Program Tracks

The Division of Rheumatology offers three fellowship training tracks.

The first year for all fellows is devoted to direct patient care and conferences. An important element of the first year is to meet regularly with an assigned mentor to assist with the development of a career path.

The content of the second (and subsequent) years will vary as indicated below:

Clinical fellowship

The Clinical Fellowship track is designed for physicians who wish to pursue careers in clinical care.  During the second year, clinical fellows devote a portion of their time to clinical research (as planned with their mentor), and the remaining effort to patient care.  The fellowship program will support matriculation in up to two research related courses through the University’s Clinical Research and Training Center (CRTC; refer to accompanying handout and crtc.wustl.edu.

 Clinical research fellowship

This track is designed for physicians who are committed to an academic career in clinical research. The second and third years are devoted primarily to a clinical research project and formal clinical research training.  The fellowship program will support the fellow’s matriculation into a master’s degree program offered by the University’s Clinical Research and Training Center (CRTC) Please refer to accompanying handout and crtc.wustl.edu.  Coursework begins in year two and concludes in year three.

Laboratory research fellowship

The Laboratory Research Fellowship tract is designed for physicians who are committed to an academic career as a physician-scientist involved in basic science or translational research.  During the subsequent years, the fellow devotes the great majority of time to a laboratory research project

Patient care and research responsibilities

Distribution of days/week between patient care and research responsibilities as a function of fellowship tract and year of training
Training Year Year 1 Year 2 Year 3
Patient Care Research Patient Care Research Patient Care Research
Clinical Fellowship 5.0 + Minimal 3.01 2.0
Clinical Research Fellowship 5.0 + Minimal 0.5 4.5 0.5 4.5
Laboratory Research Fellowship 5.0 + Minimal 0.5 4.5 0.5 4.5

1 For the Clinical Fellowship track, this division of time can vary according to the goals of the individual.

Educational goals

Provide clinical exposure and didactic presentations so that the trainee is competent to care for patients with a variety of rheumatic diseases, including the most complex presentations.

  1. Teach the scientific basis of the pathophysiology and treatment of the rheumatic diseases.
  2. Allow the trainee to develop skill as a consultant in the in-patient and out-patient settings, to provide continuing care for patients with chronic rheumatic diseases, and to work with physicians in other specialties in this regard.
  3. Teach the rational and efficient use of laboratory and radiographic testing, and expert interpretation of the results.
  4. Acquaint the trainee with the techniques necessary for the critical evaluation of the medical literature and new treatments.
  5. Provide understanding of the realities and details of managed care and documentation requirements.
  6. Provide exposure to the care of socio-economically challenged individuals with rheumatic diseases.
  7. Enhance the development of public presentation skills for clinical and scientific material.
  8. Teach the performance of aspiration and injection of joints.
  9. Provide an opportunity for trainees to take part in clinical research protocols so that they will understand the process by which new treatments are tested.
  10. Provide an opportunity for individuals to develop the necessary basic science skills for pursuing a career as an independent basic science investigator.

Fellow responsibilities

Fellows serve as consultants for both inpatients and outpatients at Barnes-Jewish and John Cochran Veteran’s Administration Hospitals. Elective outpatient clinics at the Shriners Hospital for Crippled Children and Children’s Hospital provide additional training in pediatric rheumatology and genetics of rheumatic diseases. The training program also includes weekly Rheumatology Grand Rounds, journal clubs, didactic clinical conferences, and monthly journal reviews. Fellows are also encouraged to attend Department of Medicine Grand Rounds and the Immunology Seminar Series. Finally, fellows help coordinate clinical activities of medical students and residents on the rheumatology rotation.