The Division of Rheumatology offers four fellowship training tracks

  • Clinical Track
  • Clinical Research Track
  • Laboratory Research Track
  • Teaching Physician Pathway (WUTPP)

The division maintains an outstanding environment for the training of research-oriented physicians for careers in rheumatology. Four fellowship tracks are available: a two year clinical track for those who desire careers in clinical rheumatology, and three year clinical and basic laboratory research tracks for those interested in investigative, academic careers.

For all fellows, the first year is devoted to direct patient care and conferences. Fellows serve as inpatient and outpatient consultants at Barnes-Jewish and John Cochran Veterans Administration Hospitals. Elective outpatient clinics at Children’s Hospital and the Shriners Hospital for Children provide additional training in pediatric rheumatology and genetics of rheumatic diseases.

Fellows attend and present at weekly Rheumatology Grand Rounds, journal clubs, didactic clinical conferences, and monthly journal reviews and are encouraged to attend Department of Medicine Grand Rounds and the Immunology Seminar Series.  (Refer to “Educational Opportunities” for titles of recent Rheumatology Grand Rounds, didactic rheumatology clinical coursework, and examples of the diverse educational opportunities available in the Medical Center.) Fellows also help coordinate clinical activities of medical students and residents on the rheumatology rotation.

The content of the second and subsequent fellowship years varies as indicated in the chart below. An important component of developing a career path is the relationship, developed in the first year, with one or more faculty mentors selected by the fellow.

Proportional time distribution between patient care and research responsibilities as a function of fellowship track and year of training

YEAR 1
Patient care / Research
YEAR 2
Patient Care / Research
YEAR 3
Patient Care / Research
Clinical Fellowship95% / 5%60% / 40%– / –
Clinical Research Fellowship95% / 5%10% / 90%10% / 90%
Lab Research Fellowship95% / 5%
10% / 90%

10% / 90%
Teaching Physician Fellowship
95% / 5%

55% / 45%
– / –
For the Clinical Fellowship track, this division of time can vary according to the goals of the individual.

Clinical track

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, 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).

Clinical research track

The clinical research track is designed for physicians who are committed to an academic career in clinical research. Applicants are encouraged to state their intent to enter the clinical research track at the time of the fellowship application, although accepted fellows can delay their decision until early in Fellowship Year 1. During Fellowship Year 1, in collaboration with a research mentor, the fellow develops a clinical project which must be presented to and approved by a University faculty review panel. The second and third years are devoted primarily to implementation of the approved project, and formal clinical research training.  The fellowship program will support the fellow’s matriculation into either of two master’s degree programs offered by the university’s CRTC. Coursework begins in fellowship year two and concludes in year three. The CRTC provides didactic curriculum and mentored training in clinical and translational research for predoctoral students, house-staff, postdoctoral fellows, and junior faculty. The CRTC offers two degree programs relevant to rheumatology fellows pursuing an academic career in clinical research:

In addition, the Postdoctoral Mentored Training Program in Clinical Investigation (MTPCI) includes the ability to obtain a MSCI degree within a broader framework of didactic coursework, structured research mentorship and interactions with a diverse group of peers.

The Institute of Clinical and Translational Sciences (ICTS), Washington University’s umbrella research resource organization, includes a commitment to clinical research training. Established in 2006 as part of the university’s Clinical and Translational Science Award (CTSA), the ICTS encourages collaboration among existing research groups, helps ensure efficient use of the University research organization, and funds new resources. The ICTS facilitates investigator access to state-of-the-art infrastructure, financial support, education, assists in the creation and sustainment of interdisciplinary research collaborations, and supports the progress of research findings from laboratory bench to clinical implementation. ICTS includes 24 cores. Four cores are potentially most relevant to rheumatology fellows interested in clinical training and research:

The laboratory research track

The laboratory research track is designed for physicians who are committed to an academic career as a physician-scientist involved in basic science or translational research. The Rheumatology Division has a long history helping develop the careers of academic investigators. The Division has maintained an active and formally recognized postdoctoral fellowship program since 1977, with the inception of an NIH T32 training grant that has been continuously renewed for the past 40+ years. Trainees, 87 in total, supported by this T32 training grant have gone on to distinguished careers, including six Rheumatology division chiefs, leaders in industry, and faculty at academic institutions around the country.

The T32 Immunobiology of the Rheumatic Diseases Training Program is currently under the direction of Dr. Deborah Lenschow, Professor of Medicine, and Dr. Anthony French, Professor of Pediatrics. Drs. Lenschow and French are also co-directors of the Oliver Langenberg Physician Scientist Training Programs in Medicine and Pediatrics. The T32 training grant program leverages the strengths of the Divisions of Adult Rheumatology and Pediatric Rheumatology, together with the world-class immunology community at Washington University as well as the active participation of outstanding faculty members who serve as preceptors and are dedicated to training young scientists in the field of immunology and areas of investigation with direct relevance to rheumatic diseases.

The extremely strong mentorship provided in the trainees’ chosen laboratories is supplemented by 1) divisional seminars and participation in the Departmental Pathology/Immunology seminars; 2) access to the resources provided by the many centers at Washington University including the Bursky Center for Human Immunology and Immunotherapy Program (CHiiPs) and the WU-Rheumatic Disease Research Resource-based Center (RDRRC); and 3) course work offered through the Division of Biomedical and Biologic Sciences, as well as through the Institute for Clinical and Translational Sciences (ICTS).These resources will facilitate the formation of individual career development programs to prepare the trainees on the T32 for independent scientific careers in the fields of inflammation and immunology as they apply to rheumatic diseases.

Teaching Physician Pathway (WUTPP) Fellowship

The Washington University Teaching Physician Pathway (WUTPP) offers opportunities for rheumatology fellows to enhance their training as clinician educators. In collaboration with WUTPP, Lisa Zickuhr, MD, assistant professor, Division of Rheumatology, mentors fellows as they engage in teaching opportunities and hone their approach to education scholarship.

Rheumatology fellows enrolled in WUTPP who are in good academic standing will complete the WUTTP Certificate Program as part of their second year of fellowship. This program provides a foundation in education theory, pedagogy, and curriculum design as well as opportunities to practice teaching techniques in various learning environments. Participants will apply their skills to a final project of their design and choosing and will be awarded a certificate upon completion of the program.

An example list of activities that might be completed during the second year of fellowship as part of the WUTTP Certificate Program includes:

  • Participation in two blocks of didactic teaching about educational pedagogy
  • Teach at the bedside at least twice
  • Record a didactic session that you deliver and receive feedback from a peer
  • Create an eLearning module related to musculoskeletal and rheumatic diseases

Click here to review the curriculum in more detail.

Please feel free to contact our fellowship coordinator for more information.
Lacey Feigl: laceyfeigl@wustl.edu