The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in affected tissues, mostly involving the lungs and lymph nodes.1,2 The etiology of sarcoidosis remains unknown but is thought to be due to an inflammatory response to an antigen exposure in genetically predisposed individuals.1 Tumor necrosis factor-α (TNF‑α), a pro-inflammatory cytokine, plays an essential role in…
A 26-year-old woman presented to our emergency department (ED) with intermittent fevers, nausea and vomiting. She had a past medical history of well-controlled, anti-nuclear antibody positive and rheumatoid factor negative polyarticular juvenile idiopathic arthritis (pJIA) and Crohn’s disease. Her maintenance treatment consisted of monthly intravenous infliximab, 10 mg of oral methotrexate weekly and 20 mg…
As rheumatology fellows approach the end of what for many is 25th grade, it’s time to focus on what you want to do for the rest of your life. For most rheumatology fellows it will be some form of clinical practice, although enormous opportunities exist throughout the medical field for you to apply your talents….
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries. The clinical subsets of PAN are idiopathic, generalized, secondary hepatitis B virus (HBV) associated and cutaneous PAN. These clinical subsets are important because of their therapeutic implications. Virtually any organ system can be affected in generalized PAN, but this vasculitis tends…
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,…
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…
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…
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…
Interactive rheumatology education has flourished online thanks to grassroots efforts & ACR support…