Rheumatology Fellowship Curriculum

Fellows will have opportunities to customize their schedules to a certain extent. The following represents the major areas of training throughout the fellowship.

GOALS: The overall goals for Years 1 and 2 are competency-based, and we strive to provide trainees with the proper education to:

• Provide patient care that is compassionate and effective for the treatment of rheumatic disease, other associated health problems, as well as the promotion of health.
• Develop a solid knowledge base in the basic and clinical science of rheumatology to apply to research and patient care.
• Cultivate a commitment to professionalism, with regard to all professional responsibilities, adherence to ethical principles, and sensitivity to diverse populations of patients to whom they will provide clinical care and/or research.
• Pursue a lifelong commitment to practice-based learning and improvement so that they may continue to improve their patient care and research practices and hone their skills to provide state-of-the-art education to medical students, physicians and other health care professionals.
• Build interpersonal and communication skills that result in effective interactions with their patients, families, colleagues and other health care professionals.
• Utilize resources to effectively call on system resources to provide optimal care for their patients with respect of the larger health care system (i.e. system-based practice).
• Function in multiple capacities and/or settings, including: primary provider of care of rheumatic disease patients; consultant to other physicians; leader of a multidisciplinary health care team; teacher; and researcher in private practice, multispecialty or academic settings.

Years at a glance

All fellows have every day split into two separate sessions, so the schedule has various combinations of half-day sessions. Inpatient rheumatology is scheduled for half days Monday through Friday and is divided between the first-year Fellow for 10 months and the second-year Fellow for two months.

Trainees attend at least one half-day session of rheumatology fellow outpatient clinic weekly, plus daily patient experiences in the private rheumatology unit. Ambulatory rheumatology (private rheumatology office and fellows ambulatory clinic) is scheduled for half days Monday to Friday. Second-year fellows also have one day per week in the pediatric rheumatology office. 

Consult rotations

Each fellow will spend a total of 12 months over their two years of fellowship training on the hospital rheumatology consult rotation. The hospital rheumatology consultation will allow fellows the opportunity to develop knowledge, skills and attitudes to become confident in the care of hospitalized patients. This experience provides exposure to common rheumatic problems of hospitalized patients and gives fellows the opportunity to develop their skills with the diagnosis and treatment of rheumatic inpatients. Additionally, fellows are exposed to common and uncommon rheumatic conditions and have the opportunity to interact with other members of the care team while managing patients with both routine and complex rheumatic disorders.

During the inpatient consult service months, fellows get a broad understanding of the various rheumatic problems presented by inpatients. The learning process during the month emphasizes patient evaluation and management. Fellows learn how to confirm diagnoses by ordering appropriate laboratory, radiologic and procedural studies. The fellows become familiar with current diagnostic and therapeutic recommendations. Acquiring optimal communication skills with patients and other professionals is constantly emphasized. As in all areas of the curriculum, fellows will display continued mastery of previous milestones prior to management at the next level.

Continuity clinic

The continuity clinic in downtown Allentown will serve as one of the rheumatology fellow’s office practices. Here each fellow will follow his/her own patients longitudinally for the entire two-year period, providing continuity of care, two half-days per week throughout the fellowship. There is also another fellow patient panel clinic occurring 3 additional half days per week. The clinic and fellows panel of patients are precepted by rheumatology division faculty. Patients are referred to this clinic by their primary care physicians or by other specialists for consultation regarding diagnosis and management of a wide range of rheumatic disorders.

Scholarly conferences

Rheumatology Fellow Core Curriculum Course: Three-day course in July, sponsored by the University of Pennsylvania

Rheumatology Weekly Conferences:

Tuesday and Wednesday Conference: weekly

Rheum 101: General Intro to the Management of Rheumatic Patients

Workshops

Crystal Analysis MSK Exam and Joint Injection Workshop Nail Fold Capillary Microscopy Ultrasound Introduction

Core Curriculum - ACR outline

Faculty presentations

Brigham Board Review, and Board Review Questions

Chart reviews

MSK Radiology monthly

Interdisciplinary Conferences

Tuesday Conference: bimonthly

Journal Club

Research Conference: includes QI and research updates, and Challenging Cases in Rheumatology

Medical Grand Rounds: weekly

Elective rotations

Fellows spend one month in the first year and three months in the second year doing elective rotations with the goal of meeting individualized training needs for specific career plans. These elective opportunities range from self-designed elective experiences to established, highly structured experiences. Examples of elective rotation include physiatry, physical therapy, radiology, sports medicine and musculoskeletal ultrasound. Each fellow meets with the program director prior to each elective rotation to discuss specific plans and design the elective rotation.