Fellows receive superb clinical training by caring for patients with a wide range of rheumatic conditions while learning from faculty who are leading experts in many sub-specialties within rheumatology.
Curriculum
Fellows participate in numerous other educational activities, including:
Weekly case-management conference- Journal club facilitated by faculty with expertise in epidemiology
- Mortality and morbidity conference
- Rheumatology Grand Rounds given by experts from within the University of Pennsylvania and across the country
- Joint conferences with Dermatology, Pediatric Rheumatology, Allergy & Immunology, Endocrine, Pulmonary, and Musculoskeletal Radiology
- An immunology lecture series led by faculty experts in basic science and immunology
- Didactic lectures covering the full range of clinical and basic pathophysiologic topics necessary to become a well-rounded rheumatologist
- Monthly Chief Rounds with Division Chief, Peter Merkel to chat miscellaneous topics and cases in Rheumatology, informally, over snacks
Continuity Clinics
Throughout their fellowship, fellows maintain two continuity clinics at: one at the University of Pennsylvania (with clinic at either the Perelman Center for Advanced Medicine at Penn Medicine University City) and one at the Philadelphia VA Medical Center (located a short walk 2 blocks west of the Penn Campus). Through these continuity clinics, fellows follow their own panel of patients and are responsible for all aspects of the patients’ care with support and guidance from teaching attending physicians. The case mix in the fellows’ practices include the full spectrum of rheumatic diseases. Fellows also participate in the care of patients through experiences within specialty clinics (including Inflammatory Arthritis, Sjögren’s Syndrome, Lupus, Scleroderma, Vasculitis, and Ultrasound) and through additional opportunities for co-practice with faculty.
First Year Rotations
During the first year, fellows rotate through four different rotations, each providing a unique educational experience and patient population:
Inpatient Consultation Service at the Hospital of the University of Pennsylvania
Fellows will spend approximately 16 weeks on this rotation during their first year, with two fellows on service together for the first portion of the year and a single fellow on service later in the year. This rotation involves the care of patients in the Hospital of the University of Pennsylvania (HUP). Our service is a purely consultative service. The on-service fellow directs the daily working rounds with the rheumatology team which includes an attending physician, residents, and medical students. HUP serves both the local Philadelphia community and is a referral center for patients throughout the region, drawing patients with a wide array of complex medical illnesses, including a remarkable spectrum of patients with rheumatic disease. After the first year, fellows are well trained in the inpatient assessment and care of patients with both routine (e.g. crystal disease) and complex multisystem rheumatic illnesses (e.g. lupus, antiphospholipid syndrome, myositis, and vasculitis).
Inpatient and Outpatient Consultation Service for the Veteran Affairs Medical Center of Philadelphia
In addition to time in continuity clinic at the VA, first-year fellows will spend approximately 10 weeks at the Philadelphia Veterans Administration Medical Center, located 2 blocks west of the Hospital of the
University of Pennsylvania, contiguous with the Penn Medicine campus. The fellow takes part in the outpatient rheumatology practice at the VA center through continuity clinics, urgent care clinic, and also sees a smaller number of inpatient consults with the rheumatology attending physician. The rotation is clinically rich with a large number of patients with rheumatoid arthritis (with the Philadelphia VA serving as a site of the Veterans Administration Rheumatoid Arthritis registry), crystal diseases, spondyloarthropathies, metabolic bone diseases, osteoarthritis, and other musculoskeletal conditions. This patient mix provides a wonderful complement to the clinical spectrum on the other campuses.
Inpatient and Outpatient Consultation Service at the Penn Presbyterian Medical Center/Penn Medicine University City
First-year fellows spend approximately 10 weeks at the Penn Presbyterian Medical Center (PPMC) Hospital/Penn Medicine University City outpatient rheumatology practice, which can be reached in a short 10 minute walk through the University of Pennsylvania campus. Fellows attend faculty clinics at Penn Medicine University City and see inpatient consults at PPMC. PPMC serves the diverse, local West Philadelphia community and includes the care of patients with common and rare rheumatic conditions.
Ambulatory Service
For approximately 14 weeks of the year, fellows will rotate through faculty rheumatology clinics at the Perelman Center for Advanced Medicine, Penn Medicine University City, and the Children's Hospital of Philadelphia (CHOP). Clinics include but are not limited to Systemic Lupus Erythematosus, Inflammatory Arthritis, Scleroderma, and Vasculitis clinics at the Perelman Center, Sjogren’s Syndrome and Ultrasound clinic at Penn Medicine University City, as well as Pediatric Rheumatology clinic at CHOP, a nationwide leader in Pediatric Rheumatology care that is located immediately next to the Hospital of the University of Pennsylvania. This outpatient experience complements the fellow’s regular continuity clinics.
Second Year
The second year is tailored to each individual fellow's career goals. All fellows continue continuity clinics at the Perelman Center for Advanced Medicine and the Philadelphia VA Medical Center. With input from their faculty advisors, fellows will develop an individualized learning plan to guide their training. All fellows will engage in mentored scholarly activity, which can include basic science or clinical research, quality improvement, medical education, or other academic work.
Fellows pursuing a career in research will begin research rotations and those seeking additional research training may be enrolled in one of several formal programs, such as the Masters of Science in Clinical Epidemiology and the Masters of Science in Translational Research (see Fellow Career Development Opportunities).
Those not planning a research career will have an intensified outpatient experience in addition to scholarly projects, learning from experienced, master clinicians, and also spending time in subspeciality clinics within and outside the division to develop additional expertise, including clinics focused on interstitial lung disease, osteoporosis, pulmonary sarcoidosis, and dermatology/rheumatology overlap. Fellows may also supplement this training with additional experiences, including (but not limited to):
Rheumatology sub-specialty clinical training, advanced ultrasound training by working with faculty and applying for the USSONAR training program, Measey Medical Education Certificate Program, Clinical Research Certificate Program, additional training in quality improvement or patient safety.
The Penn community offers a variety of well-established training programs to help you achieve your career goals. Please take a look at the Fellow Career Development section for more information.
Third Year
Fellows pursuing a research career will complete a third year of fellowship dedicated to completion of research efforts in the laboratory or clinical setting, while maintaining a continuity clinic experience. Third-year fellows are often supported through the Division via an NIH T32 training grant.
Mentoring
Fellows receive comprehensive mentoring throughout their training, a process beginning in the first year of fellowship. All incoming fellows are assigned a faculty advisor that will help fellows set training and wellness goals, discuss career options in rheumatology, serve as an advocate for the fellow, and help identify additional mentors. During the first year of fellowship each fellow will also select one or more academic mentors who will help guide academic projects during the second year of fellowship as well as additional clinical mentors based on their clinical interests.