Our program is one of the oldest and most highly regarded in the U.S., and we take great pride in the quality and accomplishments of our trainees. To help you better understand our program we are providing you with this very brief summary of its various elements.
The program consists of four elements: the hospital rotations, the outpatient clinic experience, the didactic lectures and conferences, and research training.
Our program is proud of the extraordinary size and diversity of our patient population. All fellows spend time on service at each hospital, doing consults and managing patients.
Bellevue Hospital: This is the flagship of the NYC hospital system, and the oldest public hospital in the country. Bellevue is a place to see many acute illnesses, rare illnesses, and the natural history of illness in people who have not previously sought help. In this institution you will find one of the broadest and most interesting patient populations to be found anywhere, with a strong representation of nearly every type of rheumatologic disease.
The Hospital for Joint Diseases: One of the few institutions in the country dedicated specifically to rheumatologic and orthopedic diseases, this private hospital with a large public service mission is noteworthy for a large patient complement of individuals with lupus and seronegative arthritis. However, all rheumatologic illness is represented here. HJD is one of the few institution in the nation to have its own inpatient rheumatology service. It is also an exceptional place at which to learn about the orthopedic and rehabilitation aspects of rheumatology.
The NY Harbor Health Care System (Manhattan VA): One of the largest VA hospitals in the country and the flagship VA for the region, this service provides exceptional exposure to the management of RA, OA and crystal diseases, as well as vasculitis and myopathies. Virtually all other diseases, including male lupus, are also represented.
Tisch Hospital: Tisch Hospital is the university hospital of NYU Medical Center. This is a large, private institution, whose admissions by our full-time and voluntary faculty include a large number of tertiary referrals and unusual cases. The opportunity to rotate through this world-status institution will further broaden our already extraordinary patient experience to include more exposure to unusual diseases as well as a chance to participate in patient management with some of our most seasoned attending physicians.
In each of these above settings, attending supervision is on a monthly basis with the assigned attending rounding regularly, In addition, each hospital has at least one full-time attending on staff (The Hospital for Joint Diseases has a multitude!) who are available to see a patient or discuss a case on short notice. At Bellevue, a weekly walk rounds with all first-year fellows also supplements the regular attending supervision. Finally, we are proud of the fact that virtually all of our attendings are available all the time to consult with both formally and informally on cases of particular difficulty.
Our training program has an exceptionally rich outpatient base, and we operate five general clinics weekly, including two lupus and two arthritis clinics (one each at Bellevue and HJD) and a general rheumatology clinic at the VA.
In their first year, each fellow attends three of these clinics: one lupus, one arthritis, and the VA rheumatology clinic. The schedule is designed to assure that each fellow gets at least one clinic experience at each hospital. Each clinic is supervised by one or more clinic director and staffed by faculty in addition to the fellows. Our clinics are quite busy and provide an exceptional exposure to outpatient rheumatology
In their second year, fellows generally discontinue their VA clinic experience and maintain a lupus and an arthritis clinic as their continuity clinics. Thus the second year clinic experience is reduced somewhat to allow more time for scholarly activities.
In addition to these regular clinics, first-year fellows continually attend one or more “related” clinics on a rotating basis. These clinics are "attached" to the hospital rotations, so that the fellow at each hospital will be scheduled to attend a specific clinic for that month of rotation. These clinics have been selected to provide enrichment in areas directly related to rheumatology, and currently include a pediatric rheumatology clinic; a connective tissue diseases dermatology clinic; an autoimmune eye disease clinic and an orthopedic clinic. We are considering adding, or substituting in lieu of one of the other clinics, an osteoporosis clinic experience .
We are especially proud of our didactic programs here at NYU/HJD and believe that they are unmatched anywhere in the country. Our teaching and conference schedule is designed to promote both the education of our trainees and the lifelong scholarship of our faculty. The initial programs for the fellowship are designed to teach you the things you need to know to be an excellent rheumatologist. As the first year moves on, you continue to learn in the setting of Divisional conferences in which fellows and trainees come together with the attending staff as colleagues in learning; everyone participates together in participation and teaching in these conferences.
We have included some of the conference schedules for this year in your packet; we hope you will look at them closely and recognize the tremendous breadth and depth of our didactics.
Our didactic programs consist of.....
The Summer Course--Each year NYU/HJD rheumatology provides a unique series of lectures designed to provide our new fellows with a strong starting background in rheumatology. On almost every weekday morning for the entire summer (more than 40 lectures in all!), our faculty and faculty from related departments presents a lecture on an important aspect of rheumatology. By the end of the summer you should be extremely knowledgeable and begin to develop a level of comfort in evaluating even unusual cases. We are extremely proud of this program; to our knowledge, no other didactic program matches the breadth and depth of what we do. Topics include rheumatoid arthritis, osteoarthritis, lupus, crystal disease, myopathies, etc, but also include training in radiology, emg/ncs, rehab, metabolic myopathies, and other related subjects, which cry out for exposure. Although this conference set is designed for first-year fellows, second-year fellows and attendings also attend many of these lectures, and second year fellows and junior faculty have found them particularly useful for board review.
During the year, we sponsor a minimum of five conferences weekly designed to provide teaching on various aspects of clinical or academic rheumatology. Fellows are expected to be full participants in these conferences, presenting alongside their faculty colleagues. These conferences include:
Monday Journal Club: Clinical and basic science articles presented weekly by faculty and fellows.
Tuesday Bellevue Case Conference: The Bellevue fellow presents an interesting inpatient case, which is then discussed by senior faculty. This conference includes bedside rounds to evaluate the patient and is typically attended by 3-4 faculty members weekly.
Thursday Rheumatology Seminar: Weekly presentations by prestigious outside speakers as well as our own faculty, on current research relating to rheumatology. In addition, fellows give presentations, including morbidity and mortality and pathology conferences.
Thursday Meet-The-Professor Lunch/Radiology Rounds: On alternating Thursdays the first and second year fellows participate in a luncheon, sponsored by the Division, in which an outpatient management case is presented to one of our clinical faculty in rheumatology. This is an informal meeting, and designed to allow the fellows to learn about outpatient management in the "real" world as well as to get to know our practicing faculty in a more personal manner. On the remaining Thursdays the fellows meet with a member of the bone radiology team at the Hospital For Joint Diseases; cases are presented and films and studies evaluated, and formal teaching is done either on the real cases or on films from the teaching files.
Friday Case Presentation: Weekly presentation of a VA or Tisch Hospital patient with discussion by the VA Clinic directors.
In addition, we have several monthly conferences, including:
Rheumatology Grand Rounds: A clinical or clinically-oriented research talk, given each month by an academic rheumatologist of national prominence. Speakers are invited from all over the country and this is considered our "premier" conference of the month.
Interesting Case Conference: A monthly meeting in which two attendings each present a difficult case to the entire faculty and fellowship group. This is an excellent opportunity for fellows to observe the styles and approaches of senior clinicians as they actually manage their own patients. Interesting Case Conference is preceded by a monthly business meeting in which our Chairman, Dr. Abramson, discusses the state of the Division.
Research Seminar: A monthly meeting in which second-year fellows present their research work to the academic faculty in a casual and supportive setting. Each fellow presents twice: once toward the beginning of the year, to lay our their plan, and once toward the end of the year, to report on their progress. The goal is to provide the fellows, and their mentors, with helpful input and cross-fertilization.
Rheum/Renal/Path Conference: On a monthly basis, representatives of the rheumatology, renal and nephropathology sections meet to review the clinical history and biopsy pathology of several cases of autoimmune renal disease, and to compare and contrast approaches to management across the separate divisions.
Finally, all fellows are welcome and encouraged at all times to take advantage of the rich educational opportunities of our exceptional medical school, including many conferences daily given by other branches of the Department of Medicine and other departments of the school. These include Medical Grand Rounds, and The Honors Lecture, the medical school's flagship clinical and research conferences, respectively.
We are extremely proud of our faculty, which is one of the largest anywhere in rheumatology (more than thirty physicians, as well as PhDs) and ranges the gamut from superb private practitioners to full-time clinical staff to clinical researchers and bench scientists. All of our faculty have strong local and many have national reputations. Research interests range the gamut from lupus to rheumatoid and osteoarthritis to pure cell biology and pharmacology. We believe that this breadth is especially useful for the intellectual growth of our trainees, who have the opportunity to learn from people with great enthusiasm for a wide range of rheumatologic issues. For your convenience, we have included in your packet just a few of the many articles published by our faculty and fellows in the last several years. We also encourage you to visit our website for more information about our faculty and their interests.
In addition to their research, our faculty take teaching very seriously, and we both emphasize and value teaching on the part of both our faculty and fellows. We are particularly proud of the fact that, from among the approximately 100 rheumatology training programs in the country, nearly 10% are headed by graduates of the NYU fellowship and/or the School of Medicine. Many other graduates of NYU serve as chairs of rheumatology and/or research divisions, both nationally and internationally.
Our program is, officially, a two-year program in rheumatology. We are looking for the strongest possible candidates of all stripes, and are interested in future clinicians, clinical researchers and bench researchers, and any mixture of the above. We believe that our program has the breadth and depth to accommodate all of these directions, and that the environment is made richer for all by having a group whose interests can complement each other. Regardless of your current interests, what we seek in our fellows is future leaders, people who have the potential to make an impact on the field of rheumatology in one aspect or another.
The first year of fellowship is almost exclusively clinical in nature, but with important didactic introduction to the science (both basic and clinical) behind rheumatology. The clinics, wards and conferences discussed above make up the bulk of the first-year fellows’ experience. Each fellow rotates through each hospital, attends three clinics where they see their own patients, as well as the “attached” enrichment clinics, and participates in the conferences. Four weeks of vacation are provided, generally in two-week blocks.
The second year of fellowship continues the fellows' clinical training, mainly in the form of our outpatient clinics fellows cut back to two weekly clinics in this year, (as noted above), with some limited time spent on the wards. Fellows also continue to attend and participate in conferences. Much of the second year is intended to give trainees an exposure to research in its various forms, including a project that you will be expected to perform under the supervision of a faculty mentor. This project may take the form of a basic or translational research project, or of a clinical study. While we do not expect everyone to pursue a research career in the long term, we expect rigor and productivity from our trainees during this research experience. We believe that learning how to do and appreciate research is critical to your future as a rheumatologist who is capable of keeping up with the cutting edge of the field.
While our program is a two-year training experience, a third year of fellowship for additional academic and research training is available at the mutual agreement of the fellow and faculty and is strongly encouraged for those interested pursuing an academic career. These fellows typically reduce their clinical contact to a single clinic (unless clinical exposure is a direct benefit to their research). Interest in a third year should generally be declared as early as possible, ideally by the beginning of the second year of fellowship. Appropriate candidates will be entered into our NIH-sponsored training program for support. Fellows who seek to remain a third year are also strongly encouraged and mentored to apply for grants during their second year of fellowship, as a first step towards developing independence.
This year, for the first time, we will be making available to candidates the possibility of a three-year basic science research track to begin at the time of starting the program. For a single highly motivated individual, the Division will agree to a minimum of three years of research training and support. Candidates for this track are expected to aspire to an academic career in basic science or translational research, and to have demonstrated the capacity to succeed in such endeavors. If you are interested in this track, please speak to Dr. Steven Abramson, Division Chairman, or to Michael Pillinger, Training Program Director during or after your interviews.
We at NYU/HJD are proud of our triple commitment to teaching, academic scholarship and patient care. We think we have one of the finest rheumatology training programs anywhere, and hope you will agree. Since this synopsis can only touch upon our many resources, we encourage you to call us if you have any further questions. Ms. Amy Reyes (212-598-6518) can direct your call to the appropriate faculty member or fellow.Good luck, and congratulations on your choice of rheumatology as a future career!