Rotation: Rheumatology Elective
Site:
- Private office of the attending physician and both hospitals (BSA and NWTH)
Instructors:
- Dr. Schwartzenberg, Dr. Saadeh, Dr. Plata,and Dr. Hulsey,
Make up of the Team:
- One attending physician and one resident, usually an upper level resident.
Days per week:
- Five days a week or at the discretion of the attending physician. One upper level ICU night call per month possible.
Hours:
- Generally 8am to 5pm.
Types of patients encountered:
- Generally private patients of the attendings, primarily adult patients of both genders and several ethnic groups. Patients are seen in both the outpatient settings and in the hospital.
Educational Goals/Competencies
Patient care:
The resident will learn to do a comprehensive history and physical on a patient presenting with a rheumatologic symptom. Based upon the information he will develop a differential diagnosis.
The resident will learn to do procedures that are useful in a rheumatology practice such as joint injections & arthrocentesis.
Medical knowledge:
Residents will learn about and develop an understanding of the most common rheumatologic conditions such as osteoarthritis, fibromyalgia, rheumatoid arthritis, lupus, scleroderma, reactive arthritis, and polymyalgia rheumatica. The resident will develop a systematic approach to the patient with localized joint pain, back and neck pain, generalized musculoskeletal pain, and osteoporosis due to rheumatologic conditions. They will also learn to differentiate between the different arthropathies, the serologic and diagnostic tests used and the appropriate treatments of these disorders.
Interpersonal/communication skills:
Residents will spend sufficient time with the patient to obtain a complete history and will need to effectively communicate this to the attending. Residents will learn how to listen, how to ask judicious questions, and how to communicate in understandable, jargon-free language to the patient.
Professionalism:
Residents will encounter patients from a variety of ethnic and socio-economic backgrounds who may not share the resident's belief on religion, sexuality and attitudes toward drug, alcohol, or cigarette use. Residents will treat these diverse patients with respect and dignity. In addition these patients are private patients of the attendings and as such the resident is viewed as a representative of that attending. Therefore, effective communication between the resident and the attending will be maintained.
Practice based learning and improvement:
Residents on this rotation will learn to use current journals and on-line resources as recommended by the attending physician. They will be expected to read the recommended text. Some of the resident's time will be spent observing the attending in his evaluation and interaction with the patient.
Systems-based practice:
Residents will see the private patients of the attending in the office. They will also see the private patients who are hospitalized as well as in-hospital consults. They will understand the role of the consultant and the need for timely recommendations.
Text/references to be consulted:
- Primer on the Rheumatic Diseases (current edition is recommended).
- The MKSAP section on Rheumatology is an excellent review.
- Rheumatology section from Harrison 's Textbook of Internal Medicine
Methods of evaluation:
Direct evaluation by the attendings is based on the resident's knowledge base, eagerness and interest in learning, and participation in patient care.