Rheumatology Fellowship Program

Welcome to the University of Pennsylvania Division of Rheumatology Fellowship Program. We take great pride in educating the next generation of rheumatologists. For over 100 years, Penn Rheumatology has had a strong tradition of education, research, and clinical care. Our fellows are trained to be compassionate clinicians, superb diagnosticians, and lifelong learners. They are given the tools, resources, and opportunities to embark on careers in clinical care, research, academics, or industry. Our teaching faculty includes outstanding clinicians and leading researchers who have been mentoring medical trainees for many years. Our faculty members have diverse backgrounds which provide our trainees with a wealth of educational and research opportunities to create a rich and rewarding experience and form the foundation for fellows to fulfill their career goals.

Chris T. Derk, MD, MSc
Fellowship Program Director

Curriculum

During the program, fellows learn the fundamentals of clinical rheumatology and participate in scholarly activities including case management, journal club, multidisciplinary conferences, and didactic lectures covering the full range of clinical and basic pathophysiology topics necessary to become a well-rounded rheumatologist. In addition, rheumatology fellows participate in joint conferences with Pediatric Rheumatology, Dermatology, Orthopedics, Musculoskeletal Radiology, Clinical Immunology and Laboratory Medicine. All fellows are expected to conduct scholarly activity and have the opportunity to participate in clinical, translational, or basic science research. Some rheumatology fellows will elect to pursue a research-track, which includes a third year of fellowship and often times additional post-doctoral training.

Continuity Clinics

Throughout their fellowship, fellows maintain two continuity clinics: one at the Penn Perelman Center for Advanced Medicine and one at the Philadelphia VA Medical Center. 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 (psoriatic arthritis, Sjögren's Syndrome, scleroderma, vasculitis) and through additional opportunities for co-practice with faculty.

Mentoring

Fellows receive comprehensive career development mentoring throughout their training, a process beginning in the first year of fellowship. Additionally, based on the career interests and needs of each fellow, a specific research and/or clinical mentor is assigned.

First Year

During the first year, fellows rotate four times through three different one-month rotations (see below) and maintain their continuity clinics.

First Year Rotations

Inpatient Consultation Service at the Hospital of the University of Pennsylvania

The 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 is known for caring for 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, and vasculitis).

Inpatient and Outpatient Consultation Service for the Veteran Affairs Medical Center of Philadelphia

The Philadelphia Veterans Administration Medical Center is 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 daily inpatient ward rounds with the rheumatology team that includes an attending physician, medical students and residents. The rotation is clinically rich with a large number of patients with rheumatoid arthritis, crystal diseases, spondyloarthropathies, and metabolic bone diseases. This patient mix provides a wonderful complement to the clinical spectrum on the other campuses. The VA experience consists of participation in continuity clinics, experience triaging rheumatologic diseases, development of expertise with polarizing light microscopy with Dr. Schumacher's assistance, attaining excellent clinical skill sets in rheumatologic procedures. In addition, fellows develop skills in musculoskeletal ultrasound imaging. Dr. Pullman-Mooar leads a curriculum at the VA center directed at establishing comfort with both diagnostic ultrasounds and ultrasound- guided injections.

Ambulatory Service

The fellow attends outpatient rheumatology clinics within the division at the Perelman Center for Advanced Medicine, the Penn Presbyterian Medical Center, and the Children's Hospital of Philadelphia (CHOP). Clinics include but are not limited to systemic lupus, psoriatic arthritis, scleroderma and vasculitis clinics at Perelman, Sjogren's syndrome clinic at Penn Presbyterian Medical Center, and a Pediatric Rheumatology clinic at CHOP. Additionally, fellows spend time in the Immunology Laboratory at the Hospital of the University of Pennsylvania. The ambulatory service block is in addition to the fellow's regular continuity clinics.

Second Year

The second year is tailored to each individual fellow's career goals (see below for examples of individual tracks). All fellows continue continuity clinics at the Perelman Center for Advanced Medicine and the Philadelphia VA Medical Center. Fellows that are pursuing a career in research will begin their research rotations in their second year.

Third Year

The third year of the research fellowship is dedicated to completion of research efforts in the laboratory or clinical setting.

Tracks Within The Penn Rheumatology Fellowship Program

The Penn Rheumatology fellowship program prides itself in its ability to train outstanding clinicians and researchers. The goal of the program is to personalize the training experience based on each fellow's individual career goals and training needs. While all fellows participate in the first year intensive clinical rheumatology rotations and two continuity clinics (HUP and VA), the remainder of the training experience is individualized.

Clinical Track

The goal of this track is to train outstanding rheumatology clinicians that will practice within academic settings or in private practice. The second year in this track is an intensified outpatient clinical experience. Fellows are assigned to an experienced, master clinician for directed one-on-one teaching throughout the entire year and spend time in subspecialty clinics aligned with their interests. In addition, fellows may choose to spend additional time in dermatology clinics or with musculoskeletal radiology. Fellows in the clinical track participate in scholarly activities such as writing a review article or completing a quality improvement project.

Research Tracks

Some rheumatology fellows choose a research career path. In this case, the latter two years of a three-year rheumatology fellowship are tailored to the individual needs of the fellow. Some fellows will extend their training beyond three years. Penn Rheumatology fellows have the opportunity to conduct research in a wide range of areas including basic laboratory, translational, clinical epidemiology, patient-oriented research, and health services. The primary objective of the research years is to assist the fellow in developing their own line of research through a mentored research experience. The end result of the research training years is a record of publications and application for a career development award.

Penn is an ideal training environment for a young scientist. Penn's Perelman School of Medicine (SOM) is ranked among the top five in U.S. News & World Report's survey of the nation's finest research-oriented medical schools and second in the nation in terms of research support received from the NIH. With access to tremendous resources throughout the University and a highly collaborative atmosphere, virtually any type of research could be fostered here. In addition, research fellows have the opportunity to attend a range of conferences, seminars, and career development workshops and have access to numerous core and pilot grant programs.

Some fellows choose to complement this training with a formal master's degree program or a certificate program. Master's degrees and certificate programs within the Perelman School of Medicine include:

• Master of Bioethics (MBE)
• Master of Science in Clinical Epidemiology (MSCE)
• Master of Science in Health Policy Research
• Master of Science in Medical Ethics (MSME)
• Master of Public Health (MPH)
• Master of Science in Translational Medicine
• Clinical Research Certificate Program