The focus of our program is the development of academic rheumatologists and scientists competent in the treatment and investigation of rheumatic diseases. The fellowship consists of a first year of comprehensive inpatient and ambulatory clinical rheumatology training, followed by a one to two year mentored investigator phase with concurrent ambulatory clinical experience.
The Rheumatology Division has over 15,000 patient visits per year. In addition to the program at Northwestern Medicine, fellows participate in clinical activities at the Jessie Brown VA Hospital Arthritis Clinic, the Shirley Ryan AbilityLab and Ann & Robert H. Lurie Children’s Hospital of Chicago. Regular conferences are an important component of the training program. These seminars include Rheumatology Grand Rounds, Clinical Vignettes, Core Didactic Lectures, Multidisciplinary Clinical Research Conferences, Radiology Rounds, Journal Club and the Chicago Rheumatology Fellows Basic Science Course. In addition to participating in the organized didactic conferences established within the fellowship program, it is also strongly encouraged that all fellows become members of the American College of Rheumatology as well as The Chicago Rheumatism Society. Participation in the continuing medical education activities of these professional organizations is encouraged and helps foster standards of professionalism and augment the process of lifelong learning.
Please find details about our program via the information below.
Regular educational conferences are held on a scheduled basis with attendance required of all fellows and divisional faculty. There are one clinical conference, one basic science conference, one literature review conference (journal club) and one research conference each month. The content of these conferences often includes members from clinical divisions outside of Rheumatology, as well as participation from members of the Departments of Radiology, Microbiology-Immunology, Molecular Pharmacology and Biological Chemistry, Cell and Molecular Biology, Pediatric Rheumatology, Pathology, Physical Medicine and Rehabilitation, and Physical Therapy and Human Movement Sciences who have specific clinical or basic science interests related to the field of rheumatic disease. Fellows will be required to attend a minimum of 70 percent of each of the conferences.
An active, mandatory research component is included within the fellowship training program. A meaningful research experience is provided by the inclusion of appropriate protected time for each fellow who undertakes intensive research. A third research year is available for research-oriented candidates with a desire to continue in academic medicine. Fellows who choose to undertake a third year do not have inpatient duties and are only required to be in the outpatient clinic one half-day each week. The third year is supported by a T32 National Research Service Award, a 15-year grant from the National Institute of Health. With the support of this grant, a number of laboratories at Northwestern University participate in research training opportunities focusing on Rheumatoid Arthritis, Scleroderma and other Rheumatologic research interests.
Exposure to divisional research programs is initiated early in the fellowship, within the first few months, to allow the fellow adequate insight into the areas of research in preparation for the ultimate selection of a faculty member to serve as a specific research mentor for the remainder of the fellowship training program. The immediate goal of the research experience is for the fellow to learn sound methodology in designing and performing research studies and the correct interpretation and synthesis of research data. During this phase of training, the fellow works under close guidance of the research mentor. Fellows are provided opportunities for basic science research or for work in the fields of epidemiology and health services research conducted by members of the division.
The first-year fellow assigned to the inpatient consult service is responsible for organizing the activities of the service each weekday. During the first and second years of the fellowship, the trainee is on call an average of every third weekend, carried out under the direct supervision of an attending rheumatologist. Third-year research fellows have no required inpatient duties, in order to provide sufficient protected time for research. Fellows also develop a comprehensive understanding of the indications, contraindications, techniques, and complications of arthrocentesis as well as the interpretation of results from this procedure. Fellows also acquire knowledge of and skill in educating patients about the procedure and in obtaining informed consent. Faculty supervision is required in developing these skills.
The consult team is responsible for care of patients at Northwestern Medicine, the Prentice Women's Hospital, the Jesse Brown VA Medical Center and the Shirley Ryan AbilityLab during this period of time. Duties primarily include the supervised evaluation of inpatient consultations and the continued follow up of these patients during their hospitalization. Essential in this role is the development and refinement of the skills necessary for the clinical evaluation of patients with rheumatic diseases. These skills include the development of appropriate differential diagnosis, assessment of the need for hospitalization, diagnostic evaluation strategies and treatment plans.
The inpatient consult service at Northwestern Memorial Hospital (NMH) provides experience with the care of rheumatology inpatients, inpatient consultations to both generalists and specialists of all varieties, care of patients in specialty units, consultations on patients going to orthopedic surgery and emergency room consultations. The fellow assumes a consultative role, and guides the medicine residents on the rheumatology service in the routine care of patients. The non-specialty residents evaluate a subset of patients and report to the fellow, who is responsible for managing all the patients on the service. Fellows are responsible for the rheumatologic care of inpatients during their entire stay and for the acute and necessary daily follow-up evaluations on consultations. Non-rheumatologic medical management is performed by the managing service, under whom the patient is admitted. During this rotation the attending rheumatologists generally change every week, providing the fellow with exposure over time to all of our clinical faculty in a meaningful environment.
First-year fellows care for outpatients during three half-days in the outpatient clinic. Fellows are in clinic two half-days in their second year and one half-day in their third. One half-day during each of the first two years may occur at the VA under the direct supervision of an attending rheumatologist. In each half-day, a fellow is generally responsible for one to two new consultations and six to eight follow-up patients. All fellows have outpatient experience at the outpatient facility of the academic faculty of the Northwestern University Feinberg School of Medicine.
The fellow is given progressive autonomy in outpatient care throughout the fellowship, and will be appropriately supervised by assigned attending faculty members. The goal of this experience is for the fellows to gain expertise in the outpatient evaluation and management of rheumatic problems. The experience provides an opportunity to develop an understanding for the natural history of these conditions over an extended period of time.
Fellows are also provided an experience with other disciplines whose expertise is required in the care of patients with rheumatic diseases. These disciplines include rehabilitative medicine and pediatric rheumatology. The goal of these experiences is for the fellow to appreciate the approach to the specific conditions that relate to rheumatic disorders within these subspecialties. This interdisciplinary interaction can occur in the form of a clinical rotation, multidisciplinary conference, etc. Clinical experiences are under the direction of attending physicians in the respective subspecialty who participate fully in the educational goals of the rotation. For first-year fellows, these rotations occur during months when the trainee is not on duty on the inpatient consult service.
Developing Procedures and Teaching Skills
Procedural skills are taught in both the inpatient and outpatient settings. These skills include musculoskeletal examination, joint aspiration, joint injection, soft tissue injection and synovial fluid analysis. Procedures are performed under the direct supervision of a faculty member. Direct observation will occur until the faculty member and the fellow are confident of successful completion. During the course of the program, the fellow keeps a procedure log to ensure adequate skills have been obtained. Musculoskeletal Ultrasound has been incorporated into the training program by an American College of Rheumatology certified faculty member.
The program provides an environment for the fellow which fosters and highly regards the activities of teaching. This includes the education of not only medical students, physicians and other allied health personnel but also the education of patients. The development of these skills occurs during inpatient teaching rounds, the outpatient clinical experience, didactic lectures and personal feedback from individual faculty.
Diversity & Inclusion
The Department of Medicine at Northwestern University seeks to attract inquisitive, motivated residents and fellows and is committed to providing them with every opportunity for success. The greatest challenges facing the medical field are complex, and addressing them will require a diverse body of physicians and researchers who can work collaboratively. Northwestern offers unparalleled training and research opportunities and encourages fellowship applications from those who seek to become future leaders in the subspecialties of medicine. We are committed to and inspired by a diverse and inclusive work environment that allows each trainee to achieve their personal goals.
For more information on Northwestern’s commitment to diversity please see the following resources:
Requirements & Eligibility
Applicant qualifications include successful completion of an ACGME-accredited Internal Medicine residency and eligibility for the American Board of Internal Medicine's certification exam prior to the start of fellowship training. Because of support by an NIH National Research Service Award T32 training grant, applicants must be a citizen or a noncitizen national of the United States or have been lawfully admitted for permanent residence at the time of appointment to the grant. Applicants must also be eligible for an unrestricted Illinois medical license prior to beginning training.
The McGaw Medical Center of Northwestern University is committed to providing and maintaining a healthy learning environment and educational culture for all house staff, faculty and other members of the McGaw community including patients and employees of affiliated educational institutions and medical facilities. The commitment includes maintaining and educational environment that is free of unlawful discrimination and harassment on the basis of any legally protected status. In accordance with McGaw's educational goals and mission, and applicable law, McGaw does not discriminate or tolerate harassment based on sexual, racial, national origin or any protected group status.
The fellowship application process is managed through ERAS.
Fellowship selection occurs after the interview process and takes place through the NRMP fellowship match program.
Further program details, including our Housestaff Manual and a sample training contract, are available on our McGaw Medical Center Graduate Education site. Likewise, we recommend reading through our FREIDA listing (program number 150-16-21-051).
Graduate Research Resources
We offer a wide range of resources, mentorship opportunities and training to help our residents and fellows excel as physician-scientists. Explore all of the resources and hear from housestaff who are making research a major part of their career development plans.Visit the Housestaff Research Portal