The curriculum is intentionally heavily weighted toward clinical experience in the first year, allowing the first-year fellow the opportunity to learn to evaluate a large number of patients, with a wide variety of rheumatic, musculoskeletal, autoinflammatory, and autoimmune conditions. The first-year fellow will thereby quickly and consistently improve their knowledge of rheumatic diseases, their understanding of the principles of management of rheumatic diseases, and will also develop excellent diagnostic and technical skills. The second and third years intentionally provide a large amount of time to develop and implement a scholarly project. During these two years, fellows focus on developing the skills and knowledge that will allow them to be successful academic pediatric rheumatologists. Fellows choose to complete specific curricula in one of four scholarly activity tracks: basic research, clinical and translational research, quality improvement, and education. The specific curricula within each track serve to enhance the fellow’s education in a specific scholarly area, further preparing them for an eventual academic career. Throughout the three years, there are multiple and frequent didactic conferences which supplement the clinical learning that occurs while providing patient care.
Year 1
Clinical Experience
- 49 weeks: Ambulatory Clinics Three half-days each week (includes Fellows Clinic which is intended to develop continuity of care with Fellow as primary provider)
- 47 weeks: In-patient Consult and Rheumatology In-Patient Rounds
- Two half-days: Ophthalmology Clinic
Scholarly Activity
- One half-day every other week from October through June and one 2-week block in January is protected time dedicated to develop scholarly interests, meet with scholarship mentors, establish scholarship oversight committee, and plan for activities in years 2 and 3
Didactics
- Weekly Journal Club
- Weekly Learn-to-Teach Conference
- Weekly Board Review
- Bi-weekly Immunology Review (second half of year)
- Bimonthly Musculoskeletal Ultrasound Review (Practical Hands-On Instruction)
- Quarterly Combined Medicine-Pediatric Rheumatology Conference (Case Discussions)
- Semi-Annually Adverse Event/Safety Conference
- Semi-Annual Department Joint Fellowship Conference (all subspecialty fellows)
Year 2
Clinical Experience
- 49 weeks: Ambulatory Clinic Two half-days each week (includes Fellows Clinic)
- Nephrology Clinic (over a 3-month period fellow will attend clinic to evaluate selected patients identified in advance; average of 1 patient per week over the 3-month duration)
- Sports Medicine Clinic (Six half-days over a 3-month period)
Scholarly Activity
- 49 weeks: Fellow chooses a specific track: see Scholarly Tracks below
Didactics
- Weekly Journal Club
- Weekly Board Review
- Bi-weekly Immunology Review (second half of year)
- Bimonthly Musculoskeletal Ultrasound Review (Practical Hands-On Instruction)
- Quarterly Combined Medicine-Pediatric Rheumatology Conference (Case Discussions)
- Semi-Annually Adverse Event/Safety Conference
- Semi-Annual Department Joint Fellowship Conference (all subspecialty fellows)
Year 3
Clinical Experience
- 49 weeks: Ambulatory Clinic Two half-days each week (includes Fellows Clinic)
- 1 month: In-patient Rheumatology patients and consults (“Acting Attending”)
- Dermatology Clinic (Six half-days over a 3-month period)
Scholarly Activity
- 45 weeks: Continuation of Track Curriculum; completion of specific project; potential manuscript preparation and submission
Didactics
- Weekly Journal Club
- Weekly Board Review
- Bi-weekly Immunology Review (second half of year)
- Bimonthly Musculoskeletal Ultrasound Review (Practical Hands-On Instruction)
- Quarterly Combined Medicine-Pediatric Rheumatology Conference (Case Discussions)
- Semi-Annually Adverse Event/Safety Conference
- Semi-Annual Department Joint Fellowship Conference (all subspecialty fellows)
Scholarly Tracks
There are 4 distinct Scholarly Tracks from which each fellow may choose. In addition to the common curriculum above, there are specific expectations for fellows in each track during Years 2 and 3 of the program and these are outlined below.
Pediatric Rheumatology Fellowship Basic Research Track Curriculum
Track Director: Calvin Williams, MD, PhD
The Basic Research Track is designed to develop the fellow’s knowledge and skills in basic science research, and is designed for those with an interest in a pediatric rheumatology career focused on laboratory research. The goal is to train the fellow to become an independent and productive grant-funded research scientist.
Year 1
- Meet with prospective laboratory mentors
- Identify a project and finalize a mentorship team
- Limited directed reading in preparation for year 2
Year 2
- Take American Association of Immunologists Basic Immunology course (optional)
- Audit MCW Basic Immunology course (optional)
- Begin laboratory work
- Write K08 application if appropriate
- Complete outline of manuscript by the end of year 2
Year 3
- Take AAI Advanced Immunology course (if appropriate)
- Audit MCW Immunology minicourses (optional)
- Focus on laboratory work
- Re-submit K08 application if appropriate
- Submit manuscript by the end of year 3
Year 4 (optional)
- Hire as Instructor or Assistant Professor (successful K08 + paper published)
- On-call responsibilities (no more than 4 weeks per year)
- Clinic – ½ day/week clinic
- Focus on laboratory work (> 75% protected time)
- Re-submit K08 application if appropriate
Pediatric Rheumatology Fellowship Clinical/Translational Scholarship Track Curriculum
Track Director: James Verbsky, MD, PhD
The curriculum of the Clinical/Translational Scholarship track is designed for fellows who wish to pursue a research career that involves patient care, patient interventions, or research based on patient samples. This requires a strong understanding of the regulatory issues involved with the study of human subjects. In addition, with the advancement in genetic technologies and their ever-increasing use in patient care, this track will also provide a background on the interpretation of genetic testing.
Year 1
- Completion of the CITI training program
- Determine specific fellowship project
- Meet with prospective mentors
- Prepare and submit proposal to IRB before end of year
- Attend quarterly Clinical and Translational Education Sessions (discuss practical scholarship-related issues such as IRB, HIPPA compliance, informed consent process, etc.)
- Join Childhood Arthritis and Rheumatology Research Alliance (CARRA) and attend conference calls related to specific interests and annual meeting
Year 2
- Implementation of fellowship project utilizing patient data or samples
- Completion of MCW-sponsored Personalized Medicine/Personalized genetics course
- (Optional) Pursuit of MCW Master’s in Clinical and Translational Science (if funding available through department)
- Attendance at quarterly Clinical and Translational Education Sessions
- Attend CARRA and conference calls and yearly meeting
- Monthly meeting with Dr. Verbsky to discuss topics related to genetic testing interpretation (e.g., case reviews, recent literature, practical issues related to genetics)
Year 3
- Completion of fellowship project utilizing patient data or samples
- Continuation and completion of MCW Master’s curriculum (if enrolled)
- Attendance at quarterly Clinical and Translational Education Sessions
- Attend CARRA and conference calls and yearly meeting
- Participate in MCW DOP Grant writing workshop
- Monthly meeting with Dr. Verbsky to discuss topics related to genetic testing interpretation
Pediatric Rheumatology Fellowship Quality Improvement (QI) Track Curriculum
Track Director: Danielle Fair, MD
The goal of the QI track curriculum in pediatric rheumatology is to provide education and experiences for pediatric rheumatology fellows interested in developing knowledge and skills to prepare them for further scholarly activity in the area of QI. A completed QI project is expected, and it is desirable for this project to be the scholarly focus of the fellow. The following activities will constitute the curriculum for this track during the three years of fellowship training:
Education
- Completion of IHI on-line open school Basic QI safety and quality certificate (13 modules)
- MCW Scholars in Patient Safety and QI Improvement Program –participation in years 2 and 3 for completion of project
- QI monthly journal club: monthly discussion of journal articles with Dr. Fair
- Assigned readings on QI with discussion with Dr. Fair every other month
- OPTIONAL: Children’s Wisconsin QIP Program-participation in years 2 and 3
Experience
- Engage in national Pediatric Rheumatology QI activities:
- Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN)
- QI essentials courses will be completed
- Twice yearly learning sessions and monthly participation with national teams
- Fellow will be a leader of MCW site team
- Fellow will complete a scholarly project
- CARRA
- Fellow will participate in CARRA QI workgroup
Pediatric Rheumatology Fellowship Educational Scholarship Track Curriculum
Track Director: Jay Nocton, MD
The curriculum of the Educational Scholarship Track of the Pediatric Rheumatology Fellowship Program is designed to prepare individuals for careers in which education and educational scholarship will be a focus of their scholarly activities. Gaining additional teaching experience in various settings will enhance the teaching skills of the fellow. Developing and implementing a specific scholarly project related to education and participating in MCW's faculty development programs will help the fellow to improve their educational scholarship skills. The following activities will constitute the curriculum for this track during the three years of fellowship training:
Direct Teaching Activities and Instruction (Fellow will teach)
- Small group teaching of residents/students (along with other fellows)
- Resident Noon Conferences (large group teaching)
- The evaluation of joint and extremity pain in children
- Rheumatic Diseases of Childhood 1: JIA, reactive arthritis, inherited disorders of connective tissue
- Rheumatic Disease of Childhood 2: SLE, JDMS, Rheumatic fever, fibromyalgia, sarcoidosis
- Resident Board Review presentation (large group teaching)
- Clinic-based teaching of residents and students: One-on-One
Curriculum Development
- Develop Pediatric Rheumatology Fellowship Board Review PowerPoints for each section of Board Review
- Develop/Update Reading List for elective rotations (students and residents)
Assessment Development
- E.g. Checklists for direct observation of history and exam performance by residents and students
Educational Research Project
- Example: Direct observation of learners performing history and joint exam with checklist and questionnaire regarding self-confidence; administer pre- and post-intervention with intervention being a detailed demonstration of joint examination and discussion of essential history
- Example: Create on-line (ideally) teaching modules for common pediatric rheumatic and musculoskeletal conditions; might include video of actual patients and physical findings; interactive with questions interspersed (storyline 360-articulate is software—would need funding); Might randomize learners and administer pre-and post-tests.
Assigned Readings/ Med Education Journal Club: discussion with Dr. Nocton monthly
Participation in MCW Faculty Development Programs (2-yr program preferable)
Optional: pursuit of Master’s of Medical Education online degree