The Rheumatology Teaching Unit provides education in rheumatology to Bulgarian and international medical students as part of the Internal Medicine course. Semester-based teaching is conducted in the fourth year of study on a modular basis and includes lectures, seminars, and practical sessions focused on the diagnosis, differential diagnosis, follow-up, and treatment of the main rheumatic diseases. The educational process emphasizes clinical reasoning, physical examination of the musculoskeletal system, interpretation of laboratory and imaging findings, and the modern therapeutic approach to inflammatory, autoimmune, degenerative, and crystal-induced arthropathies.
The Rheumatology Teaching Unit participates in the state internship in Internal Medicine for sixth-year medical students, as well as in the training of residents and PhD students in rheumatology and internal medicine. The clinical base of the teaching unit is the Clinic of Rheumatology at St. Marina University Hospital, Varna, which is an established academic structure for postgraduate qualification and practical training. The clinic is the largest rheumatology structure in Northeastern Bulgaria, with a 50-bed inpatient ward and more than 3,000 hospitalizations per year of patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, gout, osteoarthritis, systemic lupus erythematosus, myositis, systemic sclerosis, systemic vasculitis, and other rheumatic diseases.
Modern diagnostic approaches are used in teaching, including musculoskeletal ultrasound, conventional radiography, computed tomography, magnetic resonance imaging, capillaroscopy, and methods for the diagnosis of crystal-induced arthropathies. The clinic has access to high-technology imaging diagnostics, including ultrasound diagnostics of the musculoskeletal system, magnetic resonance imaging, high-resolution computed tomography, and dual-energy computed tomography, enabling early detection and precise staging of joint and systemic diseases.
The habilitated academic staff of the Rheumatology Teaching Unit participate in the training of PhD students within the accredited doctoral program “Rheumatology”. Dissertation topics developed within the unit are related to inflammatory joint diseases, spondyloarthritis, osteoarthritis, imaging diagnostics, biomarkers, systemic autoimmune diseases, and modern therapeutic strategies. The teaching unit encourages the involvement of young physicians, residents, PhD students, and medical students in scientific tasks, clinical observations, projects, and publication activities.
The academic staff of the Rheumatology Teaching Unit are members of and actively participate in national and international scientific societies and professional organizations, including the Bulgarian Society of Rheumatology, the European Alliance of Associations for Rheumatology, EMEUNET, SLEuro, and other scientific and expert structures in the fields of rheumatology, internal medicine, imaging diagnostics, and medical education. Members of the academic staff participate in national and international scientific forums, review manuscripts for international journals, and maintain active publication activity in the field of clinical rheumatology. The profile of the head of the unit includes scientific interests in osteoarthritis, biomarkers, imaging diagnostics, musculoskeletal ultrasound, and spondyloarthritis.
Research activity in the Rheumatology Teaching Unit covers a broad diagnostic and therapeutic spectrum of the specialty and is oriented toward contemporary clinical practice. A major priority is the translation of scientific results into early diagnosis, individualized treatment, assessment of disease activity, pain control, improvement of functional status, and enhancement of patients’ quality of life.
The main scientific fields of the Rheumatology Teaching Unit are:
- Inflammatory joint diseases and anti-cytokine therapy in rheumatoid arthritis, spondyloarthritis, and psoriatic arthritis.
- Non-radiographic axial spondyloarthritis, early diagnosis, imaging assessment, and follow-up of patients with spondyloarthritis.
- Osteoarthritis, including hand and knee osteoarthritis, new concepts of pathogenesis, biomarkers, pain, functional limitation, and non-pharmacological treatment.
- Musculoskeletal ultrasound and imaging diagnostics in rheumatology, with applications in inflammatory, degenerative, crystal-induced, and periarticular diseases.
- Biomarkers for early diagnosis, assessment of disease activity, therapeutic response, and cardiovascular risk in rheumatic diseases.
- Musculoskeletal manifestations in psoriatic disease, including joint, entheseal, tendon, and periarticular involvement.
- Systemic autoimmune diseases, including systemic lupus erythematosus, systemic sclerosis, inflammatory myopathies, and systemic vasculitis.
- Crystal-induced arthropathies, gout, pyrophosphate arthropathy, and modern diagnostic approaches, including microscopic and imaging methods.
- Cardiometabolic comorbidity in rheumatic diseases, including the relationship between chronic inflammation, vascular risk, diabetes, obesity, and the systemic effects of biological and targeted therapy.
- Artificial intelligence, digital technologies, and new analytical approaches in the diagnosis, follow-up, and scientific evaluation of rheumatic diseases.
- Vaccination prophylaxis and infections in patients with rheumatic diseases, including management of immunosuppressed patients.
- Patient-centered outcomes, pain, quality of life, functional status, and adherence to therapy in chronic rheumatic diseases.
The Rheumatology Teaching Unit develops an independent clinical and scientific profile within the Department of Cardiology and Rheumatology. The unit combines the traditions of the Varna school of internal medicine with modern rheumatology practice based on early diagnosis, highly specialized imaging assessment, access to contemporary disease-modifying therapies, and active scientific output in the field of inflammatory, degenerative, autoimmune, and crystal-induced diseases.
The Head of the Rheumatology Teaching Unit is Assoc. Prof. Tsvetoslav Georgiev, MD, PhD. The unit also includes Dr. Svetoslav Dimitrov, MD, PhD – Chief and Administrative Assistant Professor; Dr. Simona Bogdanova, MD, PhD – Chief Assistant Professor; and Dr. Jacqueline Apostolova – Assistant Professor.
