Curriculum
Our curriculum is designed to promote critical thinking in rheumatic diseases and is built around the following core competencies:
- Medical Knowledge: Gain a deep understanding of rheumatic diseases, their diagnosis, and management.
- Patient Care: Develop exceptional patient care skills, focusing on empathy, communication, and shared decision-making.
- Practice-Based Learning and Improvement: Continuously refine clinical skills through self-reflection, evidence-based medicine, and quality improvement initiatives.
- Systems-Based Practice: Learn to navigate healthcare systems effectively to optimize patient outcomes.
- Interpersonal and Communication Skills: Master effective communication with patients, colleagues, and other healthcare professionals.
- Professionalism: Uphold the highest standards of professionalism and ethical principles and foster a culture of patient-centered care.
Caring for patients across several settings, including OHSU Hospital, the Portland VA Medical Center, and the Warm Springs Indian Health Services Clinic prepares fellows to treat rheumatic disease in patient populations from diverse backgrounds.
Clinics, consults, rotations
Level: Junior and Senior Fellows
Time: Year 1 & 2
Location: OHSU (twice per week), Portland VA (once weekly)
These clinics form the cornerstone of rheumatology training. Over two years, fellows progressively develop essential competencies through:
- Comprehensive Patient Care: Independently evaluate new and returning patients with a wide range of rheumatic diseases under the guidance of experienced faculty.
- Clinical Reasoning & Decision-Making: Learn to present findings, develop differential diagnoses, and formulate effective treatment plans.
- Procedural Expertise: Gain practical experience in essential rheumatology procedures.
- Longitudinal Care: Follow patients over time, assessing treatment effectiveness and making necessary adjustments.
- Patient Advocacy: Become a champion for patients, navigating medication approvals, assistance programs, and emotional support needs.
Level: Junior and Senior Fellows
Time: 6 months at each location over the course of 2 years
Location: OHSU, Portland VA
Our robust inpatient consultation service provides comprehensive training in managing acutely ill patients across diverse hospital settings. Fellows gain expertise in:
- Diagnosing Rheumatic Disease: Refine your skills in evaluating patients for suspected rheumatic conditions and guiding diagnostic testing.
- Managing Complex Cases: Develop a strong foundation in treating confirmed rheumatologic illnesses and associated complications.
- Consultative Skills: Learn to effectively collaborate with referring physicians and guide patient care.
- Rare Disease Exposure: As the sole tertiary care center for Oregon and Southwest Washington, OHSU offers unparalleled exposure to rare rheumatologic conditions. You'll have the unique opportunity to participate in the assessment and treatment of these complex cases, gaining invaluable experience.
- Mentorship and Teaching: Benefit from the close supervision of supportive faculty and hone teaching skills while leading the consult service team.
Level: Senior Fellows
Time: 6 months, once weekly
Location: OHSU
Our dedicated Lupus and Scleroderma Clinic provides senior fellows a unique opportunity to delve deeper into the pathogenesis and management of these complex autoimmune diseases and their associated complications. Fellows have the opportunity to apply the latest treatment guidelines to treat the range of organ involvement seen in systemic lupus and systemic sclerosis and while monitoring treatment responses and adverse reactions carefully.
Level: Senior Fellows
Time: 5 months, once weekly
Location: OHSU
Our dedicated Vasculitis Clinic equips fellows to tackle one of the most complex challenges in rheumatology. Here, fellows gain unparalleled experience in diagnosing all forms of vasculitis, honing skills in evaluating patients with suspected vasculitis and mimics, developing a comprehensive differential diagnosis, and learning about the latest diagnostic procedures used to confirm vasculitis. Fellows work side by side with faculty in planning a treatment approach for confirmed cases, utilizing both traditional and innovative immune-modulating medications. Over the course of six months, fellows have a chance to monitor treatment responses, anticipate and manage possible side-effects, and plan maintenance strategies to keep the disease in remission.
Level: Senior Fellows
Time: One month, once weekly
Location: OHSU
Our collaborative ILD clinic offers a unique opportunity to partner with pulmonologists in tackling complex lung cases. Fellows utilize their rheumatology expertise to help distinguish between ILD caused by an underlying rheumatic disease or other causes and collaborate with the treatment team to manage immunosuppressive therapy when necessary for patients with ILD linked to rheumatic disease. Fellows also join the monthly ILD multidisciplinary case conference held with pulmonologists and radiologists expert in ILD.
In myositis clinic, Fellows work closely with our neuromuscular colleagues and rheumatology faculty to develop a systematic approach in evaluating and treating the spectrum of inflammatory myopathies while appreciating the wide range of possible mimics.
Level: Junior Fellows
Time: 6 months, once weekly
Location: Portland VA
Clinics: Regional Rheum Clinic
Level: Senior Fellows
Time: 6 months, twice monthly
Location: OHSU
Clinics: Musculoskeletal Ultrasound Injection Clinic
These rotations equip you with the expertise to confidently evaluate and treat regional musculoskeletal disorders.
- First Year: Regional Rheumatology at the VA: Refine knowledge of joint anatomy and examination skills through evaluation of patients with soft tissue rheumatism and osteoarthritis. Gain proficiency in performing joint and soft tissue injections under expert guidance.
- Second Year: OHSU Ultrasound-Directed Joint Injection Clinic: Gain skills in ultrasound-guided joint injections techniques, ensuring accuracy and patient comfort.
- Elective Interdisciplinary Collaboration: Expand understanding of treatment options by observing specialists in physical medicine & rehabilitation (PM&R), physical therapy, and occupational therapy. Gain valuable insights into the role of orthotics, bracing, and non-invasive therapies in managing musculoskeletal conditions.
Indian Health Services rotation
Level: Junior and Senior Fellows
Time: Quarterly
Location: Warm Springs Indian Health Services Clinic
By serving the Warm Springs Indian Health Services Clinic, a rural community just east of Mount Hood, fellows will gain experience in the following areas:
- Clinical Efficiency and Autonomy: The fast-paced environment of this clinic teaches fellows to prioritize tasks, manage time effectively, and work independently.
- Caring for Vulnerable Populations: This rotation heightens the fellows sensitivity to the unique challenges faced by members of this and other underserved communities.
Evaluation forms and feedback
Our program fosters a collaborative learning environment that prioritizes continuous feedback and growth:
- Real-time Guidance: Faculty seamlessly integrate focused observations and immediate verbal feedback into daily clinical activities.
- Regular Assessments: Fellows receive constructive evaluations every 3 months for clinic performance and after most inpatient rotations.
- Personalized Development Plans: Quarterly meetings with the program director will explore evaluation feedback and progress towards training milestones and help tailor learning plan towards set educational goals.
- Benchmarking Knowledge: Sharpen knowledge base by taking the annual rheumatology in-training exam. This national assessment provides valuable insights into fellows strengths and areas for further development.