My brother in law is a rheumatologist and I have talked with him about his hiring process for NP's in his practice. First thing he looks for is rheumatology experience - although 99% of applicants have none and he realizes this and is prepared to train them. The next thing he looks for is an interest in rheumatology - he wants to know if he invests time and money training you that you will be there for years to come. Im in NP school now, I plan to 1/3 of my clinical hours with a rheumatologist, then take the American College of Rheumatology's NP/PA course to get certified as a mid-level. If that's not enough to show a rheumatologist that I want to work in rheumatology, I don't know what is. Unfortunately, it is pretty difficult to get experience in rheumatology as an RN. Most rheumatologists do not use RNs unless they do infusions.