Adequate knowledge and clinical competency are essential for sound rheumatology practice. The aim of this study was the assessment of the adequacy of rheumatology education at the primary care level. Two hundred and ninety-seven primary care physicians participated in this cross-sectional survey. Participants were asked to complete a question survey and to take a previously validated rheumatology examination. The participants rated rheumatology education as important but rated the time spent on rheumatology education as poor. More than 80% of the participants reported a low level of confidence in performing a musculoskeletal physical examination. Of the participants, 75% scored 65% or less in the validated rheumatology examination. The findings of the present study indicate that medical education in rheumatology is inadequate at both the basic and clinical levels. The competence level of graduating physicians in musculoskeletal problem solving is inadequate. Furthermore, the time devoted to rheumatology education and training is disproportionately low compared to the frequency of musculoskeletal complaints encountered in general practice.