of Rheumatology
  • Strengthen your cover letter and resume by highlighting experiences in residency and fellowship
  •  Attend conferences and seminars to network with fellow rheumatologists.

Rheumatology Subspecialties

Rheumatology is a broad field with many subspecialties that focus on addressing different complex rheumatic conditions. 

Metabolic bone diseases

This subspecialty focuses on a group of conditions caused by abnormal levels of the bone’s calcium, phosphorus, or vitamin D. Metabolic bone diseases or conditions such as osteoporosis or osteomalacia can lead to bone loss, fractures, bone deformities, fragile bones, or serious disabilities.

To diagnose these conditions, the rheumatologist will run the DEXA scan, bone density test, blood test, and scans of the parathyroid gland. 

Musculoskeletal conditions

This area of rheumatology involves diagnosing and treating autoimmune and inflammatory conditions or disorders of the musculoskeletal system, which can affect bones, joints, muscles, and connective tissues. Common musculoskeletal conditions include bursitis, carpal tunnel syndrome, fibromyalgia, rheumatoid arthritis, and osteoarthritis.

During the appointment, the rheumatologist will perform a physical exam to check for muscle weakness, muscle atrophy, swelling, and redness. They also test the reflexes to check for nerve damage and order X-rays or MRI scans to examine bones and soft tissues. 

Autoimmune conditions

The subspecialty of autoimmune conditions focuses on treating and managing autoimmune disorders. These disorders happen when the person’s immune system mistakenly directs the inflammation toward the body’s tissues, such as joints, muscles, kidneys, blood vessels, and any tissue in the body. Rheumatoid arthritis, scleroderma, vasculitis, and systemic lupus are some of these autoimmune conditions. 

As these conditions can be challenging to diagnose, rheumatologists may require a thorough medical history, physical exam, laboratory tests such as image scans and biopsies. 

Inflammatory joint disease

Rheumatologists also can specialize in inflammatory joint diseases. These diseases are a result of joint inflammation during which joints may feel swollen and tender. Though it targets mainly joints, these diseases can also affect other tissues in the body, including the lungs, heart, skin, and eyes. 

To treat such conditions, rheumatologists may require a sample of fluid from an affected joint (joint aspiration), alongside other scans and tests. 

Degenerative joint disease

This area of rheumatology focuses on treating joint conditions caused by “wear and tear” on the hands, knees, hips, and spine. The most common degenerative joint condition is osteoarthritis, which can cause pain, stiffness, loss of flexibility, a grating sensation, and bone spurs.

Like the subspecialties mentioned above, the rheumatologist takes thorough measures to diagnose these conditions accurately. 

Key Takeaways

The road to becoming a rheumatologist includes rigorous education and training steps, which you can ace through dedication and striving for continuous learning and improvement. Although the road to becoming a rheumatologist can seem daunting, it’s a rewarding career that allows you to profoundly impact the lives of many by giving them agency over their bodies.

So. If that’s something you want to do, you can get started today by exploring our M.D. program. Don’t wait—begin your journey toward a career in rheumatology with us now. 

Frequently Asked Questions

How much do rheumatologists make?

On average, rheumatologists make on average $253,710 annually, country-wide. However, depending on location, years of experience, and institutions working the salary can range from  $225,240 to $288,290. 

How many years does it take to become a rheumatologist?

It can take about 13 years after high school to become a rheumatologist. This includes four years of undergraduate studies, four years of medical school, three years of residency in internal medicine, and two to three years of fellowship training in rheumatology. 

What skills do you need to become a rheumatologist?

To become a highly qualified rheumatologist, you need to possess a set of hard and soft skills. These include communication skills, critical thinking, attention to detail, diagnostic skills, and time management skills.