As a way to gain clinical and research training in a chosen subspecialty, completing a fellowship provides young physicians with additional tools to advance their careers. To meet the growing and evolving needs of training young physicians in the specifics of a subspecialty, fellowship programs need to adapt to ever-changing educational requirements to receive the necessary accreditation and meet ongoing funding challenges.
Launching a new fellowship program can be daunting given these challenges. What are the key challenges in launching a new fellowship program in rheumatology or pediatric rheumatology? Who are the key people that need to be involved in successfully launching the program? What challenges remain going forward once a program is launched?
These were some of the questions posed to program directors of several rheumatology fellowship programs across the U.S. The programs in this article were all launched in the past several years and, therefore, offer a fresh perspective on the current requirements and challenges of developing a rheumatology fellowship program.
Funding, Funding, Funding
A key, if not the key, to launching a successful fellowship program in rheumatology or pediatric rheumatology is finding the money to support fellows. To that end, support from the Department of Medicine or hospital is crucial.
“Everyone agrees that support from the Department of Medicine is the anchor to starting a fellowship program,” says W. Neal Roberts, MD, program director of the Fellowship Program at the University of Louisville, Ky. “Their buy-in is key.”
Dr. Roberts, who is chief of the Division of Rheumatology and a professor of medicine at the University of Louisville, relaunched the university’s fellowship program in March 2013 within the larger context of revamping the entire rheumatology division. Therefore, he says initial partial funding for its fellowship program came from the university, but the funding will eventually come from the Department of Medicine as well as the local Veterans Affairs Hospital. Other monies, he says, will come from grants, endowments and clinical activities within the division.
Calling the initial funding a “recruitment startup package expense,” he says this “early phase” of funding is easy because of the support of the Department of Medicine. “But expanding beyond the initial program into a more stable program with additional faculty and fellows is a very difficult next step,” he says.
Currently, his fellowship program is a two-year program, with an option for an additional research year. One new fellow is recruited each year. With more funding, he’d like to see the program grow from one fellow the first year to two fellows the second year.