About the Program

The Rheumatology Fellowship is a two-year training program with the option of a third year for additional research experience. Fellows participate in two years of longitudinal clinical experience at Ohio State Davis Outpatient Care and two years of inpatient consultative experience at The Ohio State University Wexner Medical Center's University Hospital.

Comprehensive clinical practice in rheumatology offers fellows ample opportunities to become proficient in the procedures of tendon sheath and bursae aspiration and injection, musculoskeletal ultrasound and arthrocentesis and joint injection. Fellows receive adequate training experience to function as a consultant in clinical, research and academic rheumatology. At the completion of the training program, fellows will be board eligible in the subspecialty of rheumatology.

Take a Virtual Tour of Our Rheumatology Fellowship Learning Spaces and Medical Center Campus

Curriculum

The core curriculum combines didactic teaching, basic and clinical research projects and supervised patient care in the outpatient clinic and on the consultative inpatient service.

Fellows see patients with a diverse spectrum of clinical disorders, from osteoporosis, vasculitis, rheumatoid arthritis, systemic lupus and immunodeficiency to bursitis, osteoarthritis and fibromyalgia. The rheumatology fellows also attend ambulatory clinic at Nationwide Children’s Hospital for experience in pediatric rheumatology. Elective rotations include orthopedics, musculoskeletal radiology, physical medicine and rehabilitation, physical and occupational therapy and private practice rheumatology.

Weekly didactic conferences include divisional case presentation conferences, journal club, immunology research conferences and interdepartmental conferences such as musculoskeletal radiology conference. All fellows are required to take a course in biomedical statistics, experimental design, biomedical ethics and risk management.

The rheumatology training program is located at The Ohio State University Wexner Medical Center, which includes:

Pediatric rheumatology training is provided at Nationwide Children's Hospital, the second-largest children's hospital in America, located three miles from Ohio State. Approximately 1,500 clinic visits are conducted each year at the Davis Outpatient Care.

Research opportunities are offered in both clinical and basic science settings. Active graduate and postdoctoral programs complement the rheumatology training research experience. Faculty members supervise these basic science laboratories and the clinical pharmaceutical studies in the outpatient clinic.

Application to our Rheumatology Fellowship program is done via ERAS.

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Introductory Lecture Series

First Year
- Laboratory tests
- Synovial fluid analysis
- Physical examination of the musculoskeletal system
- Musculoskeletal radiology
- Pediatric rheumatology
- Rheumatoid arthritis
- Gout, pseudogout and hydroxyapatite crystal diseases
- Fibromyalgia
- Soft tissue rheumatism
- Vasculitis
Second Year
- Systemic lupus
- Metabolic bone disease
- Osteoporosis
- Monoarticular arthritis
- Arthrocentesis and tendon and bursae injection procedures
- Spondyloarthropathies
- Low back pain
- Neuromuscular disease
- Clinical pharmacology

Curricular Topics

Basic Science
- Immunology
- Musculoskeletal anatomy
- Pathology of connective tissue
- Molecular genetics
- Purine metabolism
Clinical Sciences
- Diffuse connective tissue diseases
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Scleroderma
- Polymyositis
- Spondyloarthropathies
- Vasculitis
- Crystal-induced synovitis
- Osteoarthritis
- Nonarticular rheumatic disease – inducing fibromyalgia
- Sports medicine
- Systemic disease with rheumatic manifestations
- Metabolic disease of bone and osteoporosis
- Septic joints
- Joint surgery
- Rheumatic problems requiring rehabilitation therapy
- Pediatric rheumatology
Procedures
- Use of the polarizing and light microscope to analyze synovial fluid
- Diagnostic aspiration of diarthrodial joints, bursae and tenosynovial structures
- Therapeutic injection of diarthrodial joints, bursae, tenosynovial structures and entheses
- Musculoskeletal ultrasound training
Professional Skills
- Teaching skills
  - Formal presentation critique
  - Use of graphics software for slide presentation
- Writing skills
  - Manuscript or abstract presentation
  - Research protocol preparation

Rotations

Research Rotation
The goal of the research rotation is to develop the fellow’s confidence and skills in understanding the processes required to perform clinical and basic science research including:
- Development of specific hypothesis
- Design of a protocol to test the hypothesis
- Experience in obtaining approval from the Institutional Review Board
- Experience in writing a consent form for the average patient
- Experience in writing a grant proposal
This rotation allows the fellow to pursue research interests in basic science or clinical settings. Faculty members will supervise the fellow in the laboratory along with graduate students and postdoctoral students. The fellow will be encouraged to publish their results or present their findings at a regional or national rheumatology meeting. The fellow may also participate in clinical studies evaluating new pharmaceutical agents used in rheumatologic diseases under faculty guidance.
Hospital Consultative Rotation
The goal of the hospital consultative rotation is to develop the fellow’s confidence and skills in performing consultations on the hospitalized patient including:
- Diagnosis and management of a patient with acute arthritis in the emergency room
- Diagnosis and management of acute crystal-induced synovitis in an hospitalized patient
- Diagnosis and management of patients with rheumatic disease during pregnancy and labor and delivery
- Diagnosis and management of patients with rheumatic disease in the intensive care unit
- Management of an acutely ill immunosuppressed patient
- Development of a cost-effective approach to ordering inpatient immunology laboratory tests
- Management of patients with septic bursitis and septic arthritis
- Administration of IV alkylating agents exacerbations of lupus, renal or CNS disease
- Direction of pain control management in the hospitalized patient with compression fractures
- Selection of the hospitalized patient who may benefit from inpatient rehabilitation
- Diagnosis and management of patients with vasculitis
- Development of a concise, efficient, informative consultation report
The fellow is notified each day of consults requested on the inpatient services from any of the University Hospitals or emergency rooms. The rheumatology fellow will perform a history and physical on the patient and may have medical residents and medical students in attendance. The fellow will review any pertinent laboratory data and radiographs, review the medical literature in textbooks or online to prepare for attending consult rounds.

The rheumatology attending supervises pertinent points of the patient's history, physical and the decision making process involved in the impression and plan of action for each rheumatology inpatient consultation.
Ambulatory Clinic Rotation
The goal of the ambulatory clinic rotation is to develop the fellow’s confidence and skills in the initial evaluation and longitudinal follow-up of patients with rheumatic complaints in the outpatient setting including:
- Development of techniques to evaluate individual patients response to therapy over time
- Maintenance of an internal medicine knowledge base while emphasizing the evaluation of rheumatic complaints
- Experience in reviewing outside records and incorporating them into the rheumatologic evaluation
- Development of methods to relate to patients with chronic illness
- Development of skills to rapidly and efficiently evaluate both new and follow-up patients
- Experience in communication of evaluation to patients primary care physician
The rheumatology fellow is provided with a minimum of four half-day ambulatory clinics during the first two year's of clinical training. During each clinic, one to three new patients and four to eight returning patients are seen by each trainee. All new and returning patient evaluations are supervised by an attending rheumatology faculty member which includes review of pertinent history, physical examination and the decision making process involved in arriving at the clinical impression and plan.

Grand Rounds Assignments

Fellows will be asked to present specific topics in a division grand rounds presentation format. They will be assigned specific topics to ensure that they are familiar with a broad base of educational topics in the discipline of rheumatology including anatomy, genetics, biochemistry and physiology of connective tissue disease and pathologic aspects of rheumatic diseases.

Fellows will conduct an in-depth review from among the selected topics, complete with visual aids, etc., direct discussion of the topic with attendees and a detailed list of references:

Rheumatic problems in patients with renal diseases (post-transplant gout, dialysis arthropathy, amyloid, osteomalacia, etc.)
Pregnancy related issues in rheumatic disease
Rheumatic problems in patient with endocrinologic diseases (hyperparathyroidism, diabetic cheiroarthropathy, metabolic bone disease, etc.)
Rheumatic problems in patients with hematologic diseases (hemophilia, leukemia, lymphoma, sickle cell disease, etc.)
Secondary causes of osteoarthritis (genetic, hemachromatosis, etc.)

Each quarter rheumatology fellows meet individually with the rheumatology fellowship training program director to review their progress and evaluate the training program.

Rheumatology Fellowship

About the Program

Curriculum

Introductory Lecture Series

First Year

Second Year

Curricular Topics

Basic Science

Clinical Sciences

Procedures

Professional Skills

Rotations

Research Rotation

Hospital Consultative Rotation

Ambulatory Clinic Rotation

Grand Rounds Assignments

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