Rheumatologist

You treat diseases of the joints, muscles, and immune system – conditions that disproportionately affect African women.

What this life looks like

Rheumatic diseases – conditions affecting the joints, muscles, bones, and the immune system more broadly – are among the most common causes of disability in the world. Rheumatoid arthritis, lupus, gout, psoriatic arthritis, and ankylosing spondylitis affect millions of people across Africa, causing pain, disability, and progressive damage to joints and organs. Lupus – a systemic autoimmune disease that can affect the skin, kidneys, heart, and nervous system – is more severe in people of African descent and more common in women. Yet Africa has fewer than 200 rheumatologists for a continent of over 1.4 billion people, meaning the vast majority of people with rheumatic diseases receive no specialist care and are often managed incorrectly for years before diagnosis. As a Rheumatologist you are the physician who specialises in these conditions – diagnosing complex cases, prescribing disease-modifying treatments, managing the long-term care of patients with chronic disabling disease, and working to prevent the irreversible joint and organ damage that poor management causes.

What she actually does

A Rheumatologist diagnoses and manages inflammatory arthritis, connective tissue diseases including lupus and scleroderma, vasculitis, crystal arthropathies including gout, musculoskeletal pain conditions, and the rheumatic manifestations of systemic diseases. They prescribe disease-modifying antirheumatic drugs and biologic therapies, perform joint injections and aspiration, manage immunosuppression, and monitor for treatment side effects and disease complications.

Where you can work

Sector	Places in Africa
Rheumatology departments in teaching and specialist hospitals	Chris Hani Baragwanath Academic Hospital (South Africa), Federal Teaching Hospital Owerri (Nigeria), Kenyatta National Hospital (Kenya)
Private rheumatology practice	Institute of Orthopaedics and Rheumatology (IOR) (South Africa), Arthritis and Rheumatology Centre (Kenya), Lumina Health
Academic rheumatology departments	Wits University Division of Rheumatology, Stellenbosch University Division of Rheumatology, University of Ibadan Department of Medicine
Pharmaceutical companies developing antirheumatic therapies	Austell Pharmaceuticals (South Africa), Afro Therapeutics, Roche Africa (Biologicals for RA/Lupus)
Research institutions studying rheumatic disease	The South African Rheumatism and Arthritis Association (SARAA) Research Units, KEMRI (Kenya), Irrua Specialist Teaching Hospital
Regional and international rheumatology societies working to build African rheumatology capacity.	African League of Associations for Rheumatology (AFLAR), Nigerian Society of Rheumatology (NSR)

Why it matters in Africa

Lupus is two to three times more common in women of African descent than in European women, and the disease tends to be more severe, affecting the kidneys and other organs. Rheumatoid arthritis, if untreated, causes progressive joint destruction within years of onset – yet most patients in Africa are diagnosed late when damage is already done. Gout, driven by rising uric acid levels linked to diet and kidney disease, is one of the most common causes of acute joint pain. The absence of rheumatologists means that patients with these treatable conditions become unnecessarily and permanently disabled.

Your pathway in

Biology, Chemistry, and Mathematics at secondary school. Then MBBS or MBChB over five to six years, followed by housemanship. Internal medicine residency then subspecialty fellowship in rheumatology through the West African College of Physicians or equivalent body follows. The full pathway takes approximately 12 to 14 years.

Skills you will need

Technical: Rheumatological examination, joint aspiration and injection, autoimmune antibody interpretation, imaging including X-ray, ultrasound, and MRI for joint assessment, disease-modifying drug management, and immunosuppression monitoring. Human: Long-term relationship management with patients who have chronic, painful, and often unpredictable conditions, the ability to empower patients to manage their disease actively, and sensitivity to the profound impact that visible disability has on quality of life, work, and self-image. Digital tools: Rheumatology disease activity scoring tools, musculoskeletal ultrasound systems, electronic rheumatology records, and patient self-monitoring apps.

A woman in this field

Prof. Nimmisha Govind

South Africa

The Academic Head of the Division of Rheumatology at the University of the Witwatersrand and Clinical Head at Chris Hani Baragwanath Academic Hospital. She is a leading expert in the clinical management of complex autoimmune diseases in African populations. Her research has been pivotal in understanding the presentation of systemic lupus erythematosus (SLE) and rheumatoid arthritis in the region. She is an active leader in the South African Rheumatism and Arthritis Association (SARAA) and is dedicated to training the next generation of African rheumatologists to address the severe shortage of specialists on the continent.

Take your first step

Biology and Chemistry are your core subjects at school. Start learning about the immune system – understanding how autoimmunity works, why the body's defence system can turn against itself, is the conceptual foundation of rheumatology. The African League of Associations of Rheumatology has information about rheumatic disease in Africa. If you have family members with arthritis or joint conditions, understanding their experience will give you a personal connection to the patients you will eventually care for.