Solving mysteries of rheumatology appeals to doc

When it came time to choose a specialty, Dr. Tom Appleton decided on a less-travelled career path. Having wrapped up his residency in internal medicine at University Hospital in London, Ont., he is embarking on a sub-specialization in rheumatology.

Rheumatology is not a typical choice for residents, even though demand is growing. “That seems to be a less common choice for sure,” he says.

The motivation came before medical school when he spent time working with a cartilage scientist at Western University and realized how research could be part of his medical career.

A problem solver by nature, he was intrigued by the thought of spending his life solving mysteries. “With rheumatology, I’ve discovered there are some weird and wonderful diseases that you don’t come across as often and some amazing miracle medications. From a treatment perspective, it’s incredibly satisfying, because it can be life-changing to take someone unable to carry out normal daily activities and help then reengage with life, their community and their friends and family.”

People who have worked in the field say it’s a career well worth pursuing. Rheumatology covers more than 120 diseases, including osteoarthritis, rheumatoid arthritis and autoimmune diseases. While osteoarthritis affects the largest number of people, a majority of diagnoses fall under the inflammatory category (e.g. rheumatoid arthritis, lupus, etc.).

The shortage of rheumatologists in Canada is significant, says Jonathan Riley, vice-president of research for the Arthritis Society in Toronto. “While we are training more, there simply aren’t going to be enough. One of the main drivers for demand is the tremendous increase we will see in the number of patients suffering from arthritis.”

Adding to the challenge is the fact there are not enough openings within medical schools to fulfil that demand. “Right now we’re funding clinician-educators connected with medical schools to help promote rheumatology as a career option.”

Today, rheumatology is a vastly different area, he notes. “The truth is the average age of patients with inflammatory diseases such as rheumatoid arthritis or lupus is 42. Many of the diagnoses are stoppable with the proper treatment. Because of that, interest is growing.”