The Rheumatology Training Program is a two-year ACGME accredited program, structured to meet the standards established by the American Board of Internal Medicine and the American College of Rheumatology. Clinical training is focused around the rheumatology clinics and inpatient consultation services at the university teaching hospital and Overton Brooks VA Medical Center. After two years of training, fellows generally become eligible to take the American Board of Internal Medicine Rheumatology Subspecialty Board Exam.
- To obtain a comprehensive rheumatologic history and perform a detailed examination
- To be able to develop a differential diagnosis, diagnose and treat a variety of rheumatologic disorders
- To understand the principles and methodology for laboratory techniques used in Rheumatology and be able to clinically interpret the results
- To demonstrate competence in performing arthrocentesis in multiple sites and demonstrate competency in synovial fluid analyses by light and polarized microscopy.
- To understand the indications of obtaining imaging and be able to interpret plain radiographs of joints, ultrasound, CT scans and MRIs of joints in a variety of rheumatic diseases.
- To know the pharmacology, mechanism of action, drug interactions, side effects and appropriate prescribing and monitoring practices for use of a variety of pharmacologic drugs used in Rheumatology.
- To demonstrate competency in the diagnosis and treatment of pediatric Rheumatologic diseases.
- To interpret and review medical literature in rheumatology
- To utilize health status, disease activity, functional and quality of life measurements and assessment in research as well as in clinical practice.
- To perform punch skin biopsies for diagnosis and interpretation
- To interpret bone density scans, and treat and order further tests according to results.
- To prepare and submit an abstracts, case presentations and manuscripts as well as present them in national conferences
- To understand/utilize the Medicare/Medicaid documentation guidelines and compliance with billing procedures and ICM-coding
- Long term Mentorship
- Continuity of care: Each fellow sees the same patients throughout the 2 years to be able to understand long-term disease course and impact of treatment. Fellows take ownership for the patients along with the respective faculty member.
- Breadth of clinical exposure: We have patients with severe and complicated disease presentations ensuring a rich exposure to the entire spectrum of Rheumatologic diseases.
- Research opportunities: Fellows work with experienced faculty and present their work at conferences and publish manuscripts.
- Supportive and nurturing learning environment
- Teaching: Opportunities include teaching fellows, residents and students through lectures, as well as, bedside. Fellows are also a part of the Musculoskeletal physical examination demonstration for medical students.
Conference Curriculum: Fellows play an active role in organizing and scheduling these conferences and benefit both from the clinical discussion as well as their presentation skills being developed.
Core Review: All fellows present a comprehensive review of the pathogenesis, clinical features and treatment for each disease with discussions and critique by faculty for better understanding and recognize the clinical impact.
Journal club: Once a month, discussion and critique of a relevant Journal article by faculty or fellows to understand the data analysis, biostatistics and meta-analysis to independently interpret and review the latest medical literature in Rheumatology.
Consult review: The consult Fellow does a thorough literature review on a topic that was encountered during the consult month and discusses the application of the available evidence to diagnose or treat the patient with a challenging presentation.
Musculoskeletal Ultrasound Course: Dr Kyla Lokitz, USSONAR trained Rheumatologist and our Musculoskeletal Radiologist, Dr Alberto Simoncini, demonstrate the use of ultrasound as a diagnostic and therapeutic modality and provide hands on training for all the fellows in the conference as well as at the bedside. This helps fellows acquire the confidence and skills to use ultrasound in their practice, as well as gives them an edge to get in and complete the USSONAR certification program.
Care questions and Rheumatology Board review: Faculty provide a concise review of important topics and solve the questions of the CARE question bank together to help prepare for the Rheumatology board exam.
Fellows have Monday VA clinic and Tuesday, Wednesday and Thursday LSU Health Shreveport clinics. Friday is for didactics and research. Fellows have continuity of care with each of their patients who is seen with the same faculty member.
Pediatric Rheumatology Clinic: Fellows are on this rotation for 2 months each year when they work in Pediatric Rheumatology clinic at LSU Health Shreveport on Tuesdays and Shriner’s Hospital on Wednesday’s. Fellows on call for adults cover Pediatric consults as well.
Off-site rotations: Second year Rheumatology fellows rotate with Physical and Occupational Therapy, Private Rheumatologists, Pain management, Neurologist performing Electromyography/ nerve conduction studies.
Call Schedule: Fellows are on call for Inpatient consult service covering either at LSU Health Shreveport (Adult and Pediatrics) or VA for 5 months each year when they will be on call all weekdays and half of the weekends (which will be split between the LSU Health Shreveport and VA Fellow). In patient rounds are done after clinic and after hours and weekend call is home call.