Rheumatology – Curriculum

Our combined fellows rotate through our five major teaching hospitals and three outpatient continuity clinics. Information for each is provided in this site.

Fellows are also able to see patients in specific multidisciplinary clinics throughout our teaching hospitals. Information for each is provided in the expandable sections below.

These experiences are supplemented by a variety of academic conferences. Faculty and fellows regularly attend conferences.

• A summer Rheumatology Program runs through the first eight weeks of our the Rheumatology Fellowship, designed to introduce the fellows to musculoskeletal examination, principles of immunology, and an overview of rheumatologic diseases.
• Weekly Case Conference: Fellows are expected to present cases seen in their outpatient clinics and consultation experiences. Discussions of each include background reading with evidence based literature review.
• Didactic Lecture Series: Taught by our attending faculty on specific rheumatologic topics to the fellows throughout the year.
• Musculoskeletal Ultrasound Didactic Lectures and Hands-on Session: See the expandable section below for more information.
• Monthly Journal Club: Fellows and faculty discuss recent articles published. Our journal club concerns disease mechanism and treatment of rheumatic diseases.
• Rheumatology Grand Rounds Series: Invited speakers present forefront research or updates in clinical topics for the benefit of fellows, faculty and community rheumatologists
• Boston-InterCity Rheumatology Rounds: Fellows are encouraged to attend the Boston InterCity Rheumatology Rounds, which are held once a month in the evening at a Boston teaching hospital (including Boston University Medical Center, Beth Israel Deaconess Medical Hospital, Brigham and Women’s Hospital, Children’s Hospital and Dartmouth-Hitchcock Medical Center)
• Multidisciplinary Conferences: Several multidisciplinary outpatient clinical conferences (Interstitial Lung Disease (ILD) and Dermatology-Rheumatology Conferences) have been developed to provide integrative care to our complex rheumatologic patients, which enhance our rheumatology fellows’ educational experience. Fellows have the opportunity to present cases in each conference and lead a discussion on patient care between the different specialists.
• Rheumatology Guidelines: Fellows and Attending review current guidelines for rheumatic diseases.
• Board Review Conference: Fellows and Attending review CARE questions for ITE and rheumatology board exams.

Additional educational opportunities are provided to our fellows outside the rheumatology fellowship-learning environment.

• First year fellows have the opportunity to attend the yearly “First-Year Rheumatology Fellows Regional Conference at University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
• First year-fellows are also encouraged to attend the American College of Rheumatology (ACR) State-of-the-Art Clinical Symposium (SOTA) Meeting and second-year fellows attend the ACR annual meeting
• Fellows and faculty often travel to participate in the bi-annual New England Rheumatism Society (NERS) gatherings.
• First and second tier fellows are encouraged to present at the Clinical Conference in Rheumatology (CCR) and ACR annual meeting.
• Second year fellows may attend the New York University (NYU) Seminar in Advanced Rheumatology or the Harvard’s Advances in Rheumatology.

Multidisciplinary Clinics

• Musculoskeletal Ultrasound Program

  Ultrasonography is a valuable diagnostic tool for diagnosis, monitoring, and intervention in Rheumatology. We routinely use ultrasound in our inpatient consultations and outpatient clinics in many of our clinics and teaching hospitals for the:

  • Assessment of synovial tissue, effusion, and treatment response of rheumatic diseases
  • Early detection of enthesitis in seronegative spondyloarthropathies
  • Assessment of crystal deposition diseases
  • Needle guidance in aspiration and injection
  • Assessment of soft-tissue rheumatism

  The Brown Rheumatology fellowship program is one of the first Rheumatology fellowship programs in the country to incorporate musculoskeletal ultrasound (MSKUS) into the fellowship curriculum and training. Our fellows learn diagnostic and ultrasound-guided procedures in both the inpatient and outpatient setting to assist with early diagnosis and treatment of musculoskeletal pain and rheumatic diseases. Led by Anthony M. Reginato, MD, PhD, didactic lecture series have been incorporated into the fellows’ curriculum that include:

  • History of musculoskeletal ultrasound
  • Physical principles of musculoskeletal ultrasound
  • General sonoanatomy and sonopathology
  • Knobology
  • Standard scan, sonoanatomy, and sonopathology using a regional approach followed by a hands-on practice session
  • Ultrasound needle guidance followed by a hands-on session.
  • Extra-skeletal applications of ultrasound

  Dedicated lectures to the utility of ultrasound in treat-to-target (T2T) in rheumatoid arthritis, crystal induced arthritis, and spondyloarthropathies are also part of the curriculum.

  In addition, the fellows may elect to take the MSKUS rotation elective in the outpatient setting with dedicated one-on-one training where they learn proper ultrasound interpretation, documentation and billing.

  Fellows may participate in on-going ultrasound clinical trials or research projects.

  Fellows are encouraged to participate in MSKUS courses such as:

  • ACR Musculoskeletal Ultrasound Courses for Rheumatologists Fundamentals
  • Ultrasound School of North America (USSONAR): During their second year, some of the fellows may elect to participate in this course to gain additional experience in performing ultrasound and/or increase the number of ultrasound scans to gain future certification. Since 2009, our fellows have gained certification through either the American College of Rheumatology (ACR) Musculoskeletal Ultrasound Certification in Rheumatology (RhMSUS) or the American Registry for Diagnostic Medical Ultrasonography (ARDMS) and accreditation of their practice through the American Institute of Ultrasound Medicine (AIUM) culminating in the incorporation of ultrasound into their clinical practice.

  The Rheumatology Clinic at Brown Medicine is equipped with 2021 Logic p9 x D, 2015 GE Next Gen LOGIQ e, Butterfly IQ + and the Providence Veterans Affairs Medical Center is equipped with 2021 Logic p9 x D, GE LOGIQ e BT12, 2015 GE LOGIQ S8 and GE Vscon Air.

  The Rheumatology Clinic at the Roger William Medical Center Rheumatology Clinic is also equipped with a 2018 GE Next Gen LOGIQ e.

  Rheumatology Ultrasound Educators
  Dr. Anthony M. Reginato
  Dr. Joanne S. Cunha
  Dr. Katarzyna Gilek-Seibert
  Dr. Deepan Dalal
  Dr. Amorese-O’Connell

• Specialty Care in Pregnancy Program

  Women and Infants Hospital Specialty Care in Pregnancy program (SCIP) is a monthly multidisciplinary conference and outpatient clinic between the Center for Obstetric and Consultative Medicine at Women and Infants Hospital and our Rheumatology department. The conference involves discussions on cases of women whose pregnancy or plans for pregnancy are complicated by a rheumatologic condition. A plan for these patients’ pregnancies, deliveries, and postpartum periods is formulated with the consultants. The team also discusses preconception counseling and topics related to rheumatologic diseases and pregnancy. Following the conference, the multidisciplinary team including the OB medicine physicians and rheumatologists see patients and coordinate care in the outpatient clinic at Women and Infants Hospital. The conference and clinic is led by Drs. Tarabulsi and Cunha.

  Obstetric Medicine Specialists
  Dr. Gofran Tarabulsi
  Dr. Srilakshmi Mitta

  Rheumatology
  Dr. Joanne S. Cunha

• Dermatology-Rheumatology Clinics

  There are several opportunities for fellows to experience combined multidiscriplinary Dermatology-Rheumatology Clinics. Fellows have a chance to diagnose and manage patients with both skin and musculoskeletal diseases.

  Center for Skin and Musculoskeletal Diseases

  A multidisciplinary clinic formed by the Department of Dermatology and Division of Rheumatology at Rhode Island Hospital. The outpatient clinic provides comprehensive care, diagnosis, and management for patients with concomitant skin and musculoskeletal disease, including those with psoriasis and psoriatic arthritis, systemic lupus erythematosus, dermatomyositis, systemic sclerosis, morphea, vasculitis, and other autoimmune etiologies. The Center for Skin and Musculoskeletal Diseases (SAM) is led by both Drs. Abrar Qureshi and Anthony M. Reginato.

  Rheumatology
  Dr. Anthony M. Reginato

  Dermatology
  Dr. Abrar Qureshi

  Providence VA Medical Center – Dermatology-Rheumatology Clinic

  Combined Dermatology-Rheumatology Clinics occur on a bi-monthly basis.

  Rheumatology
  Dr. Anthony M. Reginato
  Dr. Joanne S. Cunha

  Dermatology
  Dr. Abrar Qureshi

• Interstitial Lung Disease Multidisciplinary Conference

  A multidisciplinary conference between the Department of Pulmonary and Critical Care Medicine and Division of Rheumatology at Rhode Island Hospital. The conference involves discussions of patients with ILD and a rheumatologic condition. A coordinated plan for diagnosis and treatment is formulated with the consultants.

  Pulmonary and Critical Care
  Dr. Douglas Martin

  Rheumatology
  Dr. Edward Lally

• Boston Inter-City Rheumatology Rounds

  Fellows are encouraged to attend the Boston Inter-City Rheumatology Rounds, which are held once a month in the evening at a Boston teaching hospital (including Boston University Medical Center, Beth Israel Deaconess Medical Hospital, Brigham and Women’s Hospital, Massachusetts General Hospital, and Dartmouth-Hitchcock Medical Center).