Rheumatology and General Internal Medicine

Rheumatology is a sub-specialty of internal medicine involving the diagnosis and treatment of rheumatic diseases.


Rheumatology incorporates the study of joints, soft tissues and related structures called connective tissues. Many rheumatic disorders are defined as ‘auto-immune’ conditions because the triggers for disease onset and maintenance are related to immune aberrations that identify ‘self’ proteins as foreign. Equally, newer and more sophisticated treatments use specific components of the immune system to mitigate the disease process. A trainee in rheumatology must therefore have an in-depth knowledge of internal medicine, excellent general diagnostic skills, an aptitude for clinical analysis and an ability to work in a team environment with clinicians and health professionals from different specialties. Proficiency in joint and soft tissue aspiration and injection is also essential. The duration of HST in Rheumatology is five years, one year of which may be gained from a period of full-time research. Those who wish to obtain dual certification in rheumatology and, for example, in general internal medicine will require at least a fifth year of training.

Higher Specialist Training (HST)


You must have completed Basic Specialist Training in the relevant specialty (or an equivalent programme) by the start date for HST. Please note that not all BST programmes offer consideration of equivalence.

You must have achieved a relevant postgraduate qualification such as MRCPI in General Medicine, General Paediatrics or Obstetrics and Gynaecology. Please note: we have reverted to the previous regulations regarding the examination which were in place before COVID-19. That is, all HST candidates must have successfully passed their MRCPI Clinical Examination relevant to their speciality before their HST interview date.

There are no exceptions to this requirement. You must be currently or previously registered on one of the divisions of the Irish Medical Council, or provide proof of eligibility for registration You must have proof of competency in the English language in line with HSE specifications.

You must have demonstrated an aptitude for, and an interest in, that specialty.