Clinical Training

Our fellows are guided in the clinical science of rheumatology at two principal training locations: Yale-New Haven Hospital (YNHH), the main teaching hospital of Yale University School of Medicine and the Connecticut Veterans Administration Healthcare System. These venues, the leading medical centers in southern New England, provide state-of-art clinical care and education. Clinical training spans two years during which time fellows participate in the diagnosis and management of patients with a wide variety of rheumatic diseases and other diseases with rheumatologic manifestations. Fellows become part of a team of residents and students headed by faculty who supervise the practical aspects of patient care and provide didactic teaching in the scientific disciplines that underlie the clinical practice of rheumatology.

During their first year in the program, fellows are assigned to the inpatient consultation service interspersed with elective months for research. The fellow on service carries a long range beeper and responds to calls and consults during weekdays. Inpatient consultations usually range from 3-6 per week. Weekend coverage is equally divided among all fellows in the program.

In addition to inpatient consultations, fellows attend selected outpatient clinics throughout their training. Outpatient clinics are held weekly and include:

  • Fellows' General Rheumatology Clinic at Yale-New Haven Hospital North Haven Medical Center and Saint Raphael Campus where fellows see a diverse range of patients with rheumatic diseases, and which also provide didactic teaching conferences in musculoskeletal radiographic imaging and orthopedic hand cases;
  • Bone and joint clinics at the Veterans Administration Healthcare System, with a large number of patients with inflammatory and mechanical arthritis and with a didactic collaborative teaching conference with orthopedics; and
  • Private rheumatology clinics of the faculty covering systemic inflammatory diseases with special emphasis on inflammatory arthritis and connective tissue diseases.

During their first two years, fellows also perform rotations in pediatric rheumatology, orthopedic outpatient clinics, including sports medicine and hand and general orthopedics clinics, and rehab medicine. Fellows also learn bone densitometry from experts in its performance and assessment.

Educational conferences sponsored by our program include weekly Rheumatology Grand Rounds, a clinical conference, and several research conferences. Each week there is a post grand rounds session at which a fellow presents an interesting case, leads a discussion around a journal article, or presents a rare topic for discussion. Fellows play an active role in organizing and scheduling these conferences and benefit both from the clinical discussion as well as their presentation skills being developed. The Yale University School of Medicine also has numerous conferences on issues relevant to academic rheumatologist sponsored by other clinical and basic science departments.

All fellows are exposed to the methods and interpretation of laboratory tests commonly used by rheumatologists, including antinuclear antibody, anti-neutrophil cytoplasmic antibody, and anti-phospholipid antibody testing, rheumatoid factor, Lyme disease serologies and synovial fluid analysis. Many of these tests are performed by a clinical laboratory located within the Section of Rheumatology where technicians and faculty are readily available for instruction and consultation.

All fellows are also required to conduct a research project during their training.