Core Clinical Time
During the first year, fellows are on-call and covering the inpatient consult service for approximately 50% of weekends and up to 75% of weekdays, to ensure adequate exposure to inpatient clinical care. Throughout the year, fellows have two half-day continuity clinics, during which they build and care for a panel of their own patients. In addition, first-year fellows participate in an additional three half-day clinics per week, during which they work with a variety of faculty and benefit from exposure to different clinical practice styles. As part of these clinics, fellows rotate through subspecialty, interdisciplinary clinics (see Subspecialty and Interdisciplinary Clinics), and clinics in different practice settings, such as in a nearby satellite clinic (similar to a private practice setting), as well as occasional clinics in adult rheumatology, orthopedics, and sports medicine, to ensure depth in the development of clinical care.
First-year fellows also have a dedicated research month when they develop a research plan for the second and third year research project in addition to meeting with potential advisors. During this time, fellows also work on case reports or prepare submissions to the American College of Rheumatology national meeting.
Second and Third Years
Throughout the research years, fellows will maintain a continuity clinic (one-half day per week for categorical pediatric rheumatology fellows; one day per week for fellows enrolled in a combined fellowship program or those intending to pursue a primarily clinical faculty position). In addition, fellows in their second and third years will spend four to six weeks per year on the consult service with increasing independence, with the ultimate goal of gaining competence in the inpatient care of pediatric rheumatology patients prior to the end of fellowship.
Fellows have the opportunity to participate in ongoing research projects within the division or throughout the School of Medicine. Alternatively, some fellows opt to develop their own research projects, with the assistance of mentors. Per American Board of Pediatrics (ABP) requirements, all fellows will create a scholarly oversight committee (SOC) comprised of faculty within and beyond the Division of Pediatric Rheumatology. Trainees will meet every six months with their SOC to share updates on their progress, get feedback on their research, and develop future research plans. Previous fellows’ research projects have comprised a broad spectrum from basic science, to translational research, to clinical research. Fellows with strong interests in quality improvement or medical education have worked with Duke leaders in those respective fields to engage in scholarly activities that apply the core principles of these methodologies to problems unique to pediatric rheumatology. In addition, our division’s faculty is very involved with the Childhood Arthritis and Rheumatology Research Alliance (CARRA), and fellows are encouraged to use this as an opportunity for engaging in multi-institutional research. Throughout the three year fellowship, trainees participate in seminars that teach research skills, from advanced literature search skills to grant writing skills. Some fellows opt to take additional coursework, leading to certificates or masters’ degrees. Fellows work with their SOC to set educational goals that complement fellows’ research goals. Most of our fellows will have produced at least one publication over the course of the three years, and many will have more, in addition to chapters and other scholarly work conducted in partnership with division faculty. Some fellows opt to write grants in their senior year, to support their time when they begin as faculty. Notably, over the past several years, we have had multiple fellows successfully obtain national foundation funding while still in fellowship.