Rheumatology Fellowship Program

MedStar Washington Hospital Center's Division of Rheumatology, a division of the Department of Medicine, is an active and challenging place to learn and work. Its general arthritis clinics, and lupus clinic, along with the practices of full-time faculty, log more than 3,500 outpatient visits per year.

On the inpatient service, the division provides approximately 500 consultations yearly with a wide variety rheumatic conditions.

The program is an ACGME-approved, two-year program with an option for further research training. Its primary goal is to train physicians to be highly skilled consultants in rheumatology with demonstrated competencies in patient care, medical knowledge, professionalism, practice-based learning, and systems-based practice.

The program's emphasis on clinical experience, didactics, and research prepares fellows for their choice of career: clinical practitioner, clinician educator, or researcher.

The program offers fellows every benefit of training at a renowned acute care, teaching, and research hospital. There is a shared schedule of conferences with MedStar Georgetown University Hospital, adding a broader base to the teaching faculty. 

The Washington Hospital Center serves a diverse patient population presenting a wide range of usual and unusual cases. The faculty provides expertise not only as clinicians, but also as researchers.

Exposure    

Fellows receive the majority of their clinical training at MedStar Washington Hospital Center; second-year fellows can schedule elective rotations at Children's National Medical Center and MedStar Georgetown University Hospital.

Fellows see outpatients in two to four clinics/practices weekly (fewer in the 2nd year): the General Arthritis Clinics (2), Lupus Clinic, and the practices of the full time faculty. They spend approximately four months on the inpatient service in the first year and two months in the second year.

Fellows average approximately 150 joint/tendon/soft tissue aspirations/injections during the two years and develop expertise in synovial fluid analysis and polarizing microscopy. In addition, fellows learn musculoskeletal ultrasonography and have the opportunity to utilize an ultrasound in our joint injection clinic as well as in other inpatient and outpatient settings.

Technology

Along with experience in traditional methods of evaluation and treatment, the fellows' education includes exposure to advances in technology as they relate to rheumatology patients.

The Washington Hospital Center has state-of-the-art imaging capabilities including regular angiography, CT angiography, cardiac MRI, PET-CT, and 3.0 Tesla MRI. The division also has two dedicated musculoskeletal ultrasounds. Fellows are instructed on the use of these diagnostic procedures, especially in patients with serious systemic rheumatic diseases and systemic vasculitic disorders.

Through monthly radiology conferences with musculoskeletal radiologists, fellows become familiar with the use of traditional X-rays as well as nuclear scanning, CT, MRI and ultrasound to diagnose articular, periarticular, muscular, and bone disorders.

As part of their training, fellows are required to participate in investigator-initiated clinical or translational research. The research requirement is flexible, enabling research-focused fellows the ability to develop a project from beginning to end as well as allowing more practice-focused fellows to gain research experiences as part of pre-existing projects.

The goal of the research requirement is to develop critical thinking skills that are unique to scientific investigation and provide fellows a broader perspective to interpret scientific literature. Typically, fellows develop their research projects during the first year and have reduced responsibilities on the inpatient service and in outpatient clinics in year two to allow time for the completion of their projects.

Fellows are guided and supported in their projects by the research director, faculty mentors, research coordinators, and the resources of the MedStar Health Research Institute. Dedicated lectures about research methodology, immunology, and statistical methods are part of the fellow curriculum.