Arthritis and Rheumatic Diseases Fellowship Program
- How to Apply
- Brief Overview of Clinical Activities
- Didactic Activities
- Evaluation Forms and Feedback
- Opportunities to Speak
- General Policies
The Division of Arthritis and Rheumatic Diseases seeks the most outstanding candidates regardless of race, gender, or country of origin. We accept fellowship applications through the Electronic Residency Application System (ERAS). Please go to the ERAS Fellowship Application Site for more information and to apply. If you have additional questions please contact Rheumatology Program Director Dr. Pascale Schwab or the Rheumatology Program Coordinator, Dena Dowhaniuk at 503-346-3558.
- Continuity clinics at OHSU and the Portland VA Medical Center with the entire spectrum of rheumatic diseases
- Dedicated soft tissue and injection clinics
- Musculoskeletal ultrasound expertise
- Systemic Lupus Erythematosus and Scleroderma Clinic
- Vasculitis Clinic
- Pediatric Rheumatology clinic
- Musculoskeletal radiology curriculum
- Quarterly clinic at Indian Health Services rural clinic
- Research Curriculum
- Opportunities to lecture to health professional students, medical residents, and primary care providers
- An outstanding group of faculty dedicated to the education of fellows
The subspecialty of rheumatology includes the evaluation and treatment of a wide array of inflammatory, non-inflammatory, and degenerative diseases that affect the musculoskeletal and other organ systems. The purpose of our rheumatology fellowship program is to train fellows to be accomplished and compassionate practitioners and consultants in the rheumatic diseases; to encourage their professional and scholarly pursuits to remain up to date in the field of rheumatology and immunology; and to foster their interest to contribute to future advancement of the field.
The division currently trains 4 fellows, 2 per year of training.
Both first and second year fellows participate in 3 weekly continuity clinics, 2 at OHSU and 1 at the Portland VA throughout the course of their two years of training. OHSU and the Portland VA are connected via a bridge, allowing for easy access to both hospitals without any commuting hassles. During those clinics, fellows have a chance to evaluate and treat a broad variety of patients with genuine rheumatologic conditions including rheumatoid arthritis, spondyloarthropathies, gout, vasculitis, lupus, inflammatory myositis, other connective tissue diseases, as well as osteoarthritis and regional soft tissue rheumatism.
In addition to the continuity clinics, specialty clinics include a six-month weekly regional rheumatology clinic with the goal of becoming proficient in soft tissue and joint injections; a six-week weekly pediatric rheumatology clinic to gain knowledge in the basic principles of the evaluation and management of rheumatologic conditions in pediatric patients; a six-month musculoskeletal ultrasound clinic held every other week to learn the basic use of ultrasound both for the diagnosis of musculoskeletal disorders and guidance of joint injection procedures; a six month weekly lupus/scleroderma clinic to allow a more in-depth understanding of these difficult diseases and their management, and a six month weekly vasculitis clinic. Additional elective rotations in orthopedics, sports and rehabilitation medicine, podiatry, and neuromuscular diseases are encouraged and are set up on an individual basis. Additionally, dermatology faculty interested in cutaneous manifestations of autoimmune diseases hold a weekly clinic in the rheumatology clinic space, allowing for valuable interchange between our two specialties and a monthly dermatology-rheumatology patient presentation.
Fellows additionally gain rheumatology consultative skills by rotating on the OHSU and VA inpatient rheumatology consult services. Patients with complicated and life-threatening rheumatologic conditions are routinely transferred to OHSU which allows fellows to gain competence in assessing and managing these patients.
Fellows are on average expected to be on week-end call once a month with the support and supervision of one of the faculty members. Call responsibilities start at 5pm Friday and end at 8am Monday and include covering the rheumatology consults both at the VA and at OHSU as well as fielding phone calls regarding rheumatology patients enrolled in the outpatient clinics. During the week, the OHSU consult fellow is expected to take first page for OHSU and VA after-hour rheumatology calls. These calls are typically sparse and are taken from home, although fellows are expected to come in to the hospital at times when necessary.
Every Wednesday morning, all rheumatology faculty and fellows meet for rheumatologygrand rounds. Invited external or OHSUspeakers discuss their research or share their expertise on a topic related torheumatology. Faculty and fellows present in-depth clinicopathologicconferences during which other specialty experts are invited to contribute tothe discussion. Following grand rounds, a clinical and basic immunology paperare presented and discussed as a group.
Radiology conference follows and allows review of musculoskeletal images together with the musculoskeletal radiologists. Radiographs relevant to ongoing patient care activities as well as classic teaching cases are discussed.
Every Friday afternoon, rheumatology fellows meet with the program director and selected faculty members for a didactic session covering various core rheumatology topics and other specialty topics relevant to the practice of rheumatology and the rheumatology board preparation.
During the summer months, a condensed immunology course is held covering chapters in Janeway's Immunobiology.
Throughout the year, fellows are expected to read a major rheumatology textbook as well as seminal papers and reviews relevant to cases encountered in clinic or on the consult service.
OHSU offers many opportunities for immunology, translational, and clinical research.
Early in fellowship, fellows are mentored by Dr. Michael Davey and Dr. Cailin Sibley to identify and develop a research project (laboratory based, clinical, or translational) that can be completed during the course of their training. The first year fellow is encouraged to meet with the various faculty members early on to identify a research project that could be completed during the second year of training.
If interested in an academic career in clinical research, fellows may consider applying to the Human Investigator Program available at OHSU. The program is a one to two-year competitive certificate program providing training in all phases of clinical research including epidemiologic research methods, biostatistics, evidence-based medicine, outcomes research methods, and medical informatics methods.Fellows can choose to complete the program or audit specific classes. A third year of fellowship may be arranged for fellows who wish to pursue an academic career. Such an arrangement is contingent upon available funding.
Fellows are encouraged to work towards submitting an abstract to the ACR annual meeting and to team up with a faculty member to complete a peer reviewed publication (review, case report, or original research) during their training.
Our faculty team consists of 14 Rheumatologists and a nurse practitioner.
We encourage a supportive and helping culture. We encourage faculty to provide feedback to trainees in real time. Focused observations are integrated in the daily workflow for immediate feedback during clinical activities.Fellows also receive formal evaluations every 6 months and/or at the end of a specific activity. Patients and clinic support staff also provide feedback to the fellows relating to professionalism and communication skills. Fellows take the annual rheumatology in-training exam administered through the ACR which provides them with an objective measure of their medical knowledge and which helps point to areas needing further learning. The program director meets with each fellow on a quarterly basis to review progress and make sure objectives and educational needs are being met.
Fellows have the opportunity to attend the annual national scientific meeting of the American College of Rheumatology (ACR) and the ACR's State Of The Art annual meeting. Fellows are encouraged to attend the Northwest Rheumatism Society's annual meeting which takes place on a rotating basis in Portland OR, Seattle WA, or Vancouver BC. If engaged in spondyloarthritis research, the second year fellows may also be invited to attend the Spondyloarthritis Research and Treatment Network's (SPARTAN) yearly meeting.
Opportunities to Speak
In addition to Wednesday morning conference, fellows have ample opportunities to speak publically either to physicians in the community (Warm Springs Clinic), to peers (internal medicine residents during the rheumatology core curriculum series), to other learners (physician assistant students, medical students), and to lay people (medical coders or others). We feel that the ability to present to the medical community or to the public is an important skill needed to become a proficient consultant.
Please view the Rheumatology General Policy Statement.
Diversity and inclusion are central to OHSU and our division's core values.