How to Find Space for Scholarship in Private Practice

Dr. O’Rourke

Not all private practice physicians assume their jobs straight out of fellowship. Kenneth O’Rourke, MD, a rheumatologist with Rheumatology Associates in Portland, Maine, joined this practice in 2017 after 25 years at Wake Forest School of Medicine, Winston-Salem, N.C., where he was professor of medicine and director of the rheumatology fellowship training program.

Dr. O’Rourke has been intricately involved in medical education and curriculum development across the country, including as chair of the Rheumatology Board Exam Committee through the American Board of Internal Medicine and as a member of the ACR’s Curriculum Task Force of the Committee on Education, and the Next Accreditation System Working Group of the Committee on Rheumatology Training and Workforce Issues (COTW), which created the Rheumatology Entrustable Physician Activities and Rheumatology Curricular Milestones.

He is also a founding member of the Carolinas Fellows Collaborative, whose work has included the creation of a competency-based curriculum of goals, objectives and linked evaluations for rheumatology fellowship training programs.

Among his many publications, he is a co-author of a forthcoming paper describing Rheumatology Milestones 2.0, which will be used in the coming years by every rheumatology fellowship training program in the U.S.⁵

Dr. O’Rourke says he has an advantage over graduating fellows in having made enough contacts with like-minded clinicians and educators over the years to have what can be called a community of practice. Thus, for a graduating fellow, it is important to figure out a surrogate, such as a faculty mentor at their training institution, who can provide suggestions for research projects or help network with contacts in the ACR and other organizations.

Dr. O’Rourke also notes that it is important to consider the infrastructure and support available to young clinicians as they look at practices where they may work. Does the practice have an existing relationship with a residency or fellowship program? Is there time or opportunity for educational conferences with colleagues or multidisciplinary meetings with other specialists? Dr. O’Rourke points out that, in private practice, there are fewer structured opportunities for teaching and education than in academia, but that simply means one must be diligent in seeking out these activities and availing oneself of local, state and national programs.

With his transition to private practice, Dr. O’Rourke has invested far greater time in direct teaching of internal medicine residents. Whereas his work at the university focused on teaching rheumatology fellows, he now relishes the chance to put the spark in resident trainees and inspire them to pursue careers in rheumatology.

In Sum

As all three rheumatologists can attest, balancing scholarship and private practice is not for the faint of heart, but when done well and by putting these lessons into practice, such a path can create excitement and intellectual rewards for an entire career.

Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.

References

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2. Mease PJ, Goffe BS, Metz J, et al. Etanercept in the treatment of psoriatic arthritis and psoriasis: A randomised trial. Lancet. 2000 Jul 29;356(9227):385–390. 
3. Wallace DJ, Hahn BH. Dubois’ Lupus Erythematosus and Related Syndromes, 9th edition. Philadelphia: Elsevier; 2019.
4. Wallace DJ, Furie RA, Tanaka Y, et al. Baricitinib for systemic lupus erythematosus: A double-blind, randomised, placebo-controlled, phase 2 trial. Lancet. 2018 Jul 21;392(10143):222–231. 
5. Liebowitz JE, Torralba KD, Kolfenbach J, et al. Rheumatology Milestones 2.0: A roadmap for competency-based medical training of rheumatology fellows in the 21st century. Arthritis Care Res (Hoboken). 2020 Nov 12. doi: 10.1002/acr.24507. Epub ahead of print. PMID: 33181000.