Mission
As one of the world’s leading academic medical center, we strive for the provision of comprehensive, compassionate, superior, expert patient care for rheumatologic and related immunologic diseases. The division of rheumatology is committed to ensuring that our fellows and residents are trained to act as compassionate consultants in rheumatology, capable and adaptable to a variety of work place settings and possess the motivation and desire to continue a lifetime of learning, continual self-reflection and professional growth. As a center of excellence for musculoskeletal ultrasound, we continue to build on our efforts to innovate and expand our pioneering research of common rheumatic diseases. We are committed to further building internal networks of collaboration and aspire to deepen collaborations with colleagues from other institutions.
Program Aims
- To develop physicians to act as competent, compassionate consultants in rheumatology
- To develop physicians who would be capable and adaptable in a variety of work place settings
- To foster and reinforce lifelong learning in order to keep abreast of the evolving profession
- To empower future innovations in the field of rheumatology
Program Goals and Objectives
Consults
To develop a focused approach to the diagnosis and therapy of inpatient rheumatic diseases and to understand the proper indications, contraindications, interpretations, and complications of all rheumatic procedures. The fellow will understand the role of the Rheumatology consultant in the interaction between the referring physician, other consultants, and all ancillary services necessary for the evaluation and therapy of patients under the care of the fellow.
Supervised Consults
Identify key medical problems that the first-year fellow needs to address, while providing direction in the workup and therapeutic management of rheumatology inpatients. Direct literature searches, especially in complex cases, and assist with directing consultations with other medical providers and allied staff.
Musculoskeletal Ultrasound Clinic
The goal of the musculoskeletal ultrasound clinic is to provide a structured training experience through which the fellow will be able to perform accurate musculoskeletal ultrasound (MSU), interpret the results of MSU, and perform MSU-assisted joint aspiration and injection. In the first 12 months of training, the fellow will be expected to know the musculoskeletal anatomy and normal ultrasound scans, as well as to perform injections in large joints (e.g., knee). By the end of the following 12 months, the fellow should be able to recognize pathology on ultrasound scanning and perform injections in small joints/tendons.
Research
All trainees receive practical and theoretical training in the principles of research, including training in the ethical conduct of research, to enable each trainee to evaluate the scientific literature and become a critical decision-maker. Every fellow is encouraged to submit at least one abstract to a national meeting and to play a significant role in at least one paper submitted for publication.
Early on in their first year, fellows identify a mentor and choose either a laboratory-based or a clinical research project. This project is conducted during a month in the middle of the first year, and additional time is allocated throughout the second year of the fellowship. In addition to their actual research work, formal training during these years may include lab seminars and attendance at national meetings in their particular research area of emphasis.
Dermatology
Fellows will be familiar with dermatologic manifestations of rheumatic diseases and, at the end of the rotation, will be able to suspect, recognize, and coordinate care with dermatology.
Pediatric Rheumatology
The fellow will be taught how to examine and evaluate pediatric patients with collagen vascular diseases. The focus will be on the importance of a detailed history and musculoskeletal examination in the diagnosis of connective tissue diseases. The fellow will be exposed to the physical findings in all major collagen vascular diseases, including juvenile arthritis, lupus, dermatomyositis, and scleroderma.
Neurology
This rotation is designed to provide the fellow with complete exposure to a wide array of neurologic complications of connective tissue and neuromuscular diseases, and their investigation and treatment. This rotation also provides extensive experience with electrophysiology, and the fellow will spend considerable time in the EMG lab interpreting EMG/NCS studies.
Radiology
The goal of the radiology elective rotation is to provide the opportunity for the rheumatology fellows to understand the relative strengths, weaknesses, and indications for conventional radiography, CT, MRI, US, and Bone Scan imaging modalities. Fellows will develop an understanding of the basic steps of reading a plain film of the musculoskeletal system.
Ophthalmology
Fellows will be familiar with ophthalmologic complications of connective tissue disease, and at the end of the rotation will be able to suspect, recognize and refer such cases to ophthalmology.
Orthopedics
The goal of this rotation is to provide regular instruction to rheumatology fellows to allow them to gain responsibility and experience in caring for patients with common rheumatologic and orthopedic problems. This instruction, responsibility, and experience allow the development of judgment in clinical skills needed to accurately assess patients and to appropriately refer rheumatologic patients to orthopedic care. Instruction will enhance the knowledge of the fellow in clinical physiology and pathology of orthopedic conditions. This instruction includes the natural history, prevalence, manifestations, differential diagnosis, rational therapy, and preventive and rehabilitative features of the orthopedic condition.
Physical and Occupational Therapy
Through this elective rotation, the fellow will grasp the scope of regional musculoskeletal disorders and the musculoskeletal mechanics that may give rise to regional syndromes. Fellows will understand the utility and role of orthotics and bracing, non-invasive treatment modalities (topical analgesia, ice/heat, TENS unit, iontophoresis, physical and occupational therapy in treating regional musculoskeletal disorders).