Mission

To cultivate compassionate and exceptional rheumatologists through comprehensive clinical training, scholarly development, and a collaborative learning environment that empowers fellows to pursue their unique interests and become influential leaders in rheumatology.

Vision

To be a nationally recognized leader in rheumatology fellowship training, renowned for its commitment to patient-centered care, cutting-edge research, and the development of well-rounded, future leaders in the field.

Aims

We aim to cultivate exceptional rheumatologists who not only provide leading-edge care to our nation's military heroes and their families, but also advance the field through research and education, leveraging the unique capabilities of the WRNMMC and the National Capital Consortium (NCC).

Fellowship didactics are daily Monday-Friday. There are management conferences weekly and multidisciplinary radiology rounds biweekly. About once per month, there are journal clubs and intracity grand rounds where learners review unique cases from other fellowships within the National Capital Area. The remainder of the academic schedule is filled with board review, fellow and staff led didactics, ultrasound didactics and practice, research meetings, and quality improvement/process improvement sessions.

Fellows who wish to pursue elective rotations may do so in coordination with the program director.

Prior fellows have completed electives at the National Institutes of Health in the Autoinflammatory Diseases Group and with the Physical Medicine and Rehabilitation procedure clinic.

Outpatient call

This is distributed roughly evenly between fellows. From 7:30 a.m. - 4 p.m. the outpatient call fellow will field calls from outpatient clinics or the emergency department. Outpatient call changes daily.

Inpatient call

First-year fellows will have slightly more inpatient call than senior fellows. The inpatient fellow will field inpatient consults and after-hours or weekend calls. Inpatient call is scheduled in one-week blocks.

Fellows in the NCC Rheumatology fellowship are active-duty officers in the United States Army. Musculoskeletal syndromes and injuries are the most common non-combat medical problem of active-duty members during training, while on duty around the globe, and in the combat theatre of operations. Up to 60% of all DNBI (disease non-battle injury) is musculoskeletal in nature.  Having the skills to manage these problems is a core mission of the NCC Rheumatology Fellowship program.

Additionally, leadership is an expectation of the Military Medical Officer. A recent QI project demonstrated that WRNMMC Rheumatology Fellows will graduate and be thrust into leadership roles immediately upon graduation. They will be expected to effectivity organize and lead teams, foster quality improvement, and model professionalism and professional behaviors. Fellows are encouraged to attend the LEAD 2.0 curriculum over the course of their fellowship to improve medical leadership skills and prepare them for a career of leadership. The military rheumatologist must possess a broad array of skills to be an effective Medical Officer.

Fellows will complete the Stanford teaching course and Institute for Healthcare Improvement quality improvement course prior to graduation.

Incoming fellows will practice arthrocentesis in the simulation center during their orientation and complete an OSCE in the fall of their first year. They will have opportunities to teach ultrasound and arthrocentesis in the simulation center.

Fellows are expected to participate in the LEAD 2.0 GME Leadership Curriculum. Over the course of 24 months fellows are encouraged to attend all sessions at least once. Fellows will also participate in a leadership book club led by the staff within the fellowship.

Requirements

• Participate in the local WRNMMC research competition
• Submit an abstract to the D.C. fellows’ forum
• Submit an abstract to Triservice ACP
• Submit a paper to a peer-reviewed journal prior to graduation

Opportunities

• Numerous opportunities for case reports
• Potential collaboration with our pediatric rheumatologist
• Join an ongoing longitudinal protocol with staff
• Perform bench or transitional research with USU faculty
• Collaborate with NIH staff during your rotation

Examples

• Our fellows have won national recognition awards at the North American Young Rheumatology Fellows conference 11 of the last 12 years
• Triservice ACP routine accepts fellow submissions
• National ACP and the American College of Rheumatology conferences are also common venues prior fellows presented their research

All fellows will participate in a clinic-wide quality improvement project. Recent projects include:

• Standardizing patient intake processes
• Creating a picture book of common rashes and exam findings to aid patient education
• Assessing the utilization and results of teleconsultation across the Department of Defense

Fellows are encouraged to participate in faculty development courses as offered by USUHS. Additionally, they are eligible for a faculty appointment as assistant professor.

• WRNMMC – Adult Rheumatology
• WRNMMC – Pediatric Rheumatology
• NIH – National Institute of Arthritis and Musculoskeletal and Skin Diseases

Residents interested in rotating can contact their leadership to request a rotation and coordinate that rotation through our Associate Program Director.

The interview process for rheumatology fellowship applicants at Walter Reed has used virtual interviews for the last several application cycles due initially to the COVID-19 pandemic. While there are drawbacks to this method, it is still effective and the American College of Rheumatology found that both programs and applicants believed it to be adequate. However, if the applicant is in the National Capital Area and would like to visit the program they are welcome to do so. No preference is given to an applicant based on in-person or virtual interview.

Program graduates take the American Board of Internal Medicine Rheumatology certification exam. This exam is offered annually in the fall. To become fully board certified, applicants are eligible to take the board certification exam the fall following graduation. To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the American Board of Internal Medicine by October 31st of the year of the exam. See the American Board of Internal Medicine website for comprehensive requirements.

Fellows will teach at USUHS participating in medical student’s physical exam, introduction to clinical reasoning, and multisystem diseases modules. Senior fellows will work with rotating residents and medical students.

Fellows interested in medical education will have numerous additional opportunities to teach at the medical school and internal medicine residency. Additionally, some prior fellows have sought certifications and degrees in medical education offered by USUHS’s Center for Health Professions Education.

All faculty are board certified in both Internal Medicine and Rheumatology. One core faculty member is also board certified in musculoskeletal ultrasound. One faculty member has a Master’s Degree in Health Professions Education (HPE) and another is currently working towards their PhD in HPE.

Fellows are encouraged, but not required, to identify a faculty mentor. Fellows will also have the opportunity to mentor medical students and residents interested in Rheumatology.

1. Art in Medicine/Narrative Medicine Conference is held annually.
2. Fellows are given literature and resources on wellness.
3. The following topics will be made available via lecture or another medium:
• Work-life balance
• Fatigue Mitigation
• Fitness
4. Service wide social events
• Holiday party
• Graduation
• The Engraving
5. Fellows are encouraged, though not required to attend social events with faculty through the year