Two or three fellows are trained in rheumatology at any one time. Most years, one new fellow is accepted for two years of training.
Thirty percent of a clinical fellow’s time is devoted to an introduction to clinical research and to ancillary clinical areas, such as orthopedics, neurology and pathology. National Institutes of Health-funded research includes programs in mast cell biology and immunogenetics of rheumatic diseases. Current clinical trials interests include bone density and biologic agents for rheumatoid arthritis and lupus. Other ongoing projects are aimed at increasing minority participation in clinical trials, health literacy and at national rheumatology work force planning.
The majority of clinical practice is in the outpatient setting, with approximately 9,000 visits each year. Active in-hospital consultative practices are provided at both the VCU Medical Center and Hunter Holmes McGuire VA Medical Center, at a rate of one new consult per day at each site. Mode number of in-patient consultations is five weekly in each hospital.
The program is nationally recognized for its ongoing, fellow-directed curriculum revision process. The curriculum is a conference-intensive one and includes a publication requirement to graduate. All graduates of the past five years have taken and passed the American Board of Internal Medicine Rheumatology Board Examination.
More than 80 postdoctoral fellows have been trained in the Rheumatology, Allergy and Immunology Division, many of who are in full-time academic positions. Thirty percent of rheumatology graduates since 1951 have begun their careers in tenure-track teaching positions. Seven have become rheumatology division or section chiefs.
The particular strengths of this training program for M.D. trainees are the balances between clinical exposure, clinical research and basic research, and the faculty to fellow ratio of 4:1. Separate tracks are offered for clinicians, clinical investigators and laboratory investigators.
The didactic program for rheumatology fellows includes weekly board-review sessions led by the program director and two weekly conferences conducted by the fellows. In addition to boards review, these conferences include zebra case conference, clinical journal club, basic science journal club, division grand rounds, and either radiology or pathology conferences.
All applicants use ERAS to apply to the program.