Each fellow has two continuity clinics (one at a UPMC facility and one at the VA) in which they perform complete initial evaluations and follow up evaluations, correspond with the patient’s referring physician, and function as the patient’s primary rheumatologist for longitudinal care under the supervision of a faculty member. These patients will be followed by the fellow throughout the duration of their fellowship which gives them the opportunity to manage various disease processes from onset of symptoms to maintenance and remission. Each fellow sees one or two new patients and four to six follow-up patients per half-day clinic session.
Over the course of training each fellow will spend 4 months on “A” service and 4 months on “B” service. The “A” service fellow is responsible for all consults received from Presbyterian and Montefiore University Hospitals. The “B” service fellow sees all consults received from Magee-Women’s Hospital, and the VA Medical Center-Oakland. The fellow is expected to function as a junior attending by organizing rounds, communicating closely with both house staff and family, teaching residents and students on the team, and interacting with the other medical services involved in the care of the patient.
Fellows will have two to three outpatient rheumatology sessions (half-day clinics) per week in addition to their continuity clinics where they will rotate through electives with faculty with clinical expertise and research interest in specific rheumatological disorders. These disease-specific sessions include:
First year electives:
• Systemic Lupus Erythematosus
• Systemic Sclerosis
• Pain management
Second year electives:
• Pediatric rheumatology
• Multidisciplinary rheumatology/pulmonary clinic
• Multidisciplinary rheumatology/ophthalmology clinic
• Telerheumatology – mandatory for fellows in the clinician and clinician educator track
• Musculoskeletal ultrasonography required mandatory for fellows in the clinician and clinician educator track
Immunology didactics will be presented in a workshop format throughout the year which will cover the curriculum in basic immunology. Fellows will participate in monthly, highly-interactive sessions requiring reading and discussion in a workshop once a month, organized by faculty who are translational researchers in the division.
Fellows will also receive hands-on experience with commonly performed immunologic laboratory studies in the Clinical Pathology Laboratory. These sessions are held four times and spread throughout two years of training. Fellows will learn the detection and characterization of autoantibodies associated with the spectrum of connective tissue diseases. Objectives of this rotation include:
- To learn the techniques of immunofluorescence and immunoprecipitation
- To recognize different ANA patterns and correlate these findings with antigen specificity
Rheumatology Fellows Telemedicine Elective
Director: Christine Peoples, MD
Workforce estimates of rheumatology subspecialists are predicted to be short about 2,500 practitioners by 2025. A recent ACR workforce analysis also highlighted an acute lack of rheumatology care in rural areas. Consequently there is an increasing demand from patients and healthcare systems for access to academic specialists through telemedicine. Responding to these needs and to prepare our trainees for the changing terrain of healthcare delivery in the future, we are proud to announce a rheumatology telemedicine elective for our second-year rheumatology fellows.
The UPMC Rheumatology Telemedicine Program provides telerheumatology services throughout PA at the following locations: UPMC Northwest, UPMC Bedford, and UPMC Cole Memorial Hospital. In addition, UPMC has telemedicine capabilities in the University campus clinics that fellows rotate through. Dr. Peoples, director of the telemedicine elective, has provided tele-rheumatology services for over six years and has been recognized as one of the top providers of telehealth services in the country. Fellows will also be involved in providing E-consults at the Pittsburgh Veteran’s Affairs Medical Center, during their VA rotations under the guidance of VA faculty.
Rheumatology Telemedicine Elective goals and objectives:
- Introduce our rheumatology telemedicine clinical care model
- Participate in rheumatology telemedicine clinical care through Dr. Peoples’ rheumatology telemedicine outpatient clinic at UPMC Northwest
- Become familiar with the IT equipment needed for rheumatology telemedicine visits
- Understand the importance of providing rheumatology care to underserved and rural areas in PA through telemedicine
- Understand how to apply telemedicine concepts to future rheumatology care and practice
Musculoskeletal Ultrasonography Elective
Musculoskeletal Ultrasonography (MSK USG) is rapidly becoming widely available in rheumatology clinics for diagnostic imaging as well as for USG guided injections. Procedures that typically required referral for x-ray or CT guided interventions such as hip and sacroiliac joint injections can now be performed with accuracy in the outpatient setting. In order to equip our trainees with the skills to use this imaging modality in their clinical practice, we have a well-established a training program in our division since 2015 which includes the following:
A) Annual MSK USG workshop – in combination with the physical medicine and rehabilitation division, we organize a half-day workshop where trainees are introduced to the basics of MSK USG and scan various joints in stations.
B) Monthly USG procedure clinic in Falk Clinic – Faculty trained in MSK USG procedures precept fellows performing various procedures on clinic patients
C) Weekly clinics at the VAMC are also precepted by faculty who are trained in MSK USG.
D) Fellows are encouraged to apply for the USSONAR MSK USG certification program; at successful completion of the program, they are reimbursed the cost of the course.
E) Fellows are invited to attend the MSK USG session conducted in the radiology department on a monthly basis.
Goals of MSK USG training:
- Understand the role for use of USG in the clinical setting.
- Introduce MSK USG as a diagnostic modality in the management of rheumatologic diseases.
- Utilize MSK USG to perform diagnostic and therapeutic outpatient procedures in the appropriate clinical setting.
- Encourage certification in the use of MSK USG for clinical practice.
Division of Rheumatology and Clinical Immunology Offices
S700 Biomedical Science Tower
3500 Terrace Street
Pittsburgh, PA 15261
412-383-8000 | Email Us