Fellowship Program Structure

Division of Rheumatology

Inpatient rheumatology at the University: the consultation service is run by one of the first year fellows, and consists of approximately 8-13 patients who are actively followed at a given time. Residents and Georgetown medical students also rotate through the service.

Outpatient rheumatology at the University: Includes a Rheumatology Specialty Clinic where each fellow spends ½ day per week for 6 months. Fellows rotate through the Vasculitis, Scleroderma, Pediatric  rheumatology, or General Rheumatology Clinic attended by a faculty member with expertise in that area. In the second year, fellows rotating at Georgetown attend additional clinics with various attendings to enhance their outpatient experience.

Inpatient rheumatology at the Veterans Affairs Hospital:  The consultation service is run by one of the first year fellows, and an average of 5-7 inpatients are followed at any time. The consult service provides a wealth of opportunity for mastering procedural skills.

Outpatient rheumatology at the Veterans Affairs Hospital:  Each fellow attends a weekly ½ day continuity clinic at the VA, where they have their own patient panel with continuity over  the  two  years  of their fellowship.  Fellows rotating at the VA also attend additional general rheumatology clinics with a heavy emphasis on rheumatoid arthritis, spondyloarthritis, and crystalline arthropathy. In addition, there is a dedicated weekly procedure clinic, where fellows learn  to  use  ultrasound,  perform arthrocentesis and joint/tendon steroid injections.

Pediatric rheumatology: Each fellow spends ½ day per week for 6 months in clinic with a pediatric rheumatologist to gain familiarity with the evaluation and management of pediatric rheumatic disease.

Electives:  Fellows may choose to rotate through a combined dermatology-rheumatology clinic at Georgetown, through the lupus clinic at Washington Hospital Center, the myositis or auto-inflammatory disease center at NIAMS/NIH, or in the orthopedic subspecialty clinics.

Ultrasound: Education in ultrasound techniques for diagnostic and therapeutic purposes is incorporated into the weekly procedure clinic. Didactics in ultrasound is  part  of  our combined  lecture series  with  Washington Hospital Center,  and an exposure to ultrasound in real world practice is provided while rotating at the VA.

Didactics:

Summer Lecture Series:At the start of each academic year, fellow trainees attend a city-wide lecture series as an intensive introduction to rheumatology.  This consists of 36 hours of didactics presented jointly by faculty from Georgetown University Hospital, Washington Hospital Center, NIH, Walter Reed Medical Center, and George Washington University Hospital rheumatology programs.

Rheumatology Grand Rounds: This is a weekly conference, attended by all fellows, Georgetown and VA faculty, rotating residents and medical students, and community physicians.  Lectures include interesting case presentations, critical evaluation of the literature, and visiting speakers.

Fellow Didactics:  A fellow-specific didactic session follows grand rounds each week.

Radiology Conference: A weekly 2 hour session focused on developing skills necessary to interpret musculoskeletal radiologic images.

Ultrasound  Didactic  Lectures: Weekly  lectures  at  Washington Hospital Center,(6 months) followed  by  the Immunology  Lecture  series.

Pulmonary-Rheumatology Conference: A bi-monthly conference attended by both divisions, where mutual cases are presented and discussed.

Neuromuscular Conference: A bi-monthly conference attended by Neurology, Pathology, and Rheumatology.

Immunology Series: A weekly seminar in the spring combined with Washington Hospital Center fellows.

Other educational opportunities:

  • The D.C. Rheumatism Society holds a monthly dinner meeting featuring a nationally known guest speaker, attended by fellows, faculty, and private rheumatologists from throughout the Washington D.C. area.  
  • Bone Club is a quarterly dinner meeting held at Georgetown with a focus on bone health, featuring experts in the field and Rheumatologists, Endocrinologists, and Internists.
  • DC Rheumatology Fellows Forum (annually to present cases and research)
  • Georgetown University Hospital Center Department of Medicine Research Day (annually to present research)
  • Attendance at the American College of Rheumatology Annual Meeting

Research:  Fellows are expected to participate in a scholarly activity over the course of the two years.  In the past, fellows have participated in projects in  a  variety  of  diseases, The following are a sample of  projects and case reports by  fellows over the past few years

1.   Use of Anti-Il6 Receptor Antibody (Tocilizumab) for Induction Therapy in Secondary Hemophagocytic
               Lymphohistiocytosis/macrophage Activation Syndrome (Hlh/mas)  (ACP  Award)

2.   “Can Exercise Echocardiography Predict Future Development of Pulmonary Hypertension in a High-Risk Cohort of
               Scleroderma Patients?,"  DC  Fellow forum  award,  ACR  poster.

3.  “Exploring the Association between Air Pollutant Exposure and Seropositivity in Rheumatoid Arthritis," DC  Fellows 
               Forum Award and ACR poster

4.  Autologous Fat Grafting for Refractory Digital Ulcerations  DC Fellows Forum Award

5.  Optimal management of digital ulcers in systemic sclerosis. Published Manuscript

6.  MDA5 positive clinically amyopathic dermatomyositis (CADM) with rapidly progressive interstitial lung disease (ILD) 
               ACR Thieves Market