Curriculum

Didactic program

The didactic conference schedule starts with an introductory series on the core rheumatic diseases in July and August, followed the remainder of the academic year by weekly rheumatology grand rounds, clinical case conferences, monthly musculoskeletal radiology sessions led by a dedicated musculoskeletal radiologist and a monthly journal club. In addition, an introductory course to musculoskeletal ultrasound (MSUS) will take place through the academic year, led by Dr. Janeth Yinh. Fellows attend the Spring (SOTA) ACR Annual meeting in the first year and the ACR Annual Meeting and the Harvard Rheumatology Review course or similar comprehensive rheumatology review course in the second year. We train our fellows in all of the core competencies including humanistic care, ethics, evidenced based medicine, and collaborative and systems based practice. In addition each year’s conference series includes sessions on geriatrics, medical education and medical ethics.  Fellows benefit from the expertise in our division in methodology and epidemiology provided by Drs. McAlindon, Harvey, Vlad, Kasturi and Bannuru, and in Complementary and Alternative Medicine working with Dr. Chenchen Wang. Dr. Harvey provides sessions on the topics of Health Care Systems, the Business of Medicine and Advocacy. Evaluation and assessment occurs through a Clinical Competency Committee, the mandated milestone assessment process, individual program director-fellow feedback sessions, direct observation, 360 evaluations and a regional annual collaborative ROSCE. 

Research and academic guidance

During the current academic year established a formal structure for guiding our fellows towards successful academic and research experiences. A research mentorship committee has been formed consisting of the Division Chief, Program Director and the fellows’ research mentor and meets monthly with the second year fellow.  In addition we have established an initiative to guide the first year fellow to explore a research project earlier such that project planning, including an  IRB submission when appropriate, takes place during the second half of the first year. We have also promoted more active efforts to initiate case reports and other opportunities to add a scholarly aspect to the fellows’ clinical experiences.  

Patient population

Tufts Medical Center is a 415 bed full service tertiary care center located in downtown Boston in the heart of Chinatown. We serve all the surrounding communities of the city of Boston, and have a large tertiary care referral base. Fellows encounter the full spectrum of rheumatic disorders, including the common rheumatic diseases seen in the local patient population and rare diseases that derive from tertiary referral sources and the presence at Tufts Medical Center of the full spectrum of intensive care beds, cardiac, renal, and bone marrow transplantation programs, orthopedics, Physical and Rehabilitation Medicine, maternal-fetal medicine and a neurosurgical unit. As a result complex clinical problems including abundant exposure to the connective tissue diseases, vasculitides and rheumatologic problems in the immunosuppressed patient are frequently seen by the fellows. The spectrum of faculty interests provides more specialized exposure to several areas of rheumatology including osteoarthritis, pediatric rheumatic diseases, musculoskeletal ultrasound, and Lyme arthritis.

Fellows’ exposure to procedures

We teach our fellows the procedural techniques of all generally-performed rheumatologic arthrocenteses and therapeutic injection of joints and bursae. A didactic session on clinical anatomy is taught by Dr. Kalish during the introductory summer series. Our fellows also benefit from an annual visit and didactic session from Dr. Juan Canoso, Adjunct Professor at Tufts, who is renowned for his skill and expertise in clinical anatomy including an informed approach to common and infrequently performed musculoskeletal aspirations and injections.  Finally through the MSUS course clinic fellows receive further training in clinical anatomy, anatomic diagnosis and procedural skills that MSUS has made available to the rheumatologist.