2009 DOM Annual Report - Department of Medicine - University of ...

2007The Division of Rheumatology and Clinical Immunology strives to rankamong the top Rheumatology Divisions in the country and to providestate-of-the-art care to patients with rheumatic and musculoskeletaldiseases that is appreciated by patients and responsive to the needsof referring physicians. Our goals also include providing outstandingtraining for fellows so that they can become the next generationof academic and practicing rheumatologists and for residents andmedical students so as to increase their awareness of the frequency,impact and modern approach to diagnosis and treatment ofrheumatic diseases. Lastly, we strive to develop “cutting edge” clinicaland laboratory research programs capable of training academicrheumatologists of the future and translating investigative discoveriesto clinical practice.CLINICALTen Division faculty members are actively involved in seeingoutpatients at the University Arthritis and Autoimmunity Center, theOakland Veterans Affairs Medical Center Arthritis Clinic, the LupusCenter and our Greensburg site. The total number of patient visits tothese four facilities was over 10,000, an increase of 14.5% comparedwith fiscal year 2006. Thetotal number of patientvisits to our Arthritis InternalMedicine (AIM) and Margolispractice sites during fiscalyear 2007 were 13,615and 14,892, respectively.Division faculty serve botha consultative, tertiary carerole, seeing complicatedautoimmune diseasepatients referred by otherrheumatologists andinternists, and an ongoingcare role to patients with alltypes of rheumatic diseases.There are three designatedspecialty clinics which serve as regional and national referral centers:Scleroderma Clinic, Polymyositis Clinic and Lupus Clinic. The ArthritisNetwork of 26 rheumatologists recorded over 41,500 outpatient visitsat six practice sites this year, and our faculty completed over 600 newinpatient consultations at UPMC-affiliated institutions and the VAMC.RESEARCHThe Division’s research program continues to be nationally recognizedfor its high quality and productivity. Extramural funding has remainedsteady during the past year. We had five years of funding for theRheumatic Diseases Core Center (RDCC) grant sponsored by NationalInstitute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)/NIH. This grant supported three core facilities (Molecular Biology,Analytical Cytochemistry and Biostatistics) and two pilot and feasibilitystudies of basic/translational research related to rheumatic diseases.Major faculty areas of investigative interest include basic mechanismsof tissue injury and pathogenesis as well as clinical features,natural history and therapy of systemic sclerosis, systemic lupuserythematosus, polymyositis-dermatomyositis, rheumatoid arthritis,vasculitis and osteoarthritis. We have recently been awarded a fiveyear NIAMS/NIH Multidisciplinary Clinical Research Center grant, whichincludes three clinical research projects that address important clinicalproblems, an Administrative Core, and a Methodology Core. Otherresearch activities include the Arthritis Institute, established in 1998,which is an interdepartmental structure designed to foster integratedclinical and research activities related to arthritis, autoimmune andmusculoskeletal diseases.TEACHINGFaculty members of the Division have extensive teachingresponsibilities, both in the Department of Medicine and in theSchool of Medicine. Division faculty are involved in all levels ofmedical school classes, from directing first year courses to having upto six students participate in the four-week Rheumatology elective.Interns and more senior Internal Medicine residents rotate on theRheumatology Service for two to four weeks. Faculty and fellowsteach residents in the Rheumatology Clinics during their AmbulatoryMedicine block. Faculty give lectures in the annual Internal MedicineProgram’s noon conference series. Our clinical training componentfor fellows includes a comprehensive didactic curriculum (weeklyGrand Rounds, Summer Didactic Lecture Series, Immunology LectureSeries, monthly Journal Club, and monthly Radiology Conference). Allof these activities have direct faculty supervision and, thus, intimatecontact between fellows in training and academic faculty. Wecurrently have six clinical fellows (three first year, three second year),and one research fellow (third year).In addition to the traditional training of medical students, residentsand fellows, rheumatology faculty members participate in mentoringmedical students throughout their medical school careers as partof the Faculty and Students Together (FaST) program. A uniquesummer research/clinical program provides the opportunity formedical students between their first and second years to participatein American College of Rheumatology-sponsored clinical and researchpreceptorships. The Lupus Center offersall day sessions for high school studentspotentially interested in medical researchcareers and has an intensive summerresearch program which, annually,attracts one or more medical students.QUALITYThe Division continues to have a reputation as one of the best inthe country. Two faculty members are included among the peerselectedBest Doctors in America. More specifically, our focus onquality is evidenced by our work with rheumatic disease patients onimmunosuppressive medications, particularly parenteral biologicmodifier therapies.57