Rheumatology Fellowship

The First Year of Fellowship

Outpatient Clinic

Fellows evaluate and follow a variety of new patients while developing a patient panel they will follow during the second and third years. For each patient the fellow has ample time (60 minutes for new patients and 30 minutes for return patients) to evaluate the history, physical exam, laboratory studies and develop an assessment and plan. An additional 30 minutes is scheduled for each patient to discuss the case, re-evaluate the patient, and formulate a plan with the attending physician and the family. Teaching is a priority and feedback immediate. Outpatient rotations are arranged in Dermatology, Ophthalmology, Nephrology, Skeletal Dysplasia, Immunology, Orthopedics, Pain and Adult Rheumatology Clinics. Fellows also participate in our division’s specialty clinics: Renal / rheumatology, Dermatology / rheumatology, Uveitis, CRMO, Myositis, and Inflammatory brain disorders clinics.

Inpatient Service

During the first year,  6-8 months are spent in inpatient service, with the fellow conducting inpatient rounds and consultations, teaching residents, and ensuring all patient care plans are carried out. Telephone consultations are performed for primary care physicians from all over the Northwest and Alaska.

Joint Injections

Fellows perform between 2 and 10 joint injections per month in clinic and in the operating room while the patients are under general anesthesia.  Most sedated joint injections are performed with the aid of an ultrasound provider to teach trainees to do ultrasound-guided joint injections.

Education and Research

Two mornings each week are dedicated to education. Fellows attend Rheumatology Grand Rounds, Journal Club, and Fellows Lectures at the University of Washington as well as multi-disciplinary didactic sessions at Seattle Children’s Hospital. Weekly Rheumatology Team Meetings and Morbidity/Mortality conferences are held during which the fellows present patient histories for discussion. Chapter Review lectures occur twice a month. Extra time is spent reading and meeting with potential research mentors. Fellows have an opportunity to attend the annual meeting of the American College of Rheumatology each fall. Fellows also may attend the Childhood Arthritis and Rheumatology Research Alliance Conference (CARRA) meeting each spring.

Senior Fellows – Second and Third Years

Fellows solidify clinical and team leadership skills. Fellows develop research skills through conducting a project in either basic/translational laboratory investigation or clinical investigation. Each fellow develops a hypothesis-driven research project culminating in publication of a manuscript or grant proposal, which is required by the American Board of Pediatrics.  Fellows are also required to complete a QI project and write up their experience.

Outpatient Clinic

More time during the first year is devoted to developing clinical skills. In subsequent years, there is a one-half day clinic each month to maintain clinical skills while focusing on research. During the one-half day continuity clinic each week the fellow monitors a patient panel collected during year one. Senior fellows also have an outreach experience with a DEI rotation at Alaska Native Medical Center in Anchorage, AK.

Inpatient Service

Four – six weeks are spent “pretending” each year, in which fellows take major responsibility for patient care; with supervision and teaching of the residents and first year fellow, in consultation with the attending physician.