Training

Rheumatology Fellowship Training

Clinical training

Fellows learn clinical rheumatology from faculty members in the division and care for their own patients during a twice weekly continuity clinic. In 2013, the division of rheumatology at Scripps Clinic saw almost 3,500 new patient referrals and provided 14,000 return patient visits. In addition to the outpatient exposure, fellows under the supervision of an attending consult rheumatologist, provide inpatient consulting services for patients with varied rheumatologic conditions at Scripps Green Hospital and Scripps Memorial Hospital Encinitas.

Clinical training is heavily emphasized during the first year of fellowship, but also continued throughout the second year. Fellows are the responsible physicians for their own group of patients under the supervision of faculty preceptors who are present at all times. Fellows see their patients with faculty supervision, ensuring continuity of care and an excellent longitudinal clinical experience.

Additional clinical training experience in pediatric rheumatology is offered through an affiliation with Rady Children’s Hospital – San Diego. At Scripps Clinic, musculoskeletal radiology, musculoskeletal ultrasound, and a curriculum in bone metabolism are integrated into the two-year fellowship. A one-month rotation at Naval Medical Center San Diego, a tertiary care referral and training center, complements the fellowship experience.

Elective time is used to participate in areas of special interest to the fellow such as electrodiagnostics (EMG-NCV), pain management, orthopedic subspecialties, and rehabilitation medicine.

Research training

Second year fellows have the opportunity to design and carry out original research in a clinical, translational, or basic science area under the guidance of an experienced investigator. Clinical research in rheumatology, collaborative studies with other fields of medicine, and basic/translational research can all be pursued depending on the interest of the fellow. Scripps Clinic is situated on campus shared with the Scripps Research Institute and the Scripps Translational Science Institute, providing the fellow with ready research opportunities.

The Salk Institute, the Sanford-Burnham Medical Research Institute, the Scripps Center for Orthopedic Research, the University of California at San Diego, and a number of biotechnology and research centers are located in La Jolla — within a short distance of the Scripps Clinic Torrey Pines. They offer a variety of research opportunities in areas such as:

  • Immune regulation
  • Vascular biology
  • Drug design and development
  • Autoantibody mechanisms

Fellows have protected time during their second year for research efforts.

Conferences

During the course of their fellowship, fellows assume major responsibility for participating in divisional conferences. The rheumatology fellowship at Scripps has two teaching conferences every week on Tuesday and Friday mornings. Conference types include journal club, research presentations, clinical case conferences, core curriculum lectures, and a board review course. Scripps Clinic and UCSD collaborate in presenting a city-wide Rheumatology Grand Rounds series.

Fellows also attend biweekly musculoskeletal radiology rounds with fellowship-trained musculoskeletal radiologists to enhance their skill reading plain films and to promote an understanding of the role of complex imaging studies including MRI, CT, and CT/PET in assessing patients with rheumatologic disease. Training in musculoskeletal ultrasound was incorporated into the fellowship program in 2012. The teaching program and curriculum was recently reorganized around a two-year teaching cycle that guides the rheumatology fellows in a directed program of learning.