Fellowship Program

The rheumatology fellowship training program is integrated across the three primary hospital sites (UCSF Health, ZSFG, and the San Francisco VA). The three sites participate equally in the fellowship training program in that all trainees spend an equal amount of time at all three sites during their first year of intensive clinical training and faculty at all three sites actively participate in fellow training.

The ACGME-accredited program is approved for four positions annually and generally accepts three to four first-year fellows per year; 100% of these are graduates of ACGME-accredited internal medicine training programs.

Lianne Gensler, MD is the Program Director who coordinates training activities with Sarah Goglin, MD (Associate Program Director and Associate Chief for Rheumatology education), the three Site Directors and Clinical Chiefs: Krishna Chaganti, MD, MS [VA] , Sarah French, MD [UCSF Health] , Mimi Margaretten, MD, MAS [ZSFG] and Andrew Gross, MD [UCSF Health Clinical Chief]. In addition, Jennifer Mandal, MD is the Director of Educational Assessment.

The program has two tracks: a two-year clinical track and a three-year research track. The first year is identical for all fellows, regardless of track. This includes consult time at each hospital, continuity clinics at each site, research/elective time, and core didactics every week in addition to a teaching conference before every clinic.

In the second year, the research track fellows spend the majority of their time performing research with a half day of continuity clinic per week. The clinical track fellows maintain two continuity clinics plus one elective clinic a week. Elective clinics include Lupus, Rheumatoid Arthritis, Spondyloarthritis, Scleroderma, Musculoskeletal ultrasound, Vasculitis, Pediatric Rheumatology, Derm-rheum clinic and Sports Medicine). Clinical track fellows are expected to work on their teaching skills and also spend time performing scholarly work.

The program emphasizes strong research training during fellowship, and fellows participate in supervised research during the majority of their second year, as well as during a third, non-ACGME year of training. The program is widely viewed as one of the top rheumatology training programs in the country and has been very successful in attracting outstanding trainees from UCSF and other leading medicine programs in the U.S. During the past five years, 100% of trainees have passed their American Board of Internal Medicine specialty exam. In the last two years, three UCSF fellows have been selected for one of ten national ACR Distinguished Fellow Awards.

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Curriculum Overview

The Rheumatology Fellowship has a structured curriculum throughout our training program, from the first two weeks of fellowship (“Rheum to Start”), to the Core Curriculum didactic series, to site-specific and multispecialty conferences. While we know that a lot of workplace learning occurs during clinical experiences, we are dedicated to providing a space and time for education on core and advanced topics in rheumatology. These include didactics and workshops on common rheumatology topics as well as other important topics in immunology, medical education, research, career development, well-being, and diversity, equity, and inclusion.

Rheumatology Orientation “Rheum to Start”

First-year fellows start fellowship with an immersive two-week block that consists of core didactics, site-based orientations, shadowing current rheumatology fellows, and community-building events. The core didactics include common rheumatology topics as well as sessions on how to be an effective consultant. The topics covered in “Rheum to Start” can be seen below.

Core Curriculum Series

Fellows have a weekly Core Curriculum didactic series on Tuesday mornings throughout the year. The topics include core rheumatology topics as well as sessions on well-being, teaching, and diversity, equity, and inclusion. The Core Curriculum topics can be seen below.

Rheumatology Division Conferences

The Rheumatology Divisions have weekly joint conferences on Tuesday mornings. These include case, journal club, and quality improvement presentations by fellows, as well as research and other talks from faculty (within and outside of the UCSF Rheumatology Division, including invited speakers from other institutions).

Site-Specific Conferences

Our continuity clinic sites at UCSF Health, ZSFG, and the VA have weekly case conferences where fellows present cases in a “morning report” style with assistance from a faculty facilitator. Faculty and senior fellows also provide focused teaching on a variety of core rheumatology topics, such as medications and musculoskeletal radiology.

Division Retreat

Second- and third-year fellows present their scholarly work at a yearly division retreat in the spring.

Curriculum Schedule

Topic

Session

Diagnostics in Rheumatology

The Physical Exam in Rheumatology

Rheum to Start

Approach to Rheumatology Labs

Rheum to Start

Introduction to MSK Radiology

Rheum to Start

Introduction to MSK Ultrasound

Core Curriculum

MSK Ultrasound Workshop

Core Curriculum

Inflammatory Arthritis

Introduction to RA

Rheum to Start

Introduction to Arthritis

Rheum to Start

Gout

Rheum to Start

Axial Spondyloarthritis

Core Curriculum

Psoriatic Arthritis

Core Curriculum

CPPD

Core Curriculum

Treatment of RA

Core Curriculum

Extra-articular Manifestations of RA

Core Curriculum

ANA+ Diseases

Common Consults: Lupus

Rheum to Start

SLE

Core Curriculum

Lupus Nephritis

Core Curriculum

Raynaud's Phenomenon

Core Curriculum

Scleroderma

Core Curriculum

Vasculitides

Common Consults: Vasculitis

Rheum to Start

PMR & GCA

Core Curriculum

Diagnosis and Treatment of Vasculitides

Core Curriculum

Myositis

Common Consults: Myositis

Rheum to Start

Approach to Myopathy

Core Curriculum

 

Topic

Session

Other Rheumatic and Connective Tissue Disorders

Sarcoidosis

Core Curriculum

Autoinflammatory Disease

Core Curriculum

IgG4-related Disease

Core Curriculum

Antiphospholipid Antibody Syndrome

Core Curriculum

Osteoarthritis

Osteoarthritis

Core Curriculum

Fundamentals of Hip and Knee Arthroplasty for Rheumatologists

Core Curriculum

Nonarticular and Regional Musculoskeletal Disorders

Sports Medicine for Rheumatologists

Core Curriculum

Fibromyalgia

Core Curriculum

Metabolic Bone Disease

Osteoporosis

Core Curriculum

Reproductive Health

Reproductive Health in Rheumatology

Core Curriculum

Contraception Nuts and Bolts for Rheumatologists

Core Curriculum

Lupus and Pregnancy

Core Curriculum

Pediatric Rheumatology

JIA

Core Curriculum

Transitions in Care from Pediatric to Adult Rheumatology

Core Curriculum

Dermatology

Psoriasis

Core Curriculum

Cutaneous Manifestations of Systemic Autoimmune Disease

Core Curriculum

Pathology

Dermatopathology in Rheumatic Diseases

Core Curriculum

Renal Pathology in Rheumatic Diseases

Core Curriculum

Neuromuscular Pathology in Rheumatic Diseases

Core Curriculum

 

Topic

Session

Immunology/basic science

Introduction to Immunology

Core Curriculum

T cells

Core Curriculum

B cells

Core Curriculum

T cell Signaling

Core Curriculum

Innate Immunity

Core Curriculum

Lymphocyte Trafficking

Core Curriculum

Lupus Pathogenesis

Core Curriculum

RA Pathogenesis

Core Curriculum

Osteoimmunology

Core Curriculum

Medication Mechanisms of Action

Core Curriculum

Miscellaneous Topics

Approach to Rheumatologic Emergencies

Rheum to Start

Medication Safety

Rheum to Start

Neuroimmunology for the Rheumatologist

Core Curriculum

Immunodeficiencies

Core Curriculum

Immune Related Adverse Events for Rheumatologists

Core Curriculum

Pulmonary Hypertension in Rheumatic Disease

Core Curriculum

Interstitial Lung Disease in Rheumatic Disease

Core Curriculum

Ocular Inflammatory Disease

Core Curriculum

Integrative Medicine for Rheumatologists

Core Curriculum

Teaching/Leadership/Wellbeing/DEI

Introduction to Research Planning

Rheum to Start

How to be an Effective Consultant

Rheum to Start

Differences Matter workshop

Rheum to Start

Creating & Presenting an Effective Lecture

Core Curriculum

Addressing Microaggressions Workshop

Core Curriculum

Health Disparities in Rheumatology

Core Curriculum

Meaning in Medicine

Core Curriculum