Pediatric rheumatology programs?

[sunflower18]

Hey all,

I'm an MS4 applying into pediatrics and I have a short list of peds subspecialties I'm interested in, but for personal reasons, rheumatology has been a strong contender for the past 10 years and I'm now realizing as I do my rotations and sub-Is that it really fits a lot of what I'm looking for in a field (I think/hope). I don't know that for sure of course -- but what I DO know is that I want to get more exposure to peds rheum in the next few years, and thus would ideally like to do residency somewhere with an active rheum department and good rheum fellowship, whether or not I ultimately do fellowship there or not. I know some places have basically non-existent rheum departments, and I feel like those institutions wouldn't provide me with enough exposure to rheum to decide if I want to subspecialize in it. I am working on my residency list and would love to add more programs with good rheum connections.

That being said, I am having a really hard time figuring that information out from program websites alone. Does anyone have any insider information as to which hospitals/institutions have strong rheum departments or faculty? Or which programs have the best fellowships, or consistently produce residents who go into rheum?

It's such a small field so there might not be that much information floating around, but any recommendations would be very helpful. Thanks all! I appreciate all of your support and responses over the years 🙂

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[FrkyBgStok]

I don’t have an answer for you but I would say not to completely cross off the places without robust rheum. In my program, we have people interested in peds specialties, for example nephro, and we don’t have a nephro fellowship so whenever a nephro patient comes in, that resident is jumping on the case and the rest of the residents are cool with it. So you may actually get to do more in those places. However admittedly the volume is sometimes less.

 

[BigRedBeta]

FREIDA database from the AMA will list where there are fellowships

Agree with @FrkyBgStok that I wouldn't cross off places without fellowships - best pediatric subspecialists start off as great general pediatricians first. Far better to go to a resident centered program while you are a resident and then a fellow centered program while a fellow if you can.

 

[sunflower18]

I don’t have an answer for you but I would say not to completely cross off the places without robust rheum. In my program, we have people interested in peds specialties, for example nephro, and we don’t have a nephro fellowship so whenever a nephro patient comes in, that resident is jumping on the case and the rest of the residents are cool with it. So you may actually get to do more in those places. However admittedly the volume is sometimes less.

FREIDA database from the AMA will list where there are fellowships

Agree with @FrkyBgStok that I wouldn't cross off places without fellowships - best pediatric subspecialists start off as great general pediatricians first. Far better to go to a resident centered program while you are a resident and then a fellow centered program while a fellow if you can.

I definitely agree that I want to learn to be a great general pediatrician first! But how can I figure out if I want to subspecialize in a small niche field if I can't get any exposure to it during training? I feel like exposure and electives in residency is the only way to know what subspecialties I want to do (if any). Or is there another way that residents can get good exposure to cases/specialties that aren't at their home institutions?

I do have a list of the peds rheum fellowship programs, which is helpful -- I was just curious if any centers are particularly renowned for good rheum mentors or expertise, but it sounds like maybe that information is not widely available (or there might not be such a thing as a particularly strong rheum program or hospital that draws a lot of rheum consults!).

Thanks to both of you for your insight!

 

[mvenus929]

I definitely agree that I want to learn to be a great general pediatrician first! But how can I figure out if I want to subspecialize in a small niche field if I can't get any exposure to it during training? I feel like exposure and electives in residency is the only way to know what subspecialties I want to do (if any). Or is there another way that residents can get good exposure to cases/specialties that aren't at their home institutions?

I do have a list of the peds rheum fellowship programs, which is helpful -- I was just curious if any centers are particularly renowned for good rheum mentors or expertise, but it sounds like maybe that information is not widely available (or there might not be such a thing as a particularly strong rheum program or hospital that draws a lot of rheum consults!).

Thanks to both of you for your insight!

Just because it’s a resident centered program doesn’t mean that they don’t have exposure to sub specialists. My program had two fellowships: ED and child abuse. I worked directly with endocrinologists, nephrologists, GI, rheum, ortho, Heme/Onc, AI, Pulm, etc. The key is making sure the program is large enough to have all the specialists relatively available. You should really look at how many faculty there are—the more faculty, the more of a case load they have to support them, and the more opportunities there are for research.

 

[futuredoctor10]

So I have some slightly differing opinions from some of the above posts, so I will share that opinion with you and the OP.

In my opinion, it would be helpful going to a residency program associated with a strong Rheumatology division (so that you get exposure to the field to help you make your decision): most of these divisions will likely have a fellowship program. While having a fellowship in the area of your interest is certainly not a requirement, I think it can be helpful particularly for fields such as Pediatric Rheumatology (which is an extremely small knit community, where everyone knows everyone). A place with a fellowship will allow you to interact with other fellows and faculty, likely have more experiences to help you make your decision (e.g. working with different attendings as opposed to only working with 1 pediatric rheumatologist at some institutions), and potentially pursue research.

Does anyone have any insider information as to which hospitals/institutions have strong rheum departments or faculty?
Not sure on this, you could ask pediatric rheumatologists at your medical school for any insight. One surrogate for "strong rheum department" that you can consider is how many different pediatric rheumatologists are on faculty at the particular institution. This is not the most perfect measure of strength of a division, because a place may have only 1 or 2 pediatric rheumatologists and still be a very strong program. But some peds programs (if they don't have a rheum fellowship) may not have any pediatric rheumatologists! And generally I would say that the more pediatric rheumatologists that are on faculty, then the higher volume of patients will be coming through and the more exposure you will get -- not just in terms of volume but in terms of different practice styles / different opinions on the field / approaches.

Or which programs have the best fellowships, or consistently produce residents who go into rheum?
Re which programs are the best/strongest, this you will have to ask word of mouth from other individuals who know more about Pediatric Rheum fellowships (asking pediatric rheumatologists at your medical school is a good start). As far as programs which consistently produce residents that go into Rheum, this is likely highly variable depending on the resident interest (and not necessarily reflective of the residency program): particularly given so few people ultimately go into the fellowship.