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.