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A rheumatology curriculum in Pakistan for empowering family physicians and fighting disability



Pakistan has a population of over 200 million with only 75 trained rheumatologists. To address the needs of rheumatology care, it is of paramount importance to train the primary care physician as a first line of defense.


The project “Empowering Family Physicians; fighting disability” was the recipient of a 2018 ILAR grant. This project began with development of an evidence-based curriculum using ACR Rheum2learn modules along with guidelines from international societies. A blended learning approach was chosen with nine online learning modules sandwiched between two face-to-face sessions. Participants’ assessment entailed quizzes, clinical scenarios, and portfolio development all completed online, while face-to-face sessions relied upon power-point presentations and an objective structured clinical examination. Course impact was assessed with pre-course and post-course questionnaires. Overall perception of the training was evaluated through candidate feedback.


Participants were enrolled from across the country totaling 48 health care providers (44 family physicians and 4 allied health professionals). The adherence to face-to-face sessions was 82.5% and 63.6% for the online component. The mean score for post-course assessment (mean = 2.369, SD = 0.3425) was significantly higher than for the pre-course assessment (mean = 1.792, SD = 0.4838) with statistically significant difference of, t (12) = − 7.756, p < 0.0001 (confidence interval: − 0.7390 to − 0.4149). The perception of the strategy was positive with 80% strongly satisfied with the workshops and presentations.


Empowering family physicians by training them in rheumatology care can be an effective tool to fight unmet needs in access to musculoskeletal health care. We plan to offer a shortened version of the course at regular intervals.

Key Points
• Pakistan has a huge shortage of rheumatology care with only 75 rheumatologists caring for a population of over 200 million.
• To improve access to rheumatology care,the “Empowering Family Physicians; Fighting disability” course was launched in 2018 with the help of anILAR grant.
• A blended learning approach comprising of 9 online modules sandwiched between two face-to-face sessions was chosen.
• A statistically significant difference between pre- and post-courseself-assessment of participantssuggests that the courseis an effective tool for teaching Family Physicians.

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Financial Disclosures

  1. 1.

    The course “Empowering family physicians; fighting disability” was funded by The International League of Associations for Rheumatology educational grant.

  2. 2.

    This research was in part supported by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health.


ILAR for funding the project; “Empowering family physicians; fighting disability” in 2018.

Dr. SameeyaAfzal, Head of Family Medicine Department Fatima Memorial System and her team.

Dr. Amina Ahmad, Director Department of Medical Education, Fatima Memorial System

Ms. AfshanKhanum, Bio-statistician at Fatima Memorial Hospital College of Medicine & Dentistry.

This research was in part supported by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health.

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Correspondence to Sarfaraz A. Hasni.

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Part of the Topical Collection entitled ‘Empowering Medical Education to Transform: Learnings from an international perspective

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Khan, S.E.A., Saeed, M.A., Batool, S. et al. A rheumatology curriculum in Pakistan for empowering family physicians and fighting disability. Clin Rheumatol (2019). https://doi.org/10.1007/s10067-019-04797-7

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  • Family physicians
  • General practitioners
  • Primary care physicians
  • Rheumatology
  • Portfolio
  • Online learning