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. Fellows attend the ACR Annual and Spring (SOTA) ACR meetings, and the Harvard Rheumatology Review course or similar comprehensive rheumatology review course. For the first time this year our first year fellow attended the Philadelphia region’s First Year Fellow’s conference in July and we plan to continue to offer this conference to our incoming fellow(s). Fellows benefit from the expertise in our division in methodology and epidemiology provided by Drs. McAlindon, Harvey, Vlad, Kasturi and Bannuru, and in Integrative Medicine provided by 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 6Competency 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
Over the past two academic years we have initiated a more formal structure for guiding our fellows towards meaningful 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 takes place during the second half of the first year.
Patient population
Tufts Medical Center is an over 400 bed full service tertiary care center located in downtown Boston that serves the local immigrant community of Chinatown, the urban working class communities of the city of Boston and Lowell, and a larger tertiary care referral base and is the only institution at which the fellowship is held. Our patients come from diverse ethnic and racial groups, and include a substantial proportion of economically disadvantaged individuals. 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, pediatric to adult transition patients 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 including with the assistance of ultrasound. Our fellows also benefit from an annual visit and didactic sessions 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.