Welcome to UNM Rheumatology

Faculty Arthur Bankhurst, MD Wilmer Sibbitt, MD Roderick Fields, MD Distinguished Professor Chief of Division of Rheumatology Wilmer Sibbitt, MD Professor Roderick Fields, MD Associate Professor Program Director N. Suzanne Emil, MD Assistant Program Director Monthida Fangtham, MD Assistant Professor Konstantin Konstantinov, MD Professor VAMC Kimberly Reiter, MD Assistant Professor Frank O’Sullivan, MD Volunteer Faculty Robert Rubin, PhD Molecular Genetics & Microbiology

Training Objectives To acquire history-taking skills as they pertain to rheumatic diseases To acquire physical diagnosis skills necessary to evaluate rheumatic disease patients To formulate a differential diagnosis in patients with acute and chronic rheumatic diseases To interpret and use rheumatologic laboratory studies in a cost effective manner and understand the limitation To order radiological studies in an appropriate and cost effective manner and identify common radiological findings of rheumatic diseases To gain technical skills required to perform arthrocentesis and injection

Training Objectives To understand the importance of obtaining tissue biopsies in selected clinical settings To understand the pharmacology, clinical usefulness, and toxicity of rheumatic medicines To understand the indications for using physical modalities such as physical therapy, splints, and other assistive devices To understand the indications for appropriate subspecialty consultation To gain experience delivering care in an ambulatory setting to patients of ethnic and cultural diversity and of varying socioeconomic status To gain experience working in an ambulatory setting working with other physicians and permanent office staff.

Rheumatology Rotation Rheumatology Clinics UH Clinic VAMC Clinic Rheumatology inpatient round Conference & Presentation

First day of Rheumatology Rotation Meet with Rheumatology program administration: Jackie Ann Cremar Report and Review vacation/leave during Rheumatology rotation & Update leave in the rotating resident calendar Review Rheumatology Orientation Packet Inform Jackie about continuity clinic and change the clinic if this is on Tues AM/PM or Friday AM Residents required to give a 30 min presentation during their rotation: Arrange presentation date with senior fellow Borrow Rheumatology book or resources (optional)

Rheumatology Clinics Monday Tuesday Wednesday Thursday Friday AM UH Clinic Dr. Fields/ Dr. Fangtham *ECHO (12:00-1:00 pm) Dr. Bankhurst/ Dr. Sibbitt VAMC Clinic UH Clinic Dr. Emil/ Dr. Fangtham PM UH Inpatient *Journal Club (1:30-2:30 pm) Injection Clinic

Rheumatology Clinics Resident should attend: Tuesday am Fellow Clinic Tuesday pm Injection Clinic Friday am Fellow Clinic If the Resident has their own clinic at the time stated above, we recommend changing the clinic if possible to attend the Rheumatology Clinic during rotation for maximum exposure.

Responsibilities: Clinic Clinic Attendance Residents should be present at all rheumatology clinics---UH and VAMC For unexpected leave (i.e., sick leave) contact Rheumatology program administration: Jackie Ann Cremar by email and contact supervising faculty member as soon as you are aware you will be out Clinic Responsibilities Expectations: Start at 8.00 AM Resident should be able to see 3-5 patients per clinic Injection Clinic Tuesday after 2.30 PM (after Rheumatology conference) Dr. Sibbitt See one, do one

Responsibilities: Clinic During Clinic Review patient past rheumatology diagnosis and history When was diagnosed Past manifestations Past Labs Past treatments: failed, side effects etc… Medication Reconciliation and update in EMR Non complicated case for resident or medical student Notes may not be done during clinic time if patients are waiting

Responsibilities: Clinic Notes Use template(s) provided Clinic notes to be done within 48 hours of visit Must forward note to attending of record Notes may not be done during clinic time if patients are waiting Clinic Notes Dynamic Documentation/Dragon Typing

Responsibilities: Inpatient Inpatient rounds UH Consult fellow responsible to assign consults to resident rotator Review patient with fellow and discuss ddx/workup and then present to attending

Inpatient rounds Rounds during normal, non-holiday weekdays: Monday:  Dr. Fields Tuesday:  Dr. Bankhurst and Dr. Sibbitt Wednesday:  Dr. Fields and/or Dr. Emil Thursday:  Dr. Fields Friday:  Dr. Emil and Dr. Fangtham

Conferences: Rheumatology Conference ECHO Project Tuesday 1:30 – 2:30 PM, weekly ECHO Project Monday 12:00 – 1:00 PM, weekly Nephrology Pathology Interdisciplinary Conference Monday once a month (3rd or last), 11:30 am – 12:30 pm Radiology Conference Last Thursday of every month, 1:00-2:00 PM Will meet 1 week earlier if last Thursday is a holiday Residents required to attend Rheumatology conference and to present 30min once during their rotation

Rheumatology Conferences Senior fellow has been assigned to coordinate and schedule Conference We expect a 30min presentation by rotating residents Power point Email a copy to Rheumatology program administration: Jackie Ann Cremar Presentations should not be copy and past of up to date, but rather a thoughtful review of literature, text or other reliable rheumatology resource Keep us up to date! Remember to present data on all the up and coming drugs This is helpful to us as a group and to your learning.

ECHO Teleconference/ Teleconsultation Monday 12:00 – 1:00 PM ECHO Lectures Topic in Rheumatology, PM&R, Pain management Case discussions/consultation from PCPs in NM or other States Location: Fellows room or attending office Presentation by fellows: Arranged by coordinator, Cynthia Olivas, RN

Radiology Conference Musculoskeletal Radiology—contact Dr. Jennifer Weaver/ Hollie Medina Last Thursday every month 1:00-2:0pm *if this falls on a holiday, they will do this 1 week early* Collect cases, compile and 1 fellow should send them to Dr. Weaver/Hollie Medina 1 week ahead of time. ACR Image Bank Good resource to review images for boards

Nephrology Pathology Interdisciplinary Conference Review kidney biopsy pathology with pathologist and nephrologist team Monday once a month (3rd or last), 11:30 am – 12:30 pm Rheumatology case between 11.30 am – 12.00 pm Pavilion meeting room 1500 Fellow will arrange the case with the nephrology team Contact: Hayley Shadle

Resources Primer on the Rheumatic Diseases Rheumatology Secrets Hochberg Textbook of Rheumatology Kelly’s Textbook of Rheumatology ACR Image Bank Arthritis & Rheumatism Journal Up to Date Harrison’s Principles of Internal Medicine * Contact Jackie (Rheumatology Program Admin) to borrow the books. The book should be returned at the end of rotation *

Leave General Rules: Sick Must be present for 65% or greater of the rotation to pass Leave will be requested through IM/FP, notify Rheumatology department in advance Must be report and review with Rheumatology program administration: Jackie Ann Cremar on the first day of rotation Forwarded to Rheumatology program administration and she will forward to Senior fellow If leave does not meet requirements or if unsure, contact PD or Rheumatology program administration: Jackie Ann Cremar Sick Notify Rheumatology program administration: Jackie Ann Cremar and contact supervising faculty member as soon as you are aware you will be out

Evaluations Subjects: Evaluated by: Outpatient Inpatient Clinic notes Rheumatology Faculty