Clinical training

During your first year of rheumatology training, you can expect to spend three to four months on the inpatient consulting service. Also, during the first year, you rotate through the outpatient rheumatology practice and participate in an elective rotation or two.

The second year is committed to the remainder of the clinical rotations (inpatient-consulting, outpatient and electives).

Your third (optional) year is devoted to research with one half a day of continuity clinic.

Electives

The wide array of elective opportunities allows you to customize and develop the skills needed for your individualized career paths. A month-long elective rotation also is available at Mayo Clinic's campus in Phoenix/Scottsdale, Arizona.

These electives include:

• Physical medicine and rehabilitation
• Spine Center
• Hand Clinic
• Metabolic Bone Clinic
• Pediatric rheumatology
• Electromyography (EMG) lab
• Pulmonary Interstitial Lung Disease Clinic
• Pain Clinic
• Dermatology Clinic
• Nephrology Clinic
• Vasculitis Clinic
• Sports medicine

Didactic training

Core curriculum conferences, seminars, journal clubs, simulation center exercises with standardized patients, formal coursework in CCaTs, and one-to-one instruction with staff rheumatologists are integral parts of the Rheumatology Fellowship. Bedside teaching and other informal teaching methods also are part of our fellowship.

Conferences

A variety of conferences are held multiple times each week in the Division of Rheumatology. You may also find topics of special interest in other conferences sponsored by the Department of Internal Medicine, Division of Allergy and Immunology, Division of Nephrology, Department of Dermatology, and the Gonda Vascular Center.

The weekly schedule includes:

• Monday. Pulmonary interstitial lung disease (ILD) conference
• Wednesday. Internal Medicine Medical Grand Rounds
• Thursday. Department of Internal Medicine Education Grand Rounds
• Friday. Radiology conference or rheumatology division and research conferences*

*Fellows have opportunities to present at these conferences.

Procedures

All ultrasound-guided arthrocentesis and soft tissue injections are performed under the supervision of Mayo Clinic staff rheumatologists. Procedural training in musculoskeletal arthrocentesis includes injections of soft tissue tendons and bursa, and aspiration and injections of large, medium, and small joints. You're provided teaching in synovial fluid analysis to identify crystalline arthropathies.

Teaching opportunities

You have the opportunity to teach students from Mayo Clinic Alix School of Medicine, visiting students from other medical schools, and internal medicine residents through bedside teaching, small group exercises, and formal didactic lectures. You have opportunities through the Mayo Clinic School of Graduate Medical Education to attend formal courses in how to diagnose learners, provide effective feedback, and give both small and large group presentations.

Research training

The Division of Rheumatology at Mayo Clinic is known nationally and internationally for research activities with expertise in multiple subspecialty areas including rheumatoid arthritis, systemic lupus erythematosus, and vasculitis. Basic science support is provided in biochemistry and molecular biology, immunology, epidemiology, statistics, and other areas.

You have research mentors dedicated to providing guidance in protocol development, data analysis, and manuscript preparation. Our division's statistician is available to review methodology and statistical analysis. The majority of our fellows present their work at national and international meetings and publish multiple abstracts and papers.

The optional third year of fellowship training is considered the research year. This year provides protected time to perform research with one or more mentors involving any area of subspecialty interest. It is during this year that you also attend courses in the Center for Clinical and Translational Science (CCaTs).

Moonlighting

You may moonlight with program director approval. Moonlighting should not interfere with the required learning and must not violate the duty-hour rules of the Accreditation Council for Graduate Medical Education (ACGME) or visa regulations.

Evaluation and feedback

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully by the program director during the Rheumatology Fellowship throughout the duration of training. Written and oral feedback from staff rheumatologists, allied health, and patients is provided on a consistent basis. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.