Our training program places a high priority on clinical, translational, and basic research in the rheumatic and immunologic diseases with a goal of preparing fellows as independent investigators in academic research, either in the laboratory and/or in the clinic. In parallel with this focus, research interests of the faculty in the core program include laboratory and patient-focused investigation. The former are primarily devoted to studies of the fundamental immunologic and pathological mechanisms of autoimmune and inflammatory diseases, whereas the focus of the latter is upon acquisition of skills needed for development of rigorous studies involving topics in patient-oriented investigation and corresponding research methods. Research mentors in the Section of Rheumatology include Drs. Linda Bockenstedt, Richard Bucala, Joseph Craft, Insoo Kang, Mark Mamula, Ruth Montgomery, Andrew Wang and Erol Fikrig (Dr. Fikrig is also appointed in Infectious Diseases) in translational and laboratory investigation and Drs. Lenore Buckley, Abhijeet Danve, David Felson (adjunct), Monique Hinchcliff, Betty Hsiao, Fotios Koumpouras and Lisa Suter in patient-focused studies.
Additional research mentors for trainees interested in laboratory and translational investigation include faculty in the Department of Immunobiology and in its program in Human Translational Immunology, a novel initiative designed to bring basic laboratory advances to the bedside. Fellows who focus in laboratory and translational investigation also have the opportunity to be mentored by faculty in any of the multiple clinical or basic science departments and programs at the Yale School of Medicine, depending on their interest and identification of an appropriate mentor. Faculty in the Section of Rheumatology aid the trainee in this process of choosing the appropriate research training environment and mentor, as well as providing the support for such training.
Likewise, trainees interested in patient-focused investigation may also elect to work with a variety of mentors in the clinical sciences at Yale, including through the Yale Center for Clinical Investigation, an initiative supported by the Yale Clinical and Translational Science (CTSA) NIH Award and devoted to novel approaches in patient-focused, translational, and community health investigation, as well as mentors in Geriatrics and the Program in Aging, the National Clinician Scholars Program, the School of Epidemiology and Public Health and a variety of other clinical science disciplines at the Yale School of Medicine. As for trainees in laboratory and translational investigation, faculty in the Section of Rheumatology aid the trainee in patient-focused investigation in the process of choosing the appropriate research training environment and mentor, as well as provide the support for such training.
A central goal of the rheumatology fellowship is to provide training in scholarship through lectures, conferences, and mentored research. Fellows will learn the epidemiology, pathobiology, and mechanism of action of the treatments used for rheumatic diseases, as well as develop an understanding of the modern molecular assays applied in mechanistic studies. Moreover, fellows will gain a working knowledge of epidemiology, ethics in medicine, and biostatistics through required didactic coursework pursued between the first and second training years. Fellows will emerge as physicians equipped with the requisite skills for a career of scholarship in the clinical and/or research setting.
The first year of training is primarily focused on clinical training in outpatient clinics and inpatient consult service. During this time, the fellows will have the opportunity to become acquainted with many of the faculty research programs. By the end of the first year, fellows will identify a research mentor and an original research project. Extensive guidance is provided during the first year to help focus research interests. Fellows interested in clinical investigation will attend three required courses in biostatistics, medicine ethics, and epidemiology. Additional coursework can be pursued in clinical trial design, clinical research methods, and/or additional epidemiology and biostatistics courses through the School of Epidemiology and Public Health. Formal training in quantitative clinical epidemiology and clinical decision-making are also available. Fellows interested in laboratory research will also take the coursework required for clinical research trainees but may also take basic science courses in the School of Medicine, including those in immunobiology, biology, cell biology, and/or molecular biophysics and biochemistry, depending on the research interest.
Dedicated research months during the first and second years of training allow fellows to complete independent research projects while acquiring the skills necessary for a career focused on scholarship in rheumatology. Fellows planning investigative careers generally spend an additional 1-3 years in research training, during which time they obtain the necessary expertise within a specific discipline to sustain growth as an independent investigator, including skills in scientific communication and grant writing. Fellows are expected to give a presentation in at least one national conference during their fellowship. The fellows will work closely with a faculty member(s) and mentorship team who provide oversight and guidance to the trainee.
Fellows may acquire additional advanced degrees as part of their training, including a Masters in Epidemiology and Public Health (or its related disciplines, including biostatistics and chronic disease epidemiology). Finally, some individuals holding a M.D. degree may wish to pursue a formal Ph.D. degree through the Investigative Medicine Program at the School of Medicine, headed by Dr. Joseph Craft. The Ph.D. program encompasses both classroom and laboratory training tailored to the development of physician-scientists in either the laboratory sciences or in patient-oriented research. These candidates will receive appropriate financial support for tuition and salary and can choose from a variety of potential mentors in the clinical and basic sciences the School of Medicine.