Rheumatology and Clinical Immunology Fellowship Program

Clinical Training

Outpatient Experience

Each fellow maintains two continuity clinics, one at a UPMC facility and one at the VA Pittsburgh Healthcare System. In these clinics, fellows perform comprehensive initial and follow-up evaluations, correspond with referring physicians, and function as the patient’s primary rheumatologist under faculty supervision.

Because patients remain under the fellow’s care throughout training, fellows gain valuable experience managing disease from onset through maintenance and remission. Each half-day clinic typically includes one to two new patients and four to six follow-up visits, providing a rich mix of longitudinal care and diagnostic diversity.

Inpatient Experience

During the two-year fellowship, trainees spend four months on “A” service and four months on “B” service. The “A” service covers inpatient consults at UPMC Presbyterian and Montefiore Hospitals. The “B” service includes consults at Magee–Women’s Hospital and the VA Medical Center in Oakland.

While on service, fellows act as junior attendings, coordinating patient management, leading rounds, and teaching residents and students. They communicate closely with referring physicians and families and collaborate with multidisciplinary teams to ensure high-quality, patient-centered care.

Elective Rotations

In addition to continuity clinics, fellows participate in two to three specialized outpatient rheumatology sessions per week, rotating through disease-focused electives that align with faculty expertise and ongoing research.

First-Year Electives:

• Polymyositis/Dermatomyositis
• Systemic Lupus Erythematosus
• Systemic Sclerosis
• Pain Management

Second-Year Electives:

• Vasculitis
• Dermatology
• Pediatric Rheumatology
• Multidisciplinary Rheumatology/Pulmonary Clinic
• Multidisciplinary Rheumatology/Ophthalmology Clinic
• Telerheumatology (mandatory for fellows in the clinician and clinician-educator tracks)
• Musculoskeletal ultrasonography (mandatory for fellows in the clinician and clinician-educator tracks)

Telerheumatology

The demand for rheumatology care continues to outpace workforce availability, with an estimated shortfall of 2,500 subspecialists by 2025. Rural and underserved areas are particularly affected, creating a growing need for innovative care delivery models. To address this gap and prepare fellows for the evolving landscape of healthcare, UPMC offers a Telemedicine Elective for second-year rheumatology fellows.

The UPMC Rheumatology Telemedicine Program provides virtual care across Pennsylvania, including UPMC Northwest, UPMC Bedford, and UPMC Cole Memorial Hospital, as well as through telemedicine-enabled University campus clinics. Under the guidance of Dr. Christine Peoples, an experienced tele-rheumatology provider recognized nationally for excellence, fellows also participate in E-consults at the Pittsburgh VA Medical Center during their VA rotations.

Through this elective, fellows gain practical experience in delivering rheumatology care remotely, learning to navigate telehealth technology while maintaining high-quality patient care. Key objectives include:

• Understanding the UPMC rheumatology telemedicine care model and its role in improving access to specialty care
• Participating in live telemedicine patient encounters at UPMC Northwest
• Gaining proficiency with the technology and workflow required for effective tele-rheumatology visits
• Recognizing the impact of telemedicine in serving rural and underserved populations
• Applying telemedicine principles to future clinical practice

Immunopathology

Fellows participate in an ongoing immunology workshop series, featuring monthly faculty-led, discussion-based sessions that explore the cellular and molecular basis of autoimmune disease. Fellows also receive hands-on laboratory training in the Clinical Pathology Laboratory, offered four times across two years. These sessions teach key diagnostic techniques, such as immunofluorescence and immunoprecipitation, and train fellows to recognize ANA patterns and correlate findings with clinical disease.