Duke
University
provides a rich environment for clinical training in rheumatology. Fellows in our training program provide patient care in several distinct settings.
a)
Duke Clinic (Duke South): 
Rheumatology clinics at Duke with a specialized focus include early inflammatory arthritis, inflammatory eye disease, Sjogren’s syndrome, vasculitis, lupus, rheumatic lung disease, and refractory gout.
Fellows have a one half-day continuity clinic at Duke each week, caring for patients with a spectrum of diseases similar to those described above. Fellows usually see one new and six return patients at each clinic. During elective rotations, fellows may elect to see patients with a faculty clinician in the
Duke
University
Arthritis
Center.
b)
Durham
VA
Medical
Center:
Duke rheumatology fellows and rotating internal medicine house officers perform approximately 3,000 patient visits at the VA medical center. The spectrum of patients seen in this clinic is similar to that of the Duke Clinic with the exception of a greater percentage of patients with spondyloarthropathies, OA and gout. Fellows have responsibility for patient continuity at the VA clinic.
c)
Inpatient Consultation Services of
Duke
Hospital
and
Durham
VA
Medical
Center.

First year fellows lead an inpatient consultation team for eight months; with time divided between
Duke
Hospital
and the Durham VA Medical Center. Approximately seven to ten inpatient consultations are performed each week.
The spectrum of illness comprises acute manifestations of systemic rheumatic diseases, challenging diagnostic situations, and patients requiring diagnostic and therapeutic arthrocentesis. Each consultation service is supervised by a faculty member who sees patients with the team on a daily basis as needed.
d)
Duke Pediatric Rheumatology Clinic.

Rheumatology fellows spend one full day per week in the pediatric rheumatology clinic for four months during the first year of training. Fellows usually see eight to ten patients per clinic. The pediatric rheumatology division provides care to patients referred from a several state radius.
e)
Duke
Arthritis
Center
Outreach Clinics. Faculty in the Division of Rheumatology and Immunology staff outreach clinics in several communities within a 90 mile radius of
Durham
. Fellows maintain a continuity clinic supervised by a faculty member. On average, fellows devote one day per month to outreach activities. This experience is representative of community-based rheumatology practice. Fellows have an opportunity to develop relationships with referring physicians and function as a consultant sub-specialist in communities without a local rheumatologist.
f) Elective Rotations. First year fellows participate in a multi-specialty rotation comprising one half-day clinics each week in each of the following specialties: osteoporosis/metabolic bone disease, musculoskeletal radiology, and sports medicine. During three subsequent elective rotations fellows tailor clinical training experiences in a variety of clinical specialties related to rheumatology.