The MedStar Health - Georgetown University Hospital Fellowship Program in Rheumatology
The Rheumatology Fellowship Program is a two year combined program between MedStar Georgetown University Hospital and The Washington D.C. Veterans Affairs Medical Center. Either two or three fellowship positions are available on alternating years, for a total of five fellows.
The program has a strong history of training clinical rheumatologists, clinical educators and independent investigators for successful careers in both academia and private practice. Over the last 20 years, all of our fellows have passed boards on the first try, and about 50% of our fellows have chosen careers as clinical educators in academic settings. Some of our graduates have become division chairs, program directors, and chairs of ACR national committees across the country. We have received the American College of Rheumatology, Rheumatology Research Foundation’s Fellow Grant all but one year since its initiation in 2001.
Why train here
Fellows work in a variety of clinical settings, both inpatient and outpatient, with robust exposure to different patient populations in D.C. As the major referral hospital for the MedStar system, Georgetown University Hospital’s inpatient rheumatology consult service and outpatient specialty clinics expose trainees to a wide range of disorders, including rare and complex cases. At the Veterans Affairs Medical Center, fellows work closely with their own panel of continuity patients, and serve as the primary consult team for both inpatient and outpatient joint procedures. Fellows have dedicated time for research and spend time in outpatient orthopedic and dermatology clinics.
All members of the Division have active research or educational interests at the clinical and/or translational level; fellows have the opportunity to participate in these efforts, and it is expected that all fellows will participate in some scholarly activity. Primary research interests include database studies and clinical trials in rheumatoid arthritis, spondyloarthritis, systemic sclerosis, vasculitis, pregnancy in autoimmune disease, gout, and database studies through the cooperative VA rheumatology database.
An increasingly important component of the fellowship curriculum is training in musculoskeletal ultrasound. Fellows receive weekly didactics and hands-on practice under the guidance of RhMSUS certified faculty.
Curriculum
Overview
Fellows rotate their primary location and responsibilities every two months, with regular continuity clinics, sub-specialty clinics, and didactic sessions throughout.
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Inpatient/Outpatient Rheumatology at Georgetown
Inpatient: The consultation service is run by one of the first year fellows, and consists of approximately 8-13 patients who are actively followed at a given time. Residents and Georgetown medical students also rotate through the service.
Outpatient: Fellows rotate through 5 different weekly half-day sub-specialty clinics every 4 months. Rotations include scleroderma clinic, lupus clinic, vasculitis clinic at the NIH, pediatric rheumatology clinic and ultrasound clinic. Each is attended by a faculty member with expertise in that area. In the second year, fellows rotating at Georgetown attend additional clinics with various attendings to enhance their outpatient experience.
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Inpatient/Outpatient Rheumatology at the Veterans Affairs Hospital
Inpatient: The consultation service is run by one of the first year fellows, and an average of 3-6 inpatients are followed at a time. The consult service provides a wealth of opportunity for mastering procedural skills, as the rheumatology team serves as the consult team for joint aspirations and injections.
Outpatient: Each fellow attends a weekly ½ day continuity clinic at the VA, where they have their own patient panel with continuity over the two years of their fellowship. Fellows rotating at the VA also attend additional general rheumatology clinics with a heavy emphasis on rheumatoid arthritis, spondyloarthritis, and crystalline arthropathy. In addition, there is a dedicated weekly procedure clinic, where fellows practice their ultrasound skills, and become proficient in diagnostic and therapeutic procedures, including arthrocentesis and tendon sheath injections. While at the VA, fellows also have a weekly intensive radiology conference with emphasis on reading plain radiographs. This has consistently been one of the highest ranked parts of the fellowship.
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Pediatric Rheumatology
Each fellow spends ½ day per week for 4 months in clinic with a pediatric rheumatologist to gain familiarity with the evaluation and management of pediatric rheumatic disease. There is opportunity for this to be extended to 8 months for those interested.
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Ambulatory Rotation
Once during the first year, and at least twice during the second-year fellows rotate through an ambulatory rotation during which they participate in VA outpatient clinic, their continuity clinic, their sub-specialty clinic, dermatology and orthopedics clinics. The rest of their time is unstructured, leaving protected time for research, elective clinics, or any other experience.
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Electives
There are multiple opportunities for elective clinic experiences based on the individual fellow’s area of interest. Fellows may choose to rotate through a combined dermatology-rheumatology clinic at Georgetown, the dermatology clinic at the VA, the lupus clinic at Washington Hospital Center, the myositis or auto-inflammatory disease center at NIAMS/NIH, or in the orthopedic subspecialty clinics. -
Ultrasound
Education in musculoskeletal ultrasound is incorporated into the weekly training. Twice weekly didactic and hands-on practice sessions are held throughout the two year fellowship program. There is extensive opportunity to practice ultrasound skills under faculty guidance during procedure clinics at the VA, ultrasound sub-specialty clinic at Georgetown, and on a day to day basis on the wards. In fact, fellows have access to their own ultrasound at both Georgetown and the VA.
Didactics
Summer Lecture Series: At the start of each academic year, fellow trainees attend a city-wide lecture series as an intensive introduction to rheumatology. This consists of 36 hours of didactics presented jointly by faculty from Georgetown University Hospital, The Veterans Affairs Medical Center, Washington Hospital Center, NIH, Walter Reed Medical Center, and George Washington University Hospital rheumatology programs. This is also an excellent opportunity for fellows to meet and get to know the other local fellows.
Rheumatology Grand Rounds: This is a weekly conference, attended by all fellows, rotating residents and students, faculty from Georgetown, the VA, and Howard University, as well as several community rheumatologists. Lectures include interesting case presentations, critical evaluation of the literature, and a wide range of visiting speakers.
Fellow Didactics: A fellow-specific didactic session follows grand rounds each week. Topics include biopsy interpretation, CT chest radiology review, EMG review, interpretation of PFTs, DEXA scans, etc.
Radiology Conference: One of the most long standing and popular teaching sessions, this weekly 2 hour session focuses on developing skills necessary to interpret musculoskeletal radiologic images. It is co-taught by a musculoskeletal radiologist and one of the VA rheumatologists.
Ultrasound Didactic Lectures: Twice weekly sessions are held to review joint specific ultrasound, and provide hands on practice with real-time faculty feedback.
Pulmonary-Rheumatology Conference: A bi-monthly conference attended by both divisions, where mutual cases are presented and discussed.
Neuromuscular Conference: A bi-monthly conference attended by Neurology, Pathology, and Rheumatology in which interesting cases are discussed, and detailed pathology is reviewed.
Renal Pathology Conference: An additional optional monthly conference attending by Nephrology, Pathology, and Rheumatology where complex cases are reviewed and treatment plans discussed.
Immunology Series: A weekly seminar in the spring combined with Washington Hospital Center fellows.
Seminal Article Review: Each week, two practice changing articles from the rheumatology literature are reviewed with the fellows. This is so that our fellows understand the rationale for many of our clinical decisions and become familiar with common outcome measurements in rheumatology.
Educational opportunities
Additional educational opportunities
- All participate in the fellow-lead advocacy training program which includes monthly, case-based educational modules and the unique opportunity to meet directly with Congressional leaders as part of ACR’s annual Capitol Hill Advocacy Day.
- The D.C. Rheumatism Society holds a monthly dinner meeting featuring a nationally known guest speaker, attended by fellows, faculty, and private rheumatologists from throughout the Washington D.C. area.
- Bone Club is a quarterly dinner meeting held at Georgetown with a focus on bone health, featuring experts in the field and Rheumatologists, Endocrinologists, and Internists.
- The D.C. Rheumatism Society’s annual Fellows Forum is a city-wide event featuring poster presentations by area fellows.
- MedStar Georgetown University Hospital’s Department of Medicine Research Day is an annual poster presentation competition and dinner event attended by all fellows, as well as residents and hospital faculty.
- Opportunity to attend The American College of Rheumatology Annual Meeting and/or the annual State of The Art (SOTA) Rheumatology meeting. Past fellows have attended several other meetings as well, depending on their area of interest.
Research
Fellows are expected to participate in a scholarly activity over the course of the two years. In the past, fellows have participated in projects exploring a variety of diseases.
Over the past several years, fellows have pursued original research projects, literature reviews, quality improvement projects, and published variety of case reports and book chapters. The ongoing research of various faculty members and our participation in several national registries through the VA provide multiple opportunities for scholarly projects. Fellows are expected to present posters each year at the Department of Medicine Research Day and D.C. Rheumatism Fellow’s Forum (see above), but many also present at other local and national meetings.
Application information
Thank you for your interest in the Georgetown University Medical Center Fellowship Training Program in Rheumatology (ACGME # 1501021060). This is a two-year program accredited by the Accreditation Council for Graduate Medical Education that fulfills the requirements for subspecialty certification set forth by the American Board of Internal Medicine. Training in Rheumatology is offered to physicians who complete an Internal Medicine Residency Program and are Board eligible in Internal Medicine.
Applications are reviewed in July and August 2023 for the July 2024 cycle. Interviews are held on Wednesdays beginning September 2023 and will continue through the beginning of November 2023.
VISA POLICY: J1 visas are sponsored through MedStar Georgetown University Hospital. We currently do not have the ability to sponsor H1B visas.
How to Apply through ERAS
You should apply for the Rheumatology Fellowship Program at Georgetown University Hospital through ERAS (Electronic Residency Application Service). ERAS is an internet-based applications process developed by the Association of American Medical Colleges to transmit fellowship applications, letters of recommendation, Program Director letters, medical transcripts and other supporting credentials from applicants, residency programs and medical schools to fellowship program directors using the Internet. For information about the process or to register for ERAS on the web, please go to www.aamc.org/eras.
Upon receiving the applications through ERAS, Georgetown will contact candidates about the possibility of an interview. Interviews will be scheduled in the late summer, and conducted throughout the fall.
The Interview Day
In the past our typical interview day began with Rheumatology Grand Rounds, followed by a meeting with the program director, three group interviews (2-3 attendings interviewing each candidate at a time), and open discussion time with our current fellows. We plan to stick to this original schedule format as much as possible, virtually. While more details about your specific interview day will be provided prior to your scheduled date, we hope the sample schedule below assists in planning your day.
The “Match”
Once you apply to the Rheumatology Fellowship Program and meet with our faculty, fellows and staff, we hope you will choose to rank Georgetown (ACGME # 1501021060) at the top of your list.
Georgetown participates in the National Resident Matching Program’s Medical Specialties Matching Program (MSMP) in Rheumatology Medicine. This is a computerized venue for matching an applicant’s preferences for fellowship positions with program directors’ preferences for applicants. For information about NRMP or to register on the web to participate in NRMP, please go to www.nrmp.org.
Contact us
For additional information on our program, please contact:
Mary Jennings Butler, Fellowship Administrator
Rheumatology Fellowship Program
Georgetown University Hospital
Georgetown Lombardi Comprehensive Cancer Center, 2nd floor, Podium D
3800 Reservoir Road, NW
Washington, DC 20007
Email: Mary.B.JenningsButler@medstar.net