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生命．愛心．卓越．創新
LIFE ．LOVE．EXCELLENCE．CREATIVITY

Division of Allergy, Immunology and Rheumatology

About us Doctor Future Plans
Goals The training course aims to develop Doctors of rheumatology with the following professional qualities:
  1. Doctors who are internally motivated in the goal of life-long, self-oriented learning while maintaining the most current medical standards.
  2. Doctors who have the professional Knowledge to handle all types of rheumatic autoimmune diseases and care for patients.
  3. Doctors who have the passion for teaching future Doctors and clinical skills.
  4. Doctors who have the interest and potential to conduct in-depth research in rheumatic autoimmune diseases.
Content 　　The society’s current guidelines require specialists to train for a 2-year period in the aspects of basic Knowledge and clinical training.

Basic Knowledge
Possess sufficient basic Knowledge to understand the etiology and pathological physiology of rheumatic autoimmune diseases and the theoretical basis to provide further diagnosis and treatment or develop the interest and potential in research. Relevant Knowledge includes microbiology and immunology, molecular biology and biochemistry, tissue anatomy and pathology, physiology and cell biology, epidemiology and medical statistics. Additionally, individuals familiar with the principles of operating in laboratories for serum immunological testing will have the advantage of improved interpretation of tests and can be assigned to departments to observe and learn to perform techniques including immunoblot, immunofluorescence, flow cytometry, nephelometry, ELISA, and PCR.

Clinical Training
After training, Doctors should possess a wealth of professional Knowledge for all types of rheumatic autoimmune diseases including epidemiology, pathological physiology, clinical manifestations, diagnosis and differential diagnosis, clinical treatment and disease prognosis. This Knowledge will equip Doctors with skills such as the effective inquiry of medical history and precise physical examination skills and arrangement of appropriate examinations as well as interpretation of results to administer effective treatment plans, regularly evaluate the results of treatment, and notify relevant specialists for participation in the patient’s diagnosis and treatment.

Professional Knowledge of Common Diseases
Autoimmune diseases include rheumatoid arthritis, seronegative spondyloarthritis (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, etc.), systemic lupus erythematosus (antiphospholipid syndrome, etc.), idiopathic inflammatory myopathy, systemic sclerosis, Sjogren’s syndrome, Behçet’s disease, systemic vasculitis, mixed connective tissue disease, relapsing polychondritis, IgG4-related disease, adult-onset Still disease, arthritis caused by crystals (gouty arthritis, pseudogout, hydroxyapatite periarthritis, etc.), infectious arthritis (bacteria, mycobacteria, etc.), local rheumatologic disease in soft tissue (palindromic rheumatism, etc.) osteonecrosis (avascular necrosis, etc.) degenerative arthritis (erosive osteoarthritis, etc.), immunodeficiency (common variable immunodeficiency, etc.), and other rheumatic autoimmune diseases.

Relevant Skills for Diagnosis
(1). Synovial fluid aspiration
(2). Examination of synovial fluids including crystal identification
(3). Operation of musculoskeletal ultrasound
(4). Interpreting joint X-rays and special images (bone scan, CT, MRI, sonography, etc.)

Common Interpretation Skills in Laboratory Examinations
ANA (titer/pattern), anti-CCP, anti-dsDNA, anti-Sm, anti-RNP, ANCA, anti-ribosomal P, anti-Scl70, anti-Jo-1, anti-MPO, anti-PR3, lupus anticoagulant, anti-b2GPI, anti-cardiolipin, RF, Coombs’ test, ASLO, anti-SSA/SSB, ESR/CRP, HLA-B27, cryoglobulin, C3/C4, uric acid, CK/muscle enzymes, circulating lymphocyte surface markers, synovial fluid routine, etc.


Skills and Knowledge of Treatment Methods
  1. Possess the skills of synovial fluid aspiration and joint cavities and the synovial sac steroid injection.
  2. Familiarity with the mechanisms, side-effects (including effect on pregnancy and reproductive ability), and NHI pricing of common drug treatments used for rheumatic autoimmune diseases. Common drugs include NSAIDs (COS-2 selective, etc.), corticosteroids (including various dosage and different methods of drug administration), DMARDs (cyclosporin/tacrolimus, hydroxychloroquine, leflunomide, methotrexate, sulfasalazine, etc.), biologic/targeted agents (abatacept, adalimumab, belimumab, etanercept, rituximab, tofacitinib, tocilizumab, etc.), immunosuppressants (azathioprine, cyclophosphamide, mycophenolate, etc.), anticoagulant (warfarin, heparin, etc.), vasodilator (sildenafil, prostaglandin E1, etc.), anti-gout agents (allopurinol, benzbromarone, febuxostat, colchicine, rasburicase, etc.), IV immunoglobulin, etc.
  3. Familiarity with the Knowledge, techniques, and indications of plasmapheresis.
  4. Possess basic Knowledge of rehabilitation treatments and indications of orthopedic surgery as well as the ability to recommend patients to accept suitable physical therapies and appropriate surgical treatments.
Method Participate in the diagnosis and treatment of ER, outpatient clinics, and hospitalized patients. Earn professional experience by learning with a team of peers under the guidance of attending physicians and the department director. Regularly attend case discussions within and outside the disciplines, group readings of select journals, and domestic rheumatology related seminars to enrich professional Knowledge. Also learn Knowledge relevant to the medical law of this specialty.
Tasks
  • Join attending physicians from Monday to Friday where teaching is conducted while they make rounds and visit patients. Work with attending physicians to co-manage residents in handling the diagnosis and treatment related tasks of hospitalized patients.
  • Responsible for coordination between specialties within the hospital, work closely with the attending physician on duty and complete hand-offs within 24 hours.
  • In the 2nd year of training, Doctors will be responsible for public outpatient clinics once or twice each week under the guidance of an attending physician.
  • Assist in the teaching of specialist medical students (including interns and trainee physicians) and be responsible for the collection of grading charts and medical records used for teaching after training concludes.
  • Attend the seminars or annual meetings hosted by the college of rheumatology or society of immunology.
  • Must propose case reports in the regularly hosted rheumatology seminar in Southern Taiwan under the guidance of the department director; complete an original thesis paper upon completion of training for submission to a journal published by the college of rheumatology.
  • Other tasks deemed by the department director to be relevant to specialist training.
Review, Promotion Regular reviews are conducted by the department director based on the trainee physician’s learning attitude, professional Knowledge, clinical ability, and work performance as well as the opinions of other attending physicians within the disciplines. Trainees who pass the course will be issued a certificate and shall participate in the specialist examination organized by the Taiwan College of Rheumatology. Trainees who display exceptional performance will be aggressively recruited as an attending physician in the specialist disciplines of this hospital or a hospital within the related system.