Rheumatology

Rheumatology Fellowship Training at HSS

  1. Historical Perspective
  2. A World-class Academic Environment
  3. The Faculty
  4. The Rheumatology Training Program
  5. An Integrated Approach to Clinical and Research Training
  6. The Clinical Base
  7. The Research Base
  8. Eligibility and Conditions
  9. Application Process

Historical Perspective

Hospital for Special Surgery (HSS) has a proud 138-year history of commitment to treating patients with and finding the causes and cures for musculoskeletal and autoimmune disorders. HSS is regarded as the world's leading institution and center of excellence for rheumatology and orthopaedic care. At HSS, excellence in care has always gone hand in hand with world-class research and education. As an academic institution, we employ a multidisciplinary approach to define the clinical issues that affect our patients, determine reasons for individual diagnoses and, ultimately, identify a cure.

A World-class Academic Environment

The Rheumatology Fellowship Program at the Cornell University Joan and Sanford I. Weill Medical College is based at HSS and includes clinical and research resources at our surrounding sister institutions, the New York-Presbyterian Hospital, Memorial Sloan Kettering Cancer Center and the Rockefeller University. Active links with a variety of disciplines in the Weill Graduate School of Medical Sciences of Cornell University (WGSMSCU) are an integral part of the program, which is designed for training physicians interested in developing academic and clinical careers in rheumatology. The 4.5 acres surrounding HSS defines one of the largest concentrations of biomedical research and care anywhere in the world. A quad-institutional immunology program focuses internationally recognized scientists on solving the immunological puzzles that lead to autoimmunity and musculoskeletal disorders.

The Faculty

The faculty is comprised of 29 full-time members of the Division of Adult Rheumatology and 2 members in the Division of Pediatric Rheumatology. Faculty members of the Division of Rheumatology and Department of Medicine at HSS have academic appointments at the Weill Medical College of Cornell University (WMCCU) and hospital appointments at the East Campus of the NewYork-Presbyterian Hospital. The Rheumatology Program is complemented by the Weill Graduate School of Medical Sciences of Cornell University (WGSMSCU) Program in Immunology which has 30 faculty including 6 based at HSS in Rheumatology (*) and the WGSMSCU (**) Program in Clinical Epidemiology and Health Services Research which has 12 faculty including 9 affiliated with HSS. All physician faculty members are Board Certified in Rheumatology.

The Rheumatology Training Program

The training program combines a broad-based and in-depth clinical and research experience supporting our division's mission of delivering the highest quality academic training for rheumatology professionals. The clinical experience is focused on outpatient clinics in adult and pediatric rheumatology and orthopaedic subspecialty clinics, the inpatient consultation service at the New York-Presbyterian Hospital and Memorial Sloan Kettering Cancer Center, The Clinical Center at the Rockefeller University and the inpatient Rheumatic Disease Unit at HSS. Didactic sessions include introductory rheumatology, an immunology and clinical epidemiology and health services research lecture series, as well as a weekly journal club, consult rounds, professor's rounds, rheumatology grand rounds, and clinical-pathology-radiology conferences.

The research projects relate to ongoing research activities within the broad scope of the Program. Suitable projects include investigations into the biological mechanisms of autoimmune, inflammatory and musculoskeletal disease and issues pertinent to clinical epidemiology and health services delivery in the rheumatic diseases. Each fellow's research experience is coordinated by a faculty mentor and includes a weekly journal club and research-in-progress conferences. For fellows pursuing studies of immunologic mechanisms of disease, the Graduate Program in Immunology sponsors weekly research seminars, weekly guest seminars and a formal course in immunology. For fellows pursuing a project in health services research and initial intensive eight-week curriculum is complemented by ongoing weekly conferences. All fellows are expected to present the results of their research at regional and national meetings. A National Institutes of Health (NIH) research training grant contributes financial support to the second and third years of the fellowship with specific provision for obtaining a superb basic immunology research experience or a masters degree in clinical epidemiology and health services research.

This three-year program is dedicated to training the future leaders in Rheumatology. The program is approved by the ACGME and accepting 2-3 new Fellows each year.

An Integrated Approach to Clinical and Research Training

HSS and the Medical Center enhance a rich environment for learning and for the development of an academic career. In addition to the core clinical experience in adult and pediatric rheumatology, clinics in office-based orthopaedics (sports medicine, hand, shoulder, spine, hip, knee, and foot) and other musculoskeletal areas (osteoporosis, nerve/muscle, osteogenesis imperfecta, and rehabilitation) are available. Didactic conferences in radiology, pathology and metabolic bone disease are regularly scheduled. Defining characteristics of our institution include a close working relationship between orthopaedists, rheumatologists, and other health care professionals, as well as a multidisciplinary approach to clinical care.

The energy and resources of all of the institutions enrich the scientific environment. The programs in immunology, molecular biology, cell biology, and structural biochemistry sponsor daily conferences and seminars. Active scientific collaborations are encouraged and ongoing. Inter-institutional training programs are feasible when appropriate.

The Clinical Base

The clinical experience at HSS is extraordinary in its breadth and attending physician availability. HSS has around 7,000 admissions per year of which 320 are admitted to the HSS rheumatology in-patient service. Over 10,000 new rheumatology patients are seen in an ambulatory setting per year with 35,000 revisits. The Division of Rheumatology has its own ambulatory Infusion Care Unit that treated over 1,700 patients in the year 2000 with a variety of biologic agents and anti-inflammatory treatments. A broad range of rheumatology problems are assessed at HSS. The patient base includes 4,600 patients with rheumatoid arthritis and 1,500 patients with systemic lupus erythematosus. Registries that are employed in patient care and clinical and basic research include 400,000 total patients with specific registries involving 667 SLE, 650 RA, 160 anti-phospholipid syndrome and 150 pediatric lupus patients. Functional outcomes are defined in these patients and their cells, sera and DNA are stored for research activities. Over 14,000 orthopaedic surgical procedures are performed at HSS, with 50 percent occurring on an outpatient basis. Peri-operative management of these patients as part of a multi-disciplinary team is a cornerstone of care at HSS. Staff rheumatologists perform needle arthroscopy.

The Research Base

This rheumatology program is dedicated to advancing knowledge in the areas of basic and clinical research. The research interests of our staff are well-defined in the accompanying faculty description. The research program is strongly supported by multiple federal and non-federal grants. Over $20M in such grants and a $70M research institute building program define the commitment of our scientists and Board of Trustees to the highest quality of basic and clinical investigation. An NIH T32 research training grant supports our fellowship research program. The program is also supported by on-site research core facilities including flow cytometry/cell sorting, molecular biology, analytic microscopy, research methodology and statistics, an outcomes research unit and confocal microscopy. Cores found in our surrounding sister institutions support transgenic models, protein sequencing and gene therapy.

Eligibility and Conditions

Physicians who will have completed an ACGME-accredited internal medicine residency may apply to the program. HSS is an equal opportunity employer and does not discriminate with regard to sex, color, creed, religion, sexual preference or disability.

The program, designed for three fellows each year, is flexible to allow for individual interests and needs. While the first year program is predominantly clinical, fellows are strongly encouraged to explore investigative opportunities. The length of fellowship training is three years for most candidates and results in eligibility for subspecialty board certification in rheumatology. Opportunities for additional research training may also be arranged on an individual basis. Options for formal work leading to advanced degrees in immunology and health services research are available through the WGSMCU and the Rockefeller University.

Support for the program is derived from a NIH Training Grant, grants from voluntary agencies and other sources. First year stipends are $45,000, increasing by $500 annually. Fellows are eligible for university- and hospital-owned housing, but such placements cannot be guaranteed.

Application Process

The division of Rheumatology at HSS participates in the national medical residency matching program. Applications should be submitted through ERAS (Electronic Residency Application Service). For information, please visit http://www.aamc.org/eras. The HSS Rheumatology Fellowship Program Committee reviews all applications. Interviews are offered selectively.

For More Information:

Please contact Dr. Anne Bass by email or by phone at (212) 774-7043.

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