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Curriculum - Rheumatology at MedStar Washington

Clinical Program

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, the National Institutes of Health (Sjogren's Clinic) 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.

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 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 our own dedicated musculoskeletal ultrasound. 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.

Fellows also get to see bone density measurement by DEXA and learn how to interpret the results. The rheumatology division uses an infusion center in the outpatient practice for patients receiving infliximab and for patients with SLE and RA in clinical research studies of new biologic therapies. The center is an opportunity for fellows to become familiar with the technical aspects as well as the clinical use of these agents

A variety of academic conferences support the fellows' clinical training (see Conferences).

Fellows as Teachers

Fellows have significant teaching roles on the inpatient service, during outpatient activities, and in didactic sessions. There is generally at least one medical or rehabilitation resident rotating through the program on a one-month elective. There are medical students on rotation in the section as well. Twice weekly fellows lead didactic sessions. Senior fellows are given opportunities to present at clinical conferences and journal club meetings for house staff and rheumatology faculty, and at intra-city rheumatology rounds for their peers and rheumatology attendings.

For more information, please contact:

Travis Thompson
Division Administrator

MedStar Washington Hospital Center
110 Irving Street, N.W., Suite 2A-66
Washington, D.C. 20010-2975

Phone: (202) 877-6274
Fax: (202) 877-6130