Mission and Overview

The Wayne State University/Detroit Medical Center (WSU/DMC) Rheumatology Fellowship Program

Mission

To provide outstanding rheumatologic care to the Detroit Metropolitan patient population while training competent and ethical rheumatologists who are dedicated to community care, academic research and medical education. To provide education to fellows in all areas of clinical adult rheumatology, basic immunology and musculoskeletal anatomy so that graduate trainees will be able to provide excellent quality care in the subspecialty of adult rheumatology in the outpatient and inpatient clinical settings as well as passing the ABMS board examination in Rheumatology.

Overview

The Rheumatology Fellowship at Wayne State University/Detroit Medical Center (WSU/DMC) was established in 1960 and is one of two allopathic adult fellowship programs in the state of Michigan. The two-year training program maintains a complement of four fellows, with two incoming fellows per training year. Graduates from our program practice clinical or academic rheumatology throughout the United States as well as abroad, with a large number of graduates actively practicing in the state of Michigan.

Our graduates are trained to practice evidenced-based management in the treatment of rheumatologic disorders. In doing so, they employ a shared decision-making approach, with individualized treatment strategies that take into account our patient's unique social determinants of health. We are also committed to excellence in research on rheumatologic diseases as well as systemic autoimmune diseases and cancer. We aim to graduate ABMS board certified rheumatologists who exemplify the spirit of academic medicine and are committed to the growth and development of resident physicians and medical students. We seek to empower a new generation of rheumatologists who will contribute to the knowledge of the field through clinical and basic research.

Our fellows enjoy a unique training experience while providing inpatient and outpatient care to a socioeconomically and ethnically diverse patient population, throughout the Detroit Metropolitan area, at several clinical sites. Our fellows rotate at five hospitals within the Detroit Medical Center main campus including, Harper University Hospital, Hutzel Women's Hospital, Detroit Receiving Hospital, DMC Heart Hospital, and Rehabilitation Institute of Michigan. DMC is a leading academically integrated system in Metropolitan Detroit and the largest healthcare provider in southeast Michigan, with more than 2,000 licensed beds and 3,000 affiliated physicians. In addition, fellows also have the opportunity to serve our nation's Veteran's while training at the John D. Dingell VA Medical Center that services nearly 350,000 Veterans in Michigan. We also provide consultation services to the Barbara Ann Karmanos Cancer Institute, the largest cancer research and provider network in Michigan that cares for approximately 13,000 new patients annually and conducts more than 800 cancer-specific scientific investigation programs and clinical trials. Fellows gain expertise in a variety of electronic health record systems during their training, preparing them for independent practice. This diversity of pathology, patient population, clinical exposure and sites provides our fellows with a unique educational experience, while serving the needs of a mostly medically underserved and vulnerable patient population.

Program Aims

Our fellows provide outstanding, evidenced-based, compassionate management in the treatment of inpatient and outpatient rheumatologic and autoimmune diseases to the Detroit Metropolitan patient population. Fellows are educated in all areas of clinical adult rheumatology and basic immunology. Trainees receive hands-on training of musculoskeletal anatomy through a dedicated ultrasound curriculum. In doing so, trainees employ a shared decision-making approach with individualized treatment strategies that take into account our patient's unique social determinants of health. Fellow education is greatly enriched through robust didactics, by inviting nationally-recognized rheumatology experts to lecture on best practices and cutting-edge research in the field.

Training information for main clinical sites

Detroit Receiving Hospital and University Health Center

Detroit Receiving Hospital (DRH) and University Health Center (UHC) are affiliates of the Detroit Medical Center (DMC) main campus located in central Detroit. It is an urban medical center where a diverse ethnic and socioeconomic population receives healthcare. Trainees care for patients with a wide variety of rheumatology conditions with varied presentations and management obstacles, in the inpatient setting. There are typically 3-5 new inpatient consults daily for patients with complex medical conditions.

Good institutional support is available onsite for orthopedic surgery, neurology, cardiology, pulmonary and intensive care.

Three full time faculty members, Dr. Benchaala, Dr. Sarakbi, and Dr. York provide teaching at both Harper-Hutzel Hospital and DRH. Dr. Fernández-Madrid is a full time dedicated faculty researcher who provides guidance and mentoring for fellows interested in rheumatology research.

Harper-Hutzel Hospital and Harper Professional Building

Harper-Hutzel Hospital (HUH) is a main campus affiliate of the DMC. Harper Professional Building houses the Rheumatology outpatient clinic. Fellows rotate simultaneously at HUH and DRH. Trainees provide care for wide variety of rheumatic diseases of all ethnicities and socio-economic groups in the busy inpatient service and outpatient clinic sites. Fellows have support for medicine subspecialties, surgery and radiology. They also provide care for patients in the endocrinology department (for osteoporosis) and pulmonary department (lung diseases related to rheumatic illnesses).

Outpatient clinical experience including general rheumatology, uveitis, and autoimmune diseases as well as musculoskeletal hands-on ultrasound training. We are currently in development of a musculoskeletal ultrasound training course for local rheumatologists and fellows led by our faculty members with expertise in the field. In doing so, we will serve as the model for ultrasound rheumatology education in the state of Michigan.

John D. Dingell Veterans Affairs Medical Center (Detroit)

There is one full time rheumatologists at the VA Medical Center (JDDVAMC) which is adjacent to the DMC main campus, Dr. Ali, whom average more than three hundred outpatient visits per month. Veterans and their spouses of all ages, ethnicity and socio-economic-status, are referred from the entire Lower Peninsula with most patients originating from southeastern Michigan. A high proportion present with significant comorbidities with an extensive array of simple and complex autoimmune disorders (including myopathies, vasculitis) and rheumatic illnesses. Alongside faculty, fellows manage new and return patients. Every clinical encounter by a fellow is reviewed with faculty and afforded appropriate guidance. Each fellow has a dedicated examination room. Combined they perform 5-10 joint injections weekly, aided by ultrasonic visualization when needed. On-site support is available for all medical and surgical sub-specialties as well as radiology. There is a continuity clinic for one first year and one second year fellow.

Outpatient clinical education: Procedure only clinic where fellows are trained in intra-articular injections and joint aspirations as well as opportunities to practice Tele-Medicine.

Locations

The Division of Rheumatology academic offices are housed in the heart of the Detroit Medical Center (DMC) at Detroit Receiving Hospital (DRH), in the University Health Center (UHC) -  4201 St. Antoine, Suite 4H, Detroit, MI 48201. Outpatient clinics are Monday through Friday from 8 A.M. to 5 P.M. Consultation and support is provided to inpatients and outpatients upon a request from their referring physician.

Research laboratories for the faculty of the Division of Rheumatology are housed at Scott Hall, Karmanos Cancer Institute and other facilities of Wayne State University School of Medicine.