The Rheumatology Fellowship at the AUBMC provides an outstanding exposure to a wide diversity of patients with rheumatic and immunologic diseases, as well as opportunity to participate in research under the supervision of a supportive and involved faculty. The fellowship program is designed to provide internists with the optimal skills to perform as independent consultants and primary care providers for patients with inflammatory and/or musculoskeletal disorders.
Our fellowship program combines outpatient and inpatient clinical care, didactics and research experience. To be certain that the full spectrum of musculoskeletal and inflammatory/ autoimmune disease is encountered by each fellow, mandatory rotations are established in orthopedics, metabolic bone disease, neurology, radiology, ophthalmology, dermatology and physical therapy.
The fellowship is a two-year program. We are approved by the GME to accept one fellow each year.
Ambulatory Training
Our fellowship program is mainly based on outpatient experience.
The fellows are required to attend three half-day morning clinics per week at the outpatient department under the supervision of a dedicated attending faculty member. During these clinics, the fellow is required to assess new and follow-up patients, review their findings and treatment plans with the faculty preceptor. During these clinics, the trainee has also the opportunity to master procedure skills such as arthrocentesis and injections. In addition, fellows maintain their own continuity clinic, which provides an opportunity to develop an understanding of the natural history of these conditions over an extended period of time and apply practice-based learning.
One half-day afternoon clinic is reserved for medical student teaching and pediatric rheumatology cases and should be attended by both fellows.
First year fellows should also attend two half-days at the private clinics with a faculty member. During these clinics the fellow has the opportunity to learn different approaches to rheumatic diseases as well as to master communication skills and system-based practices.
Fellows also attend monthly combined dermatology-rheumatology clinics and monthly uveitis clinics at the ophthalmology department.
Over the two-year period, fellows are required to rotate for a full month at the following departments: radiology delving into musculoskeletal imaging, neurology learning about electro-physiologic studies, metabolic bone disease clinics focusing on diagnosis and management of osteoporosis, orthopedics concentrating on joint replacement surgery, dermatology studying skin manifestations of rheumatic diseases and physical therapy.
Inpatient Training
Consultations are conducted on the medicine, surgery, obstetrics and gynecology, pediatrics as well as emergency services. The fellow performs the initial assessment, formulates a differential diagnosis and treatment plan, and presents the patient to the faculty attending. Approximately 20 to 25 consultations are done each month.
The rheumatology division is also part of the fracture liaison service. During six months of the year the rheumatology fellow on the inpatient service is consulted on hip fractures admitted. His/her role is to evaluate and mange osteoporosis in these patients and schedule long-term follow-ups.
The first year fellow spends 7 months, while the second year fellow spends 5 months on the inpatient consultation service.
Research Training
Our fellowship program stresses on the importance of research training. It aims at exposing fellows to the process of clinical or basic science research including literature review, protocol design, IRB and regulatory processes, and data organization and analysis. The first year fellow is expected, with guidance and supervision of a mentor, to initiate a research project at the beginning of his training. During his two-year training, the fellow is expected to progress with his/her project and will be allocated two-months during his/her senior year to present and publish the research work.
Didactics
Fellows are enrolled in the EULAR online course on rheumatic diseases. This two-year course is an electronic form of continuous medical education in rheumatology. It begins in September of each year and comprises 42 modules that covers the entire rheumatology field. At the completion of the course the fellow is required to sit for an online exam and upon passing will receive a EULAR certificate.
Fellows are required to attend and participate in the weekly rheumatology conferences. The weekly conferences include journal clubs presented by electivers, case-based presentations by the fellows, as well as special lectures by faculty from different departments such as pulmonary medicine, infectious disease, nephrology, immunology, dermatology and orthopedics.
Fellows are also required to attend the departmental grand rounds.
Fellows receive core curriculum lectures by faculty members as well as specialty lectures in immunology, musculoskeletal radiology and bone health. The immunology course is offered by Dr. Marilyn Karam, Assistant Professor of Medicine. The course consists of weekly lectures over a four-months period reviewing the basic principles in general immunology as well as disease specific immunology. The musculoskeletal radiology course is offered by Dr. Nabi Khoury, Associate Professor of Radiology. The course consists of daily lectures over two-week period. A series of four osteoporosis lectures are lead by Dr. Ghada Hajj-Fuleihan, Professor of Medicine.
On a yearly basis, the Lebanese Society of Rheumatology organizes a region wide conference in Beirut. Fellows are required to attend and are encouraged to present their research projects.
During their two-year training, fellows attend one regional or international conference during which they are encouraged to present and publish results of their research projects.
For more information, kindly visit the Graduate Medical Education
GME website.