Clinical Training
Duke University Medical Center is a large, tertiary care center, where trainees can expect outstanding exposure to a wide range of rheumatologic diagnoses. First-year fellows spend 50% to 60% of the year on service, which includes inpatient consults and taking outside provider calls. In addition, first-year fellows complete an average of five half-day clinics per week (see First Year Curriculum). There are opportunities for fellows to participate in interdisciplinary subspecialty clinics, including an Autoimmune Brain Disease Clinic, Lupus Clinic, Myositis Clinic, Uveitis Clinic, Young Adult Clinic, and a Sedated Joint Injection Clinic (see Subspecialty and Interdisciplinary Clinics). Fellows also have the opportunity to work across a broad spectrum of practice settings, from a hospital-based clinic to a nearby satellite clinic to a clinic at the University of North Carolina-Chapel Hill (UNC-CH).
Research Environment
Duke offers all of the research benefits of a large academic medical center. In addition to the research being accomplished within the Division of Pediatric Rheumatology, fellows can choose to work with faculty in the Department of Medicine’s Division of Rheumatology and Immunology or with other clinical or basic science departments throughout Duke. Fellows also have the opportunity to participate in a variety of National Institutes of Health (NIH) research training programs (T32 grants) throughout the health system, including programs affiliated with the Duke Clinical Research Institute (DCRI). Through these programs, many previous fellows have opted to earn master’s degrees during their fellowship time. Although there are some associated additional tuition costs with pursuing a master's, these degrees are typically discounted. Fellows are encouraged to participate in whatever form of research most interests them--including basic science, translational, clinical, quality improvement, or medical education--and are connected with mentors who help ensure the scholarly work meets the highest standards (see Second and Third Year Curriculum).
Combined Fellowships
The Duke program supports motivated fellows who are interested in pursuing two fellowships simultaneously, such as adult and pediatric rheumatology (for those graduating from a Medicine-Pediatrics residency program), or pediatric rheumatology and allergy and immunology (for those interested in the interface of the two specialties). These programs are typically four years, including one year focused on pediatric rheumatology clinical care, one year focused on clinical care in the related subspecialty, and two years focused on research. Because combined fellowships require additional work to facilitate, please contact Rebecca Sadun, MD, Program Director (Rebecca.sadun@duke.edu) as early as possible in advance of submitting your ERAS application.
Division
Our division comprises nine faculty, two triage nurses, who respond to the majority of calls from parents; a nurse practitioner, who shares responsibility for autoimmune brain disease patients; and two pharmacy technicians, who manage the majority of prior authorizations. The division also has access to shared resources, such as a social worker with expertise in working with pediatric rheumatology patients; a nutritionist with expertise with the care of adolescents on chronic oral corticosteroids; a program coordinator, who assists trainees with timely completion of fellowship requirements; and several staff assistants and administrators, who support the division's infrastructure.
Faculty
Fellows have access to pediatric rheumatology faculty with a wide range of expertise in multiple disciplines, including autoimmune brain disease, dermatomyositis, ethnography, localized scleroderma, pharmacology, patient-reported outcomes, pain amplification, systemic-lupus erythematosus, and uveitis. In addition, there are two faculty skilled with using and teaching musculoskeletal ultrasound (MSKUS), and two faculty who are fellowship-trained in both pediatric rheumatology and adult rheumatology. Through close collaborations with the adult Division of Rheumatology and Immunology, pediatric rheumatology fellows are invited to participate in a weekly, joint Rheumatology Grand Rounds, which provides trainees access to additional world-class faculty.
Salary, Benefits, and Perks
Duke Graduate Medical Education (GME) offers competitive salaries, which include free parking and Duke-based health insurance with no premiums. Duke fellows also receive three weeks of vacation, in addition to time off for major holidays for which they are not scheduled to work. The program helps pay for fellows to attend the American College of Rheumatology (ACR) annual meeting, the annual Childhood Arthritis and Rheumatology Research Alliance (CARRA) meeting, and the Carolina Fellows’ Collaborative (all typically for two of the three years).