At our Joint Pain Clinic at Jacobi Medical Center (JMC), patients are seen by a rheumatology attending and first-year fellows rotating through Jack D. Weiler Hospital and JMC. A triage clinic offers care to patients who have sub-acute issues like mono-arthritis, tendonitis and gout, and who are evaluated for possible injection. Typically patients are seen for one to two visits, and may be discharged from the clinic or referred to one of Montefiore Einstein’s more specialized clinics.

Our Ultrasound Clinics, which take place at our Hutchinson Campus and Jacobi Medical Center, are dedicated to assessing and treating arthritic conditions via ultrasound. These teaching clinics are attended by one rheumatologist and one to two second-year fellows, who treat patients referred for injections and evaluations.

Located at Moses Campus and Jacobi Medical Center, our Lupus Clinics see a range of patients, including those with new diagnoses, suspected diagnoses, prior diagnoses and/or recent hospitalizations for flares of systemic lupus erythematosus, discoid lupus, mixed connective tissue disease and antiphospholipid syndrome. Several attendings, fellows and rotating residents and medical students attend these clinics. Our Lupus Clinics are teaching practices, with fellows serving as primary caregivers, and count as continuity clinics.

General Rheumatology (Arthritis) Clinics take place at Moses Campus, Jacobi Medical Center and North Central Bronx Hospital. The majority of our patients are seen at these clinics, and are suspected or known to have rheumatic diseases such as rheumatoid arthritis, vasculitis, systemic sclerosis, inflammatory myositis, spondyloarthropathies, gout and osteoarthritis. All new non-lupus patients who are seen in the hospital by the teaching service and who have the need for outpatient follow-up are also seen in these clinics. Patients are referred to these clinics by both internal and community primary care practices, subspecialists and the emergency room. Clinics are attended by several attendings and first- and second-year fellows, as well as by rotating residents and medical students. Fellows serve as the primary caregivers in these teaching clinics, which are part of a fellow’s continuity clinic structure.

Fellows assigned to inpatient rotations are responsible for the evaluation of inpatient and emergency room consultations, and the continued follow-up of these patients during their hospitalization. During rotations, fellows develop and refine clinical evaluation skills, as well as skills in providing consultation services. Inpatient rotations also allow fellows to develop a comprehensive understanding of the indications, contraindications, techniques and complications of arthrocentesis, as well as of the interpretation of results from this procedure.

All fellows, regardless of year, maintain three half-days of outpatient rotations at ambulatory continuity clinics. Under the supervision of dedicated attending faculty members assigned to each individual clinic, this experience continues with progressive responsibility through the fellowship. Each fellow has one Lupus Clinic and two General Rheumatology “Arthritis” Clinics each week, where they are exposed to the full breadth and scope of the practice of rheumatology.

The Montefiore Einstein Rheumatology Fellowship offers comprehensive training to thoroughly prepare our fellows for careers in clinical practice and/or investigative rheumatology. The first year of the program lays the groundwork for a firm understanding of clinical rheumatology through didactic sessions and inpatient and outpatient rotations. In the second year, our fellows devote most of their time to a mentored research project in a preferred area of interest. With department approval, an optional third year is available for fellows interested in pursuing intensive research training.

During their first year, fellows attend three to four outpatients continuity clinics per week: one session in a Lupus Clinic, and two to three in General Rheumatology Clinics at Moses Campus or Jacobi Medical Center. Fellows do monthly rotations on the inpatient consult service, with four months distributed over the Jacobi Medical Center and Weiler Hospital and six months distributed over the Moses Campus and North Central Bronx Hospital. First-year fellows attend first-year didactic sessions dedicated to fundamental knowledge of disease pathophysiology and management, including small group case-based sessions and periodic interval assessments; musculoskeletal radiology, including introduction to MSK ultrasound; fundamentals of immunology; culturally responsive and patient-centered care, including introductions to health disparities, bias and care for marginalized groups; and participation in division- and department-wide journal clubs and grand rounds. 

As part of their second-year curriculum, fellows attend three continuity clinics per week: one session in a Lupus Clinic, and two in General Rheumatology Clinics. Fellows are also given protected time for research and, if the fellow is interested and approved by the division, may begin the first year of the Clinical Research Training Program. During their second-year training, fellows also participate in a dedicated monthly Musculoskeletal Ultrasound (MSKUS) Procedure Clinic and the development of a Quality Improvement project. 

Our two-year Musculoskeletal Ultrasound (MSKUS) Program is led by members of our USSONAR-trained faculty, Beverly Johnson, MD, and Shereen Mahmood, MD. Ultrasound (US) training in the first year is designed to supplement clinical training as fellows learn to correlate physical exam findings with US imaging, and provides fellows with basic board review of common pathology encountered in US practice. The curriculum is intended to provide fellows with hands-on procedural experience and help them gauge their interest in developing their US skills for USSONAR certification and further practice. 

Divided into quarterly goals as defined by USSONAR requirements, training in the second year is designed for fellows to advance and refine their US skillset. The curriculum allows fellows to participate in USSONAR certification, prepare for future RhMSUS board certification and develop clinical research projects. Each MSKUS clinic session is divided into journal review and patient procedures. 

During our one-month selective program, fellows continue to participate in their continuity clinics but are provided time off from the in-patient service to explore other fields pertinent to Radiology Fellows, including orthopedics, pediatric rheumatology, physical therapy, dermatology, ophthalmology and musculoskeletal (MSK) radiology.

Our Clinical Research Training Program (CRTP) allows fellows to earn a Master of Science in Clinical Research Methods. Combining didactic learning and coursework with a mentored research experience, this intensive two-year program is designed for those pursuing a career in investigator-initiated, hypothesis-driven clinical research. CRTP scholars are drawn from all Montefiore Einstein medical specialities and subspecialties, including those interested in clinical investigation across the entire translational research spectrum.