1. Welcome to UNM Rheumatology

2. 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

3. 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

4. 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.

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

6. 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)

7. 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

8. 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.

9. 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 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. Rheumatology Conferences
Senior fellow has been assigned to coordinate and schedule Conference
We expect a 30min presentation by rotating residents
Power point
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.

16. 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

17. 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

18. 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 am – pm
Pavilion meeting room 1500
Fellow will arrange the case with the nephrology team
Contact: Hayley Shadle

19. 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 *

20. 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

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