Our weekly educational schedule is as follows:
Monday afternoon
Journal Club: on a rotating schedule, both fellows and attendings are responsible for presenting a recent article published in a respected journal. Through this activity, learners gain the skills needed to critically appraise journal articles, identifying the strengths and weaknesses of each article and making a determination as to whether the article will influence or change their daily practice.
Clinical Case Conference: each week, fellows and attendings are asked to present cases seen in the hospital or ambulatory clinics. The intent of this activity is to hone/refine presentation skills, formulate differential diagnoses, and discuss approaches to management. This forum is not an opportunity for attendings to dominate the conversation, but rather to foster and encourage clinical reasoning, generate differential diagnoses, and highlight an important aspect of clinical rheumatology.
MSK Radiology Conference: once a month, fellows meet with a dedicated MSK radiologist to go over imaging (conventional radiographs, CT, MRI, ultrasound) from cases seen over the previous month. In addition, there is a series of cased-based conferences heavily involving radiographic interpretation. These are led by attending faculty, and fellows are asked to interpret MSK imaging in a structured format using a standardized method.
Didactic Lectures: At the start of the academic year, the fellows immerse themselves in our Summer Core Lecture series. These lectures cover a panoply of topics including how to perform a complete musculoskeletal exam, applied immunology, rheumatologic emergencies, joint injections, arthritides, lupus, vasculitis, myositis, among others. In addition, throughout the year, we dedicate an entire month to a particular disease topic (lupus, RA, OA, vasculitis, myositis, APS, etc) in which we reinforce the concepts of immunology, pathogenesis, disease phenotypes, and management. During each month, we focus on pivotal studies of each disease covering basic science, clinical research, and therapeutic trials.
Board review questions: Throughout the year, fellows review board style questions (CARE questions or similar type questions) with attending physicians. These board-style rheumatology questions cover immunology, disease manifestations, management, and diseases with rheumatologic manifestations.
Quiz Bowl / Jeopardy: Learning should be fun, and in our program we create opportunities for fellows to learn in a relaxing environment. Periodically, the fellows participate in Jeopardy games based on rheumatology topics, but we also make sure to incorporate the humanities into the categories as well!
Continuity Clinics
Ambulatory clinics:
- UAMS: each fellow has two half-day continuity clinics at our main campus each week. The UAMS clinic allows fellows to see patients with a breadth of rheumatologic diseases, including lupus, RA, psoriatic arthritis, vasculitis, inflammatory myositis, OA, gout/pseudogout, Sjogren’s syndrome, and scleroderma. Fellows are precepted by an attending physician who does not have his/her own clinic at the same time and is focused on teaching fellows, allowing them independence in formulating a plan of care and providing guidance in the performance of joint/bursal/trigger finger injections.
- VA: each fellow spends a half-day of clinic at the John L. McClellan Memorial Veterans Hospital. This hospital is conveniently located on campus and is connected to the main UAMS medical center by a skybridge. In this clinic, fellows further develop proficiency in injections/joint aspirations, and provide care to a unique patient population in which there is an abundance of crystalline disease as well as other autoimmune diseases.
- Other: Throughout the year, fellows have the opportunity to work with other specialists who assist in the management of rheumatologic disease. Some of these elective rotations include allergy/immunology, pediatric rheumatology, metabolic bone disease, and physical/occupational therapy.
MSK Ultrasound
We have a dedicated ultrasound machine for use in clinic as well as the consult service. One of our adjunct faculty is trained in MSK ultrasonography and periodically spends time teaching fellows about performing an examination using ultrasonography. The division is very supportive of our fellows pursuing further training in musculoskeletal ultrasonography by attending dedicated conferences and/or in-depth training programs.
Inpatient Consultation Service
The rheumatology team provides consultation services for both the UAMS Medical Center as well as the VA medical center. The UAMS Medical Center is a statewide tertiary care center for Arkansas with 535 inpatient beds. Patients from across the state are referred to UAMS medical center, and fellows have the opportunity to see patients with a spectrum of rheumatologic diseases. Some of our recent consultations include the following:
- Juvenile dermatomyositis with calcinosis cutis and hydroxyapatite deposition disease
- Idiopathic granulomatous aortitis
- Lupus nephritis and enteritis
- Autoimmune phenomena related to myelodysplastic syndrome
- ANCA vasculitis
Fellows also participate in the inpatient VA consultation service. The Central Arkansas Veterans Healthcare Systems (CAVHS) John L. McClellan Memorial Veterans Hospital is the regional tertiary care referral center for the Veterans Administration with 258 inpatient beds. Cases seen on the inpatient consult service include crystalline diseases and, occasionally, vasculitis, inflammatory myositis, and lupus.
Scholarly Activity
Our rheumatology fellows are expected to engage heavily in scholarship. We define scholarship as the following: presentations, publications, quality improvement, creation of educational curricula, and research. The expectation is that prior to completion of the training program, each fellow has submitted/published at least one scholarly article each year, has been invited to give a talk at a local/regional/national conference, and has contributed significantly to the educational curriculum within the division/department. We expect our fellows, upon graduation, to be exemplary leaders in the areas of patient care, clinical education, or translational research.
We encourage our fellows to attend regional and national conferences. The division will cover the cost of one national conference (conference dues, travel, lodging, food) for each fellow on an annual basis. There may also be opportunities for fellows to attend other conferences throughout the year (Arkansas Rheumatology Association Annual Conference, State of the Art Clinical Symposium, Congress of Clinical Rheumatology, etc), and the division will help cover the cost of attendance if fellows are chosen to give a talk or present a poster.
There is a book fund allowance of $500 annually.