Rheumatology Fellowship
About the Program
The Rheumatology Fellowship is a two-year training program with the option of a third year for additional research experience. Fellows participate in two years of longitudinal clinical experience at Ohio State Davis Outpatient Care and two years of inpatient consultative experience at The Ohio State University Wexner Medical Center's University Hospital.
Comprehensive clinical practice in rheumatology offers fellows ample opportunities to become proficient in the procedures of tendon sheath and bursae aspiration and injection, musculoskeletal ultrasound and arthrocentesis and joint injection. Fellows receive adequate training experience to function as a consultant in clinical, research and academic rheumatology. At the completion of the training program, fellows will be board eligible in the subspecialty of rheumatology.
Curriculum
The core curriculum combines didactic teaching, basic and clinical research projects and supervised patient care in the outpatient clinic and on the consultative inpatient service.
Fellows see patients with a diverse spectrum of clinical disorders, from osteoporosis, vasculitis, rheumatoid arthritis, systemic lupus and immunodeficiency to bursitis, osteoarthritis and fibromyalgia. The rheumatology fellows also attend ambulatory clinic at Nationwide Children’s Hospital for experience in pediatric rheumatology. Elective rotations include orthopedics, musculoskeletal radiology, physical medicine and rehabilitation, physical and occupational therapy and private practice rheumatology.
Weekly didactic conferences include divisional case presentation conferences, journal club, immunology research conferences and interdepartmental conferences such as musculoskeletal radiology conference. All fellows are required to take a course in biomedical statistics, experimental design, biomedical ethics and risk management.
The rheumatology training program is located at The Ohio State University Wexner Medical Center, which includes:
- 356-bed The Ohio State University Comprehensive Cancer Center
- 230 Ohio State East Hospital
- 82-bed Ohio State Harding Hospital
- Dodd Hall Rehabilitation Hospital
- Davis Outpatient Care
- Outpatient Care Dublin
- Outpatient Care East
- Hilliard IM and Pediatrics
- Multidisciplinary Scleroderma Clinic at Martha Morehouse Outpatient Care
- Psoriatic Arthritis Clinic Officenter Gahanna
- Outpatient Care Upper Arlington
Pediatric rheumatology training is provided at Nationwide Children's Hospital, the second-largest children's hospital in America, located three miles from Ohio State. Approximately 1,500 clinic visits are conducted each year at the Davis Outpatient Care.
Research opportunities are offered in both clinical and basic science settings. Active graduate and postdoctoral programs complement the rheumatology training research experience. Faculty members supervise these basic science laboratories and the clinical pharmaceutical studies in the outpatient clinic.
Application to our Rheumatology Fellowship program is done via ERAS.
Introductory Lecture Series
- Laboratory tests
- Synovial fluid analysis
- Physical examination of the musculoskeletal system
- Musculoskeletal radiology
- Pediatric rheumatology
- Rheumatoid arthritis
- Gout, pseudogout and hydroxyapatite crystal diseases
- Fibromyalgia
- Soft tissue rheumatism
- Vasculitis
- Systemic lupus
- Metabolic bone disease
- Osteoporosis
- Monoarticular arthritis
- Arthrocentesis and tendon and bursae injection procedures
- Spondyloarthropathies
- Low back pain
- Neuromuscular disease
- Clinical pharmacology
Curricular Topics
- Immunology
- Musculoskeletal anatomy
- Pathology of connective tissue
- Molecular genetics
- Purine metabolism
- Diffuse connective tissue diseases
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Scleroderma
- Polymyositis
- Spondyloarthropathies
- Vasculitis
- Crystal-induced synovitis
- Osteoarthritis
- Nonarticular rheumatic disease – inducing fibromyalgia
- Sports medicine
- Systemic disease with rheumatic manifestations
- Metabolic disease of bone and osteoporosis
- Septic joints
- Joint surgery
- Rheumatic problems requiring rehabilitation therapy
- Pediatric rheumatology
- Use of the polarizing and light microscope to analyze synovial fluid
- Diagnostic aspiration of diarthrodial joints, bursae and tenosynovial structures
- Therapeutic injection of diarthrodial joints, bursae, tenosynovial structures and entheses
- Musculoskeletal ultrasound training
- Teaching skills
- Formal presentation critique
- Use of graphics software for slide presentation
- Writing skills
- Manuscript or abstract presentation
- Research protocol preparation
Rotations
- Development of specific hypothesis
- Design of a protocol to test the hypothesis
- Experience in obtaining approval from the Institutional Review Board
- Experience in writing a consent form for the average patient
- Experience in writing a grant proposal
- Diagnosis and management of a patient with acute arthritis in the emergency room
- Diagnosis and management of acute crystal-induced synovitis in an hospitalized patient
- Diagnosis and management of patients with rheumatic disease during pregnancy and labor and delivery
- Diagnosis and management of patients with rheumatic disease in the intensive care unit
- Management of an acutely ill immunosuppressed patient
- Development of a cost-effective approach to ordering inpatient immunology laboratory tests
- Management of patients with septic bursitis and septic arthritis
- Administration of IV alkylating agents exacerbations of lupus, renal or CNS disease
- Direction of pain control management in the hospitalized patient with compression fractures
- Selection of the hospitalized patient who may benefit from inpatient rehabilitation
- Diagnosis and management of patients with vasculitis
- Development of a concise, efficient, informative consultation report
The rheumatology attending supervises pertinent points of the patient's history, physical and the decision making process involved in the impression and plan of action for each rheumatology inpatient consultation.
- Development of techniques to evaluate individual patients response to therapy over time
- Maintenance of an internal medicine knowledge base while emphasizing the evaluation of rheumatic complaints
- Experience in reviewing outside records and incorporating them into the rheumatologic evaluation
- Development of methods to relate to patients with chronic illness
- Development of skills to rapidly and efficiently evaluate both new and follow-up patients
- Experience in communication of evaluation to patients primary care physician
Grand Rounds Assignments
Fellows will conduct an in-depth review from among the selected topics, complete with visual aids, etc., direct discussion of the topic with attendees and a detailed list of references:
- Rheumatic problems in patients with renal diseases (post-transplant gout, dialysis arthropathy, amyloid, osteomalacia, etc.)
- Pregnancy related issues in rheumatic disease
- Rheumatic problems in patient with endocrinologic diseases (hyperparathyroidism, diabetic cheiroarthropathy, metabolic bone disease, etc.)
- Rheumatic problems in patients with hematologic diseases (hemophilia, leukemia, lymphoma, sickle cell disease, etc.)
- Secondary causes of osteoarthritis (genetic, hemachromatosis, etc.)