Ralph C. Williams Jr. (Feb. 17, 1928–Feb. 2, 2020) was destined to become an artist. He started painting when he was 8 years old and never stopped. His journey, however, included a substantial career as a rheumatologist. After completing his training in internal medicine at Massachusetts General Hospital, Boston, he joined the Rockefeller Institute in…
RheumMadness is an online collaborative learning experience created to educate trainees, rheumatologists and the wider medical community about recent advances and important concepts in rheumatology. The project is funded by the Rheumatology Research Foundation Clinician Scholar Educator (CSE) Award and modeled after NephMadness, an educational initiative of the American Journal of Kidney Diseases (AJKD) that…
I have been tongue-tied, of late. When I was a medical student, I was told not to turn the physical examination into an aerobic workout. This sage piece of advice was imparted by my physical examination preceptor, who had watched me perform a complete examination on a hapless volunteer. At the time, I thought of…
Civil unrest in response to racism is a call for realignment of priorities in all aspects of society, including medical education. Hospital preparedness demands training in the treatment of victims of pepper spray, tear gas and rubber bullets, as well as planning for lockdown procedures in healthcare facilities and medical schools. Beyond logistics though, events…
“It’s crazy! None of the pictures online look like me!” a young Black woman with systemic lupus earythematosus (SLE) exclaimed. We could only affirm her observation and agree that it was unfair. Like many patients with SLE, our patient was diagnosed at a young age and suffered severe complications that required kidney transplantation before her…
Preparing for the American Board of Internal Medicine (ABIM) Rheumatology Certification Exam can easily be one of the most anxiety-inducing times for young trainees (and even seasoned rheumatologists). Once again, you are asked to demonstrate mastery of your knowledge in a medical field, and this time it is for the field of rheumatology—a discipline with…
In response to the COVID-19 pandemic, all rheumatology fellowship interviews conducted in the 2020 fellowship recruitment season were conducted in a virtual, video-based format to reduce the risks associated with travel and face-to-face meetings. In June 2020, the Coalition for Physician Accountability released guidance suggesting all programs commit to online-only interviews and recruitment events, even…
Sir William Osler, a pioneer of modern medical education, taught “medicine is learned by the bedside and not in the classroom.”1 How, then, do we learn medicine in a world dominated by virtual interactions? This question was forced upon us in the era of the COVID-19 pandemic. From telemedicine to remote meetings, the rheumatology community…
Rheumatologists are natural teachers. As a group we are drawn to the mystery of making a diagnosis and enjoy passing on our fascinating and alluring detective game to students. Some of us extend our expertise to become clinical investigators or bench scientists, and others devote ourselves to the education of trainees and education scholarship. Similar…
Although providing feedback is often discussed as separate from teaching, it is the most important teaching we do as clinician-educators. Whether attending on the inpatient consult service or precepting in the clinic, providing direct feedback is the most effective way to help fellows advance their skills. Feedback, however, is only as good as the giver…
“The task of the modern educator is not to cut down jungles but to irrigate deserts,” said mid-20th century scholar and writer C.S. Lewis. Although he was speaking to the importance of the holistic education of students, the same idea rings true for a 21st century nurse practitioner (NP) new to rheumatology. Indeed, the care…
Editor’s note (March 23, 2022): In 2022, the Division Directors Conference and Program Coordinators Conference will both be part of ACR Education Exchange, held April 28–May 1 in Orlando, Fla. Registration is now open. New fellowship program directors often step into the role with little in the way of training, resources or mentoring. That’s where…
Implicit bias negatively affects patients and clinicians alike in a variety of healthcare settings. Unconscious feelings and attitudes about others can damage professional and personal relationships. Demystifying Bias At the virtual ACR Division & Program Directors Conference in March, three physician leaders presented a panel called, Demystifying Bias: Empowering You to Have Courageous Conversations, and…
The past several decades have seen the transition of medical training from a hierarchical, teacher-driven model to a learner-centered approach that emphasizes competency-based medical education (CBME). CBME refers to several aspects of education, including: 1) flexible, lifelong learning; 2) emphasis on knowledge and skills rather than regurgitation of facts; and 3) formative rather than summative…
Engaging in lifelong learning by maintaining certification has been a required method to confirm medical competence since 1933 through the American Board of Medical Specialties (ABMS). Established by the American Medical Association and the American College of Physicians in 1936, the American Board of Internal Medicine (ABIM) is one of 24 ABMS certifying member boards….
Leslie Kahl, MD, on Coaching I have been an academic clinician-educator for my entire career and, like most of my colleagues, have been called upon to advise, mentor and coach countless trainees and junior faculty members. Unlike most clinician-educators, though, I also served as associate dean for student affairs at Washington University School of Medicine,…
Many practitioners can relate to the epiphany of Roy Basch, MD, the lead character in Samuel Shem’s satirical novel The House of God.1 During his first on-call shift as a medicine intern, long work hours combined with jaded advice from his senior resident leave Dr. Basch feeling disenchanted with the medical profession until he cares…
Scrolling through your Twitter feed, a tweet catches your eye: “Great day. Helped anxious patient with poor health literacy understand and come to terms with #SLE diagnosis and agree to start treatment. #RheumTwitter” The tweet, by a well-intentioned physician who cared deeply for her patient, resonated with many others and has been retweeted more than…
Fear of injection decreased when patients with RA switched from self-administering a treatment biosimilar to etanercept in a prefilled syringe to an injector pen, according to a small observational study.
The use of biosimilar treatments is increasing, according to surveys conducted in 2018 and 2020 of rheumatologists from eight countries. In the two-year period, Japan had the largest increase in biosimilar prescriptions, with only 6% of surveyed rheumatologists reporting they prefer prescribing originator biologic agents.
As part of the ACR’s pledge to be a leader for inclusion and change for members, trainees, staff and rheumatology patients, the ACR is holding a special image competition in conjunction with ACR Convergence 2021 dedicated exclusively to images of rheumatic disease in skin of color. “We started discussing the lack of diversity in our…
Current Procedural Terminology (CPT) codes 99446–99449 were created in 2014 to capture the time spent by a consultant who is not in direct contact with the patient at the time of service. An interprofessional telephone/internet consultation (ITC) is defined as an assessment and management service in which a patient’s treating provider (e.g., primary or qualified…