Rheumatology Fellowship

The Rheumatology program has a 2-year repeating curriculum to ensure that our fellows have the opportunity to formally participate in each learning objective set forth by the American College of Rheumatology during their fellowship training. We use a combination of grand rounds, morbidity and mortality conferences, problem-based learning, lectures, simulation, journal club and bedside experience to teach these objectives. The expectations and goals will depend on the level of training and fellows will assume more responsibility over the course of the fellowship. Rheumatology fellows have reasonable work hours with a favorable balance between work (clinical service and education) and personal life.

Rotations

Fellows Clinic

This clinic affords you the chance to apply the knowledge you have acquired from the different academic and clinical opportunities that form part of your training, into create your unique approach to patient care while still being supervised. You are expected to conduct a review of relevant medical literature applicable to your patients for precepting. This clinic was created to provide further educational opportunities, where all fellows can use evidence-based medicine in both diagnostic and therapeutic decisions. The progressive responsibility model guarantees that upon completion of the program, you will be adequately equipped to offer care to patients wherever you choose to practice.

Ambulatory Rotation is where each fellow will encounter common rheumatologic problems. During this rotation, the fellows attend the half-day outpatient continuity clinic staffed by full-time faculty and may interact and/or mentor residents, fellows from other specialties, and medical students. The patients generally include those with conditions such as inflammatory arthritis, lupus, sarcoidosis, scleroderma, inflammatory lung and muscle disease.

• Specialty Clinic
  • Lupus Clinic is also available to fellows during their Ambulatory Rotation. The lupus clinic is where each fellow will be exposed to patients with systemic lupus erythematosus. Fellows will be involved in diagnostic and therapeutic steps throughout their fellowship. They will also have access to a Lupus Registry and Bio-repository research tool.
  • Gout Clinic will be available to fellows during their Infusion Rotation. The gout clinic is where each fellow will gain experience with gout/CPP arthritis management patients.
  • RA Clinic will be available to fellows during their Research Rotation. The RA clinic is where each fellow will be exposed to patients with rheumatoid arthritis. 
• Fellow Faculty Clinic will enable fellows to spend individualized time with our diverse group of providers who specialize in different areas of rheumatology including systemic lupus erythematosus, rheumatoid arthritis, and crystal arthritis.
• Procedure Clinic will be available to fellows during their Ambulatory Rotation. The procedure clinic is where each fellow will gain experience in common rheumatology procedures including the use of ultrasound.
• Infusion Center Rotation is where fellows will be exposed to caring for patients on infused therapies and the problems that may arise from such treatments.
• Research Rotation is where fellows participate in research and scholarly activity of their choice. They will have access to a research coordinator and an assigned mentor for each project undertaken. The end goal is to have at least one academic product in clinical rheumatology, practice-based quality improvement, patient safety, or translational medicine.
• Elective Rotation is where each fellow will select where they would want to gain experience among diverse choices of specialties including, but not limited to, Allergy and Immunology, Cardiology, Dermatology, Geriatric Medicine, Nephrology, Neurology, Physical Medicine and Rehabilitation, Pulmonology, and Radiology.

Inpatient Consult Service  is mainly at Carilion Roanoke Memorial Hospital (CRMH)  is where each fellow encounters a large variety of inpatient inflammatory rheumatic disorders and diagnostic problems. The rotation is based in Carilion Clinic’s tertiary referral hospital where we provide a consulting rheumatology service supervised by a rheumatology faculty with dedicated time for call. Fellows will take approximately 1-in-4 call.

Didactic Sessions

• Didactic lectures are offered Monday through Friday. The didactics are given by rheumatology faculty that cover a comprehensive list of appropriate milestones. 
• Journal Club is held on the first and second Tuesdays of the month from noon to 1 p.m. An article of importance is presented by a fellow with discussion led by a designated faculty member.
• Morbidity and Mortality (M&M) Conferences are held on the third Tuesday of the month from noon to 1 p.m. M&M conferences are case-based directed learning to improve patient care and outcomes.
• Rheumatology Grand Rounds (RGR) are held on the fourth Tuesday of the month from noon to 1 p.m. Each fellow makes at least one presentation during the academic year on a topic of their choice.
• Renal Pathology Conferences are offered quarterly on Wednesdays from noon to 1 p.m.
• Internal Medicine Medical Grand Rounds are offered every Friday morning from 7:30 to 8:30 a.m.
• Education and Research Mentorship takes place during the Research Rotation. Planned, ongoing and/or completed research projects are discussed and presented by fellows and faculty.