How to get into rheumatology st4 guide

Published February 4, 2025 | Updated February 4, 2025

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By MedCourse

Useful, relevant, and interesting content for UK Junior Doctors.


About the Author

Urwah

Urwah Ahmed, Rheumatology ST4, Cheltenham General Hospital 

I have been the Sub-lead for the Rheumatology section of Optimise Interviews for the past year. As part of this role, I have created interview stations and knowledge update videos.

Courses & Conferences to Attend

I attended nearly every conference  and course organised by the British Society of Rheumatology that I could. This included the Annual Conference, the Case Based Conference, the Core Skills course and the Connective tissue diseases course. I also signed up to be a member of the BSR so I could access their e-Learning content. 

I also attended conferences organised by other speciality societies to present my work e.g. the British Thoracic Society Annual Conference, and the Intensive Care Society Annual Congress.

Finally, I attended the Optimise Interviews course for interview preparation.

I would recommend attending any of the conferences and courses organised by the BSR listed above. These can usually be claimed through the study leave budget. I would also recommend attending the ‘Ten topics in Rheumatology course’ which always has great reviews, but I was unable to make.

Although I did not attend a Teach the Teacher course as I was already doing a PG CERT in clinical education, I would recommend going on such a course as it can be considerably cheaper and less time consuming than the PG CERT and in the short term gets you just as many points on the application. 

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How to Maximise Your Portfolio

I would look at the scoring matrix for the ST4 applications (available on the JRCPTB website) as early on as possible and create a to-do list for yourself to ensure you meet those targets.

Whilst it is important to get stuck into projects that you have a genuine interest in and may take a while to complete, you also need to be pragmatic and ensure you have something to show on your CV (and the application) for all your hard work.

Similarly, try not to say yes to every project you are offered -the project should either

  • Develop or enhance your skillset
  • Lead to an output that you can use for your application. 

It is also worth collaborating with your colleagues who have similar career aspirations to yourself, as you can share your workload but both potentially gain equal benefit. There are some domains on the application (e.g. organising teaching) where liaising with colleagues gets you more points.

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Making the Most of Your Day Job

If you have rotations that are less busy or demanding (e.g. with no on-call commitments), consider getting your membership exams out of the way early so that you can focus your attention on maximising other portfolio opportunities later. 

Don’t limit yourself to Rheumatology based projects only – not only are a lot of the skills you gain transferable, but a lot of the scoring matrix for the applications do not specify Rheumatology specific projects.

Making the Most of Rheumatology Placements

Ensure everyone in the department knows about your career aspirations so that they can loop you into any ongoing projects, and when the time comes, help you prepare for interviews. 

Attend plenty of clinics, especially Early Inflammatory clinics, as this will set you up well for dealing with some common scenarios both for the interview, as well as when you start work as a registrar.

What About Non-Rheumatology Placements?

Whilst you may have a specific speciality in mind very early on in your career, remember that almost all medical specialities now require dual training, requiring you to work as a medical registrar.

Therefore, it is important that you make the most out of the experiences you gain in other specialties so you feel confident when being the on-call medical registrar. 

As above, think about taking up any projects that may yield an output such as a poster, presentation or publication, even if it is not directly related to Rheumatology.

Top 3 Tips for Getting Into Rheumatology

  • Make a to-do list
  • Look at the scoring matrix for ST4 applications early, and try to match any projects you take on to this in the first instance.
  • Get plenty of practice for you interview
  • The interview has a much higher weighting on your overall score than the self assessment, so don’t despair if the latter is not as high as you would like and just keep practising for the interview.
  • Prepare in advance
  • Start preparing for your interview at least a couple of months prior than the advertised interview date assuming that you have got an interview (they don’t officially inform you if you have got an interview until a week or two in advance of the interview, by which point it would be far too late).


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