Wais Afzal MD
Bhakti Deshmukh MD
Vinisha Kota MD
Leeza Patel MD
Goals of the Rheumatology Training Program: The Rheumatology Training Program at UAMS is organized to provide training and experience at a level sufficient for the trainee to acquire competence in the field. In general these goals include:
- Outpatient and inpatient experience to allow the trainee to manage patients with common or uncommon rheumatic diseases and other illnesses with rheumatologic manifestations.
- The program provides the environment and resources for the trainee to gain experience in the diagnosis and treatment of patients with the diseases listed in the curriculum.
- The program provides sufficient experience for the trainee to acquire skill in the performance and interpretation of the use of diagnostic and therapeutic procedures pertinent to the subspecialty.
- The formal educational program provides teaching in the basic science aspects of the subspecialty including anatomy, genetics, biochemistry, physiology of connective tissue bone and muscle, as well as purine metabolism. The trainee will acquire basic knowledge in the area of immunology and pathogenesis of inflammation.
- The trainee will be given the opportunity to devote a substantial amount of time to do hands-on clinical research.
Specific Objectives: The training program provides the environment resources for the trainee to gain experience in the diagnosis and treatment of patients with connective tissue diseases, rheumatoid arthritis, SLE, scleroderma, polymyositis, spondyloarthropathies, vasculitis, crystal-induced arthritis, osteoarthritis, nonarticular rheumatic diseases, non-surgical exercise related injury, systemic diseases with rheumatic manifestations, metabolic diseases of bone (including osteoporosis), infection of joints, joint surgery, and rheumatologic problems requiring rehabilitation therapy.
Each trainee has the equivalent of 4 half days of continuity care experience each week. During each half day session, 1-3 new patients and 4-7 followup patients are seen by each trainee.
The program provides sufficient experience for the trainee to acquire skill in the performance and of interpretation of:
- The use of non-steroidal anti-inflammatory drugs, disease modifying drugs, biologic response modifiers, glucocorticoids, cytotoxic drugs and hyperuricemic drugs, and antibiotic therapy for septic joints.
- Examination of all patient to include a specific examination of structure and function of all joints, both axial and peripheral, as well as periarticular structure and muscle units.
- Construction of differential diagnosis for complexes of symptoms and signs related to rheumatologic diseases.
- Diagnostic aspiration and analysis by light and polarized light microscopy of synovial fluid from diarthroidal joints, bursae, and tenosynovial structures.
- Therapeutic injection of diarthroidal joints, bursae, tenosynovial structures and entheses.
The program provides sufficient experience for the trainee to acquire skill in the performance and/or interpretation of biopsies of tissues relevant to the diagnosis of rheumatic diseases, arthroscopy, bone and joint imaging techniques including bone density measurements and EMG and nerve conduction velocities.
Additional specific content areas that are included in the formal program include:
- Anatomy, genetics, biochemistry and physiology of connective tissue, bone, muscle, and purine metabolism.
- Pathologic aspects of rheumatic diseases.
- Nonarticular manifestations of joint disease, including emotional factors that influence or result from rheumatic diseases.
- The scientific basis of the methodology, indications and interpretations of laboratory tests and imaging procedures used in diagnosis and followup of patients with rheumatic diseases.
- Indications for electromyograms, nerve conduction studies and muscle/nerve biopsy.
- Pharmacology, pharmacokinetics, drug metabolism, drug side effects, drug interactions and costs of therapy of agents used in the therapy of rheumatologic diseases.
- Principles of rehabilitation for patients with rheumatic diseases including physical therapy and occupational therapy.
- Indications for surgical and orthopedic consultation in acute and chronic rheumatic diseases.
- Basic principles of decision analysis relating to diagnostic tests to define illness and recommend therapy.
- Principles of clinical epidemiology and health services research, medical information systems, information sciences, critical literature review and clinical and experimental protocol research design.
- Rheumatic problems in the geriatric population.
- Ethical and socio-economic issues relating to the practice of rheumatology.
Seth M. Berney, M.D.
Professor, Rheumatology Fellowship Program Director
For Additional Information:
Renee Gordon, Fellowship Coordinator
Department of Internal Medicine
University of Arkansas for Medical Sciences
4301 W. Markham St., #610
Little Rock, AR 72205