Overview
The rheumatology fellowship training program at the Kirk Kerkorian School of Medicine at UNLV was approved by the ACGME in January 2024 with the training of fellows initiated in July of 2024, becoming the first such program in the state of Nevada. With the intended goal of addressing the significant unmet need for rheumatologists in the Intermountain West, the program focuses on preparing trainees to attend to the care and needs of the uniquely diverse patient population served by the Kirk Kerkorian School of Medicine and its affiliated training hospitals in Southern Nevada and the greater Las Vegas area. Training at the Kirk Kerkorian School of Medicine offers the opportunity to master the challenges of both diagnosis and management of autoimmune and rheumatic disorders in a patient population highly enriched for patients with admixtures of Native American/Hispanic, Asian, Pacific Islander, African and/or European ancestry. Clinical and research interests focus on disorders prevalent or severe in the community including systemic lupus, Sjogren’s syndrome, autoimmune inflammatory muscle and lung disease, and patients with autoimmune disorders overlapping with rheumatoid arthritis, psoriatic arthritis, or axial spondylitis.
Mission
Our mission is to provide a supportive and safe learning environment with opportunities to engage in high-quality scholarly investigation, education, and patient care in rheumatology.
Program Aims
- Graduate trainees with the knowledge, skills, and attitudes to provide the highest quality of care for their patients and to maintain their professional satisfaction.
- Recruit and maintain a diverse workforce in which all members feel valued and respected.
- Develop a clinical learning environment that monitors and supports the well-being of fellows, faculty, residents, and other members of the healthcare team.
- Promote participation in quality improvement and patient safety activities to achieve safe and high-quality patient care. The curriculum includes weekly conferences that cover case discussion, journal club, patient safety discussions, ethics, and legal aspects of health care.
- Develop a culture that promotes the participation in and dissemination of scholarly activity.
- Promote a learning environment that identifies and addresses healthcare disparities.
Program Director
Mitchell D. Forman, DO
Rheumatology Fellowship Program Director
Training Sites
The Kirk Kerkorian School of Medicine at UNLV serves as the official site of the rheumatology fellowship with a very active clinical rheumatology service, and is the primary site for the academic educational program provided to the fellows on a weekly basis. The program utilizes four training sites that offer complimentary clinical experiences including outpatient clinics, inpatient follow-up care, and hospital consultation services.
Fellow trainees attend clinics convened by rheumatology faculty in a 1:1 setting four half-days/week in the UNLV Health Internal Medicine Clinic, a multi-specialty clinic in the Las Vegas Medical District (LVMD) that is proximate to the Kirk Kerkorian School of Medicine at UNLV and University Medical Center of Southern Nevada (UMC). Each fellow also attends a weekly half-day continuity clinic to evaluate and follow new patient consults assigned to them as well as patients they have seen as inpatient consultations at UMC needing outpatient follow-up.
University Medical Center (UMC) of Southern Nevada, a premier teaching hospital located in the Las Vegas Medical District and another educational partner with the Kirk Kerkorian School of Medicine, is the largest hospital in Nevada with a 564-bed capacity. UMC serves a very broad and diverse patient population, serves as the primary safety net hospital for the greater Las Vegas area, and provides a unique inpatient rheumatology consultation training experience for our fellows.
To provide a more comprehensive program experience to train rheumatologists, the Kirk Kerkorian School of Medicine has formed a partnership and collaborative effort with the North Las Vegas Department of Veterans Affairs Medical Center, part of the VA Southern Nevada Healthcare System (VASNHS). The VA facility is located on the North rim of Las Vegas, approximately 15 minutes driving time after entering the freeway adjacent to the Las Vegas Medical District. The Las Vegas VA has two rheumatologists and a broad number of programs that will support the training of our fellows. These represent both required and elective rotations and include dermatology, physical medicine & rehabilitation (PM&R), occupational therapy, orthopedics, pain management, and radiology including ultrasonography, as well as a comprehensive rheumatology service.
Kids Arthritis Care, the Juvenile Arthritis & Rheumatology Care & Research Center is located approximately 20 minutes driving time from the Las Vegas Medical District and provides experience in pediatric rheumatology with the program’s affiliated pediatric rheumatologist. Our fellowship program is grateful for the opportunity our fellows have rotating with one of the very few pediatric rheumatologists in the state, Dr. Robert Lowe, an exceptional clinician and educator eager to participate in the training of our fellows.
Rotation Structure and Curriculum
Fellows alternate three month blocks at the Las Vegas Medical District (LVMD) attending faculty supervised clinics at the UNLV Health Clinic and seeing inpatient consults at UMC, with three month blocks at the Las Vegas Department of Veterans Affairs Medical Center attending VA Rheumatology Clinics as well as the respective radiology, rehab medicine, dermatology, and orthopaedic venues there. During one month of each year while on one of the three month blocks at the LVMD campus, fellows do a pediatric rheumatology rotation with Dr. Lowe at Kids Arthritis Care.
Structured thematically around recently encountered cases in the clinic or hospital, one-half day each week is reserved for faculty-led didactic sessions with fellows covering topics in the rheumatology fellowship core curriculum, review of informative journal articles presented by fellows, and fellow presentations of instructive cases from their clinical portfolio with summary teaching points derived from their relevant literature review that inform diagnosis and/or management of the patient presented.
Subject areas covered (based on the American Board of Internal Medicine (ABIM) rheumatology certification blueprint) include:
- Crystal induced synovitis
- Infection of joints and soft tissues
- Metabolic diseases of bone, including osteoporosis
- Non-articular rheumatic disorders
- Non-inflammatory musculoskeletal (MSK) pain syndromes
- Central pain syndromes including fibromyalgia pain syndrome
- Juvenile idiopathic arthritis and juvenile spondyloarthropathy
- Non-surgical, exercise-related (sports) injury
- Metabolic myopathies
- Inflammatory myopathies, polymyositis, and dermatomyositis
- Osteoarthritis
- Rheumatoid arthritis
- Systemic sclerosis
- Sjogren’s syndrome
- Spondyloarthropathies
- Systemic lupus erythematosus
- Rheumatic manifestations of systemic diseases
- Vasculitis
- Practice management
- Medical ethics
Over the course of fellowship training fellows receive supervised instruction in performing the following:
- Arthrocentesis and/or injection of the following joints with anesthetic and steroid preparation: wrist, elbow, shoulder, knee, and ankle
- Ultrasonographic arthrocentesis and/or injection of knee, ankle, elbow, and wrist joints
- Aspiration of olecranon bursa
- Injection of the following tendon sheaths and bursae with anesthetic and corticosteroids: abductor pollicis longus, flexor digitorum adjacent to MCP, medial/lateral epicondylar tendon insertion, supraspinal tendon/subacromial bursa, proximal bicipital tendon long, proximal bicipital tendon short, pes tendon/anserine bursa, and greater trochanteric bursa
- Synovial fluid analysis and identification of crystals and bacteria
- Nailfold capillary microscopy
FEL-1
LVMD – 6 months
- UNLV Rheumatology (outpatient and inpatient consults) – 5 months
- Pediatric Rheumatology – 1 month
VA – 6 months
- VA Rheumatology (outpatient and inpatient consults) – 4 months
- VA Pain Management – 1 month
- VA Physical Medicine and Rehab –1 month
FEL-2
LVMD – 6 months
- UNLV Rheumatology (outpatient and inpatient consults) – 3 months
- Research/UNLV Elective* – 3 months
VA – 6 months
- VA Rheumatology (outpatient and inpatient consults) or Research/VA Electives* – 6 months
*Electives include: Dermatology (VA), Nephrology (VA), Radiology/Ultrasound (VA), Orthopaedics/Sports Medicine (VA), Pulmonary Interstitial Lung Disease (UNLV Health Clinic), Pediatric Rheumatology
At the end of each weekday during LVMD blocks, informal debriefing rounds are convened with residents and fellows on service to collectively discuss instructive encounters or findings encountered over the course of the day.
Recognizing the importance of lifelong learning and discovery, participation in scholarly activity is embedded into the training program by providing opportunities and resources for fellows to participate in the discovery and dissemination of newly gained knowledge. Although a relatively new medical institution, the school of medicine has an established track record of promoting scholarly activity at all levels of medical training.
Fellows are encouraged and expected to participate in scholarly activities during their training. This can include (but is not limited to):
- Publication of informative case reports/series
- Utilizing and further developing registries of patients with systemic lupus and patients with overlapping rheumatic disorders that are uniquely prevalent and/or severe in the diverse population residing in the Las Vegas region to provide data that will guide optimal early diagnosis management
- Participating as local co-investigators in clinical trials of new therapies for managing Systemic Lupus, Sjogren Syndrome, Systemic Sclerosis, and/or Inflammatory Myopathies.
- Collaborative projects with other UNLV faculty studying behavioral and/or nutritional factors impacting outcomes of autoimmune/rheumatic disease in the population we serve
The UNLV Division of Clinical Immunology and Rheumatology is currently a local site for enrolling patients in lupus clinical trials and is a member of the Lupus Clinical Trials Investigator Network (LUCIN), thereby providing fellows the opportunity to be co-investigators in locally enrolling lupus trials and acquire competence in use of disease activity assessment instruments. Infrastructure is also in place for the division to consider site designation for enrolling patients in trials of cutting edge therapies for Sjogren Syndrome, Systemic Sclerosis and Inflammatory Myopathies.
The Kirk Kerkorian School of Medicine at UNLV Department of Internal Medicine has developed resources to assist trainees in study design as well as present their findings through attendance at scientific society meetings. Fellows are therefore encouraged and provided protected time to attend national or regional conferences to present scholarly work accepted for presentation.
It is our intention that participation in academic inquiry during their rheumatology training at the Kirk Kerkorian School of Medicine will equip fellows with the analytical skills to skillfully employ evidence-based assessment techniques and therapies for their patients over the course of their career.
The rheumatology training program at the Kirk Kerkorian School of Medicine is committed to enabling all trainees to achieve their career goals by encouraging attendance at local, regional, and national meetings to network with professionals in clinical practice, clinician educators or investigators in academic rheumatology, industrial development of new therapies, or medical management and oversight. Attendance and participation in fellow trainee activities sponsored by the American College of Rheumatology, the Rheumatology Association of Nevada, and the local chapter of the American College of Physicians is supported and highly encouraged.
How to Apply
Our program participates in the National Residency Matching Program (NRMP). Applications are accepted through the Electronic Residency Application Service (ERAS) only. No faxed or mailed applications will be accepted. Eligible candidates for this position should have completed three years of post-graduate training in an ACGME accredited U.S. Internal Medicine residency internal medicine and be eligible for board certification in internal medicine by the ABIM at the time of starting.
Application requirements are listed below:
- ERAS application
- Updated curriculum vitae
- Personal statement
- Medical school transcript
- Medical Student Performance Evaluation (MSPE)
- USMLE or COMLEX official transcript
- 3-4 letters of recommendation including one from the Internal Medicine residency program director and one from a Rheumatologist
Applicants needing J1 visa sponsorship are accepted. Gap years of clinical practice, dedicated research, or other meaningful experience/service since completion of IM training will only enhance and not detract from the consideration of your application, but a letter of recommendation from someone familiar with your activity during this time is recommended.
Meet Our Fellows
Medical School: Kirksville College of Osteopathic Medicine
Residency Program: Creighton University School of Medicine/Maricopa Integrated Health System
Medical School: Arizona College of Osteopathic Medicine of Midwestern University