Clinical Training & Education
Core Curriculum and Didactic Lecture Series
The core curriculum lecture series takes place every Monday between 8-10 AM. The first half of the lecture the fellows review assigned topics. The topics represented are from the American College of Rheumatology updated June 2015 Core Curriculum Outline for Rheumatology Fellowship Programs, Medical Knowledge Section. Over the two year fellowship program many, if not most, of the suggested curriculum topics are covered. The second half of the lecture series is a more formal lecture by the rheumatology faculty on his/her area of expertise. We also invite guest faculty from other divisions and departments in the UCCOM, the VAMC and the Cincinnati Children’s Hospital Medical Center (CCHMC). We incorporate lectures throughout the academic year about the business side of medicine as well. Examples are lectures on how to code an office visit and the documentation required - we have a dedicated rheumatology-specific code specialist, discussions with business and practice administrators about what it takes to run a rheumatology business whether it is a community-based practice versus hospital-based practice. The fellows also have the opportunity to practice board review questions during several sessions each year.
The Department of Medicine sponsors lecture series throughout the academic year including a Master Teachers Program, teaching workshops on dealing with the impaired physician, grant writing fundamentals, introduction to clinical research, presentation and writing skill workshops and ethics in research.
Hospital Consultative Rotation
The fellows are responsible for all inpatient rheumatology consultation requests at the UCCOM and VAMC. First year fellows will spend four months on this combined inpatient rotation and second year fellows will spend two months. The rheumatology fellow is notified each day of consults requested on the inpatient services from these two participating hospitals. The fellow will perform a history and physical on every patient and is responsible for assigning and overseeing resident and student participation in this activity. The fellow will also review all pertinent laboratory data and radiographs, review the relevant medical literature, and help the residents and students to prepare for attending consult rounds. The Rheumatology attending supervises the patient's history, physical examination and the team decision making process involved in the impression and plan of action for each rheumatology inpatient. Fellows will become competent in the evaluation, diagnosis and management of a wide range of common, uncommon and rare rheumatic diseases.
Ambulatory Clinic Rotation
Each first year fellow attends the Tuesday afternoon VAMC Arthritis clinic, a UCCOM Arthritis Continuity Clinic on either Wednesday afternoon or Thursday morning, and the Friday morning TCH Arthritis Continuity Clinic. Each clinic is 12 months in duration. For additional exposure to ambulatory rheumatology care, each fellow is assigned to work one on one with a faculty members in his/her private clinic for 3-4 months out of the year. The goals of the ambulatory experience include: the development of the skills to competently and efficiently evaluate both new and follow-up patients, gain confidence and skill in the longitudinal follow-up of patients with a wide variety of rheumatologic diseases in an outpatient setting including evaluation of individual patient response to therapy over time, and fine tune the necessary interdisciplinary and communication skills needed when acting as a consultant and caring for patients with chronic illnesses. All patient evaluations are supervised by an attending rheumatology faculty member.
All second year fellows are required to attend the Tuesday AM Lupus Continuity Clinic for six months out of the year, and the Thursday afternoon VAMC Continuity Clinic for twelve months. Those fellows pursuing a research track have the rest of the time to devote to his/her individual project(s). For those fellows who opt for a clinical track, each fellow is assigned to work one on one with a faculty member in his/her private clinic. On average, each clinical fellow does an additional three half day clinic rotations per week.
All first year fellows participate in four one month electives in closely allied fields: Dermatology, Pediatric Rheumatology, Orthopedic Surgery, and Physical Medicine and Rehabilitation. These electives are primarily ambulatory/outpatient venues, inpatient rotations and call is not required. Second year fellows have the option to design one month electives in additional areas of interest such as osteoporosis with endocrinology and sports medicine.
Rheumatology Grand Rounds: Fourth Wednesday each month at 8AM. All fellows are responsible for 2-3 presentations per year.
Allergy Grand Rounds: Second Wednesday each month at 8 AM. Attendance required.
Journal Club: The first and third Friday of each month at 1 PM. Fellows present recent articles relevant to rheumatology training and practice.
Case Management: The second and fourth Friday of each month at 1 PM. Fellows, residents and students present interesting clinical cases.
Additional conferences: Quarterly radiology conference in conjunction with the Division of Radiology: Musculoskeletal section, periodic combined Connective Tissue/Interstitial Lung Disease conference in conjunction with the Department of Pulmonary, “Cross Talks” – a monthly meeting in the Department of Medicine that provides fellows doing clinical research the opportunity to present his/her research and receive feedback, Internal Medicine Grand rounds.
Second year fellows have the opportunity to apply for and complete the MSUS course through USSONAR. Ultrasound machines are available for use at three of our ambulatory clinical venues and we have faculty that have trained in MSUS and completed the USSONAR course.