Clinical Experience

The fellowship program places a heavy emphasis on clinical skills, particularly in the care of extremely complex, critically ill patients in the hospital, as well as diagnostic and therapeutic conundrums in the outpatient setting.  To that end, the Clinician Educator faculty has been significantly expanded over the past several years. Fellows gain experience in the diagnosis and treatment of patients with the full range of rheumatic diseases and musculoskeletal conditions, as well as technical skills in the musculoskeletal exam, joint aspiration and injection, musculoskeletal ultrasound, and interpretation of musculoskeletal imaging. Longitudinal clinical care allows fellows to gain experience in the management of patients with rheumatic diseases over time, and in the assessment of changes in clinical status and responses to treatment. Guided by the ACGME, post-doctoral fellows are expected to master the core competencies.

We utilize three distinct training venues for inpatient and outpatient care: Stanford University Hospital and Clinics, the Palo Alto VA, and Valley Medical Center Hospital and Clinics which serves Santa Clara County’s indigent. The University campus is the academic, tertiary care medical center. The Palo Alto VA, one mile away, serves the area’s veterans, and Valley Medical Center is an urban, community teaching hospital.  The three sites provide for a diverse patient and faculty experience for our fellows.

During the first year, fellows spend 9 to 10 months on the inpatient consultation service at either Stanford/VA or Santa Clara Valley Medical Center. During the second year, fellows may spend from 2 to 3 months on the inpatient consultation service. During the first year, fellows spend 5 to 6 half-days per week in outpatient clinics. During the second year, fellows continue to mature their clinical judgement with 1 to 4 half-day clinics per week. Besides rotating through Rheumatology subspecialty clinics such as the combined Rheum-Derm Clinic and Vasculitis Clinic, fellows can choose from several electives outside of Rheumatology including but not limited to Interstitial Lung Disease, Pulmonary Hypertension, Osteoporosis, Inflammatory Eye Disease, Orthopedic/Sports Medicine, Podiatry, Radiology, PM&R, Pediatric Rheumatology, and many more.