Why did you decide to pursue both adult and pediatric rheumatology?
Dr. Sadun: First, I can’t imagine having to give up either adult or pediatric care, which is why I entered a Med-Peds residency in the first place. I love the joys of helping children learn to thrive despite a chronic illness, as well as the challenges of triangulating the patient-parent-physician triad; similarly, I love the intimacy of the one-on-one relationship we get to form with our adult patients. And I especially appreciate the opportunity to help teens and young adults take ownership of their medical care and navigate the transition from pediatric to adult care, while making a transition from dependence to independence in other aspects of their lives. It has been an added perk to be able to draw from the experiences and practices that are particular to pediatric or to adult care and have the opportunity to apply them, when appropriate, to the care of patients on the other end of the age spectrum.
Tell us about your clinical practice of Med-Peds rheumatology.
Dr. Sadun: I have a nice 50-50 split between pediatric and adult rheumatology in my clinical care. In addition to seeing patients in pediatric and adult clinics, I run a young adult rheumatology clinic specifically for patients aged 18–28 who are transitioning from pediatric to adult rheumatology care and need additional wrap-around services; this clinic has an embedded social worker and an embedded primary care physician, allowing us to provide a medical home within a subspecialty clinic. In addition, I do a few weeks per year of inpatient consult work for both pediatric and adult patients. One of my favorite parts of the job is getting to precept fellows in any of these clinical settings.
Tell us about your research.
Dr. Sadun: I am currently engaged in several lines of research. These include medical education scholarship, largely through the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Medical Education Workgroup, where I have the opportunity to collaborate with faculty and fellows across the U.S. and Canada. I participate in clinical research focused on lupus with colleagues at my institution, on a national level through my work with the CARRA Lupus Committee and on an international level though collaborations examining outcomes for patients with pediatric-onset lupus. Finally, I conduct translational research focused on vaccine immunogenicity in the lupus population.
How has your combined training influenced your clinical practice and research?
Dr. Sadun: There are many ways in which my combined training has influenced my clinical practice. For most of the past decade, pediatric rheumatology has put more focus on recognizing and aggressively treating macrophage activation syndrome (MAS), and these principles have served me well in my care of adult patients. I have also made a commitment to teaching our adult fellows about MAS, and I frequently assist with difficult inpatient cases of MAS. (Editor’s note: Click here for more information
