Rheumatology Fellowship

Training the future clinical and academic leaders in rheumatology.

S. Louis Bridges, Jr., MD, PhD,  Physician-in-Chief, Chair, Division of Rheumatology
Juliet Aizer, MD, MPH, Program Director
Karmela Kim Chan, MD, Associate Program Director

The mission of the Hospital for Special Surgery Rheumatology Fellowship Program is to train the future clinical and academic leaders in rheumatology by providing rigorous clinical teaching and experiences, fostering habits of lifelong learning, and closely mentoring fellow research projects and career planning.

The HSS Difference

Advancing rheumatology research, care and education is central to our institution. 
HSS is the world’s leading academic medical center focused on musculoskeletal health. Our institution’s purpose is to help people get back to what they need and love to do better than any other place in the world. Our mission is to provide the highest quality patient care, improve mobility and enhance the quality of life for all, and to advance the science of orthopedic surgery, rheumatology and their related disciplines through research and education. Our vision is to lead the world as the most innovative source of medical care, the premier research institution and the most trusted educator in the fields of orthopedics, rheumatology and their related disciplines.  

We designed a program to train future leaders in the field of rheumatology. 
Our focus at HSS, combined with our relationships with Weill Cornell Medicine, NewYork-Presbyterian (NYP), Memorial Sloan Kettering Cancer Center (MSKCC), and The Rockefeller University, provides unique opportunities for rheumatology fellows. In addition to our faculty’s unparalleled expertise in research, clinical rheumatology, and medical education, they also provide excellent learning and mentorship opportunities. The HSS three-year rheumatology fellowship program is designed to not only ensure competence, but to provide individualized experiences to support each fellow’s professional development.

HSS is committed to providing high-quality care and skilled, compassionate, reliable service to our community in a safe and healing environment. We value diversity and inclusion, excellence, gratitude, innovation, passion, and teamwork. 

Our Institution

Our rheumatologists are leaders in the field who have contributed to key scientific discoveries and innovations that inform best practice. We work closely with our colleagues in pediatric rheumatology, who are themselves national leaders. HSS also boasts the highest caliber orthopedists, physiatrists and sports medicine physicians, radiologists who are expert at musculoskeletal imaging, and endocrinologists who are leading clinical and research voices in metabolic bone diseases. Furthermore, we have nationally recognized patient outreach programs led by award-winning nurses and social workers. 

Our fellows care for outpatients with rheumatic and musculoskeletal disease in the context of this multidisciplinary and interprofessional excellence at HSS. In addition, our fellows benefit from rich educational and inpatient clinical experiences at NewYork-Presbyterian (NYP)/Weill Cornell Medical Center and Memorial Sloan Kettering Cancer Center (MSKCC). Close clinical and research collaborations with specialists at NYPH Cornell, MSKCC, and Rockefeller University are cental components of our training program. 

Our Faculty 

We are the largest rheumatology division in the country, with more than 45 faculty members with diverse research and clinical interests. Our faculty have been truly transformational in the field, with innumerable contributions to the scientific and clinical aspects of patient care. They have expertise in rheumatoid arthritis, spondyloarthritis, lupus, antiphospholipid antibody syndrome, vasculitis, scleroderma, myositis, checkpoint inhibitor-induced arthritis, and orthopedic outcomes.

Our Physician-In-Chief, S. Louis Bridges, Jr., MD, PhD our Program Director, Juliet Aizer, MD, MPH and our Associate Program Director, Karmela Kim Chan, MD are fully invested in providing the best possible learning environment for our rheumatology fellows . 

Some key discoveries and contributions to the field from HSS faculty:

• Identification of aggregated gamma globulin as the target of rheumatoid factor
• Demonstration of the specificity of anti-DNA antibodies for a diagnosis of SLE 
• Elucidation of the relationship between dsDNA levels and disease activity in lupus 
• Discovery of the causal relationship between Hepatitis B infection and polyarteritis nodosa
• Discovery that ACE inhibition is effective treatment for scleroderma renal crisis 
• Definition of critical antibody profiles in patients with antiphospholipid antibody syndrome 
• Definition of neuropsychiatric lupus
• Elucidation of the role of Interferon in lupus 
• Demonstration that IL6 blockade can be used to treat polymyalgia rheumatica 
• Development of national guidelines for reproductive health in rheumatic disease patients
• Development of national guidelines for perioperative management of antirheumatic medications in patients undergoing arthroplasty
• Development of criteria for antiphospholipid antibody syndrome, and started the multinational APS Action Network
• Development of national guidelines for vaccinations in rheumatic disease patients
• Discovery of PRIME cells that signal RA flares

Our Approach to Education

Our Clinical Experiences

Our fellowship offers extensive clinical experience in the outpatient rheumatology clinics at HSS and the inpatient consultative service at NewYork-Presbyterian Hospital (NYPH-Cornell) and Memorial Sloan Kettering Cancer Center (MSKCC).

Outpatient Experiences
Each fellow sees outpatients in rheumatology clinics at HSS two to three half-days per week. One clinic session is dedicated to patients with inflammatory arthritis, another to systemic autoimmune connective tissue diseases like lupus, APS, scleroderma, vasculitis and myositis. For each of these clinics, fellows work with faculty preceptors who have the relevant expertise, allowing fellows to learn from expert clinicians how to best evaluate patients presenting with the wide range of conditions seen in outpatient rheumatology practices. Fellows take responsibility for these patients and care for them throughout fellowship. 

Fellows have opportunities to work in specialty clinics with faculty in rheumatology as well as in other divisions and departments based on interest.

Inpatient Experiences
Each fellow on the rheumatology consult service sees around 1-3 new consults per day at NYPH and MSKCC. There are two fellows on the consult service at a time. Internal medicine residents from NYP and medical student from Weill Cornell Medicine join during electives. Patients seen on the consult service have a diverse range of diseases including lupus, vasculitis, antiphospholipid syndrome, myositis, crystal-arthritis, immune-therapy related and infection related autoimmunity, among others. Diverse ethnicities, nationalities and socioeconomic contexts are represented in our patient population. Patients seen on the consult service frequently follow up with our fellows afterwards for ongoing rheumatologic care. 

Our Research Opportunities

Centers of Excellence in Rheumatology at HSS
Our Centers including the Lupus and APS Center of Excellence, the Scleroderma, Vasculitis and Myositis Center of Excellence, the Inflammatory Arthritis Center of Excellence, and the Integrated Rheumatology-Orthopedics Center of Excellence offer robust registries and other resources for fellow research. The HSS Research Institute also offers trainees a chance to engage in basic science research, exploring through genomics and precision medicine the biology of tissue degeneration and musculoskeletal integrity, autoimmunity, and inflammation. 

Timothy Niewold, MD, Vice Chair for Research in the Department of Medicine at HSS, is directly involved in advising fellows on their research plans and optimizing their mentorship. Drs. Aizer, Chan, and Niewold assist fellows in identifying mentors and research projects that fit their interests and long-term career goals. Fellows work closely with a primary research mentor. A broader network of mentors provides additional input on each fellow’s research and career plans. Fellows have been very successful in presenting in high-profile meetings, publishing their results, and achieving early-career grant support.

Program Structure

Our fellowship is a three-year program. The first two years are ACGME-accredited and result in eligibility for subspecialty board certification in rheumatology. The third year is fully funded and supports the development of each fellow’s expertise and scholarly work. The program begins July 1. 

First Year
The first year is predominantly clinical, providing fellows with experiences across the breadth of inpatient and outpatient rheumatology to inform their practice and career interests. First year fellows have two or three half day outpatient clinic sessions per week, and they spend roughly two out of every three weeks on consult service. To support exploration of career interests, each fellow meets with the program director and associate program director regularly from the start of their first year in our program, and together they establish plans for subsequent experiences directed by their interests. 

Second and Third Years
In their second and third years, fellows have two or three half day outpatient clinic sessions per week (one half day session for fellows on the ABIM Medical Research Track), and they spend two to four weeks on the consult service each year. This allows fellows to devote 60% their effort to scholarly work (80% for fellows in the ABIM Medical Research Track). Fellows’ scholarly work can be bench, translational, or clinical research, health science research, quality research, or education research. Fellows meet regularly with the program director and associate program director, their dedicated research mentorship committees, and their primary research mentor, who shepherds them to successful completion of their research projects. Fellows are expected to disseminate their scholarship through presentations and publications. 

Conferences and Courses
Our conferences are designed to address the broad learning needs of our fellows, in formats that support learning. 

• Introduction to Clinical Rheumatology: This series of sessions led by various HSS faculty members in the summer covers the most high-yield topics to prepare fellows for their new roles fielding rheumatology consults and seeing patients in the rheumatology clinic.
• Musculoskeletal Medicine: Specialists from physiatry and orthopedics meet with the rheumatology fellows in a series of sessions held each July to review common musculoskeletal issues in each body region, including how to identify key clinical findings and direct management. These sessions are reinforced subsequently through observation of fellows’ performance of the physical exam and application of clinical reasoning in rheumatology clinic and clinic conferences. 
• Arthrocentesis Skill Development: Jessica Berman, MD leads cadaver-based arthrocentesis teaching sessions with feedback on large, medium, and small joints of the upper and lower extremities. These sessions provide our fellows with valuable practice prior to their first procedures on patients, and supplemental experience, advanced skill development, and teaching opportunities for fellows over the course of training. 
• Paget Rounds: Stephen A. Paget, MD, Physician-in-Chief Emeritus, meets with first year adult and pediatric rheumatology fellows weekly to develop their critical thinking and clinical decision-making skills through stepwise discussions of cases in rheumatology. 
• Consult Case Conference: Adult and pediatric rheumatology fellows present cases from the consult service that pose a diagnostic or therapeutic challenge or raise key points for discussion and learning. This conference engages the other fellows and faculty in a lively discussion that can include a review of relevant imaging, pathologic specimens, and/or input from specialists from fields outside rheumatology. Diagnostic and therapeutic decision making, clinical evidence, implications for health systems and future research are discussed. 
• Inflammatory Arthritis Clinic Conference: Rheumatology faculty with expertise in inflammatory arthritis and musculoskeletal radiologists lead weekly conferences for our fellows. These are designed to build fellows’ diagnostic skills, understanding of clinical and research outcome measures, therapeutic decision making, and current evidence. 
• Lupus and Connective Tissue Disease Clinic Conference: Our fellows have weekly conferences led by rheumatology faculty with expertise in lupus, antiphospholipid syndrome, scleroderma, vasculitis, Sjogren syndrome, and myositis, social workers focused on supporting patients with these connective tissue diseases, and specialists from related fields including nephrology, dermatology, pulmonary, and pathology. These are designed to build fellows’ clinical skills, familiarity with relevant outcome measures, and ability to discuss and apply relevant clinical evidence in the care of patients with connective tissue disease. 
• Critical Appraisal: Lisa Mandl, MD and Dr. Juliet Aizer (Program Director) meet with our fellows three times per month to develop their skills for critical appraisal of the medical literature. In each session, fellows discuss a landmark or recent article from the rheumatic disease literature that illustrates key features of the various common study designs. These discussions are paired with questions with answer rationales for each study design, allowing fellows to assess their understanding and ensure any learning needs are addressed. 
• Immunology: In a series of ten sessions, Ruth Fernandez-Ruiz, MD reviews and discusses the immune system with the rheumatology fellows, ensuring everyone has a solid foundation, and highlighting clinical correlates relevant to rheumatologists.
• Musculoskeletal Ultrasound: Dr. Jessica Berman, certified in musculoskeletal ultrasound by the American College of Rheumatology, leads introductory lectures coupled with hands-on sessions providing opportunities for each rheumatology fellow to obtain practice with feedback on musculoskeletal ultrasound techniques for all major joints as well as ultrasound guided procedure training.
• Metabolic Bone Disease: Experts in metabolic bone disease from various disciplines review basic bone biology, assessment of fracture risk, and approaches to skeletal health.
• Infectious Disease: Specialists in musculoskeletal and rheumatologic Infectious Disease at HSS meet with the rheumatology fellows periodically to address topics relevant to rheumatology, including presentation and management of infectious causes of arthritis and autoimmune disease, as well as approaches to preventing and treating infectious diseases in patients with rheumatic disease.  
• Social Work Case Conference: Fellows meet monthly with social workers focused on caring for patients in the HSS rheumatology clinic, to discuss and address barriers to care with an interprofessional approach. 
• Quality Improvement: Fellows are introduced to concepts and approaches to Quality Improvement (QI) and then apply these to real world challenges in rheumatology.  
• Rheumatology Grand Rounds: Nationally and internationally recognized speakers present on topics relevant to our division weekly. Rheumatology fellows work with HSS faculty to arrange this conference and connect with invited speakers. In their second year, each fellow presents a case as part of a multidisciplinary Clinicopathologic Conference in this forum.
• Rheumatology Division Journal Club: Rheumatology faculty and fellows each present articles for discussion in this weekly forum twice per year, sharing relevant context, critical appraisal, and potential applications.  
• Clinical and Translational Research Workshop: Faculty and fellows in the rheumatology division present their research-in-progress in this weekly conference. 
• Enrichment Speaker Series: In these institution-wide monthly sessions, world-renowned thought-leaders share their expertise on topics relevant to leadership, wellness, the business of medicine, and strategic decision making.

Teaching Opportunities
Fellows have various opportunities for teaching, ranging from informal opportunities with residents and medical students when they are on rheumatology rotations, to formal opportunities in various formats with medical students, residents, fellows, faculty, and patients. We encourage fellows to participate in teaching activities to enhance their own mastery of the material and to help others learn. We provide mentorship for interested fellows to take scholarly approaches to medical education. The HSS Academy of Medical Educators provides support for innovations in medical education. 

Our Fellows

It is a privilege and a joy to work and learn with the fellows in our program. We value their perspectives and appreciate their comments about our program. 

Salary Information

Fellowship Year 1 = $104,050
Fellowship Year 2 = $ 104,650
Fellowship Year 3 = $ 105,250

Application Process

Physicians who will complete internal medicine training in an ACGME-accredited residency program by the start of fellowship may apply to our program. All applicants are expected to be board-eligible in internal medicine when they start in our program unless they are in the ABIM research pathway. 

HSS is an equal opportunity employer and does not discriminate with regard to sex, color, creed, religion, sexual preference or disability.

We participate in the National Residency Matching Program (NRMP). Applications should be submitted through the Electronic Residency Application Service (ERAS). For information, please visit the ERAS website. Members of the HSS Rheumatology Fellowship Selection Committee review all applications. Interviews are offered selectively. 

If you have any questions, please contact: Flaisa Roberts, Rheumatology Fellowship Program Coordinator at 212.774.2189 or robertsf@hss.edu

Learn about the general application process at HSS.

 

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