Fellowships

clinical experience | instructional experience | research experience | how to apply

Fellows in Immunology/Rheumatology at Stanford have the opportunity to learn from a faculty that includes internationally-recognized experts in immunology, applied basic laboratory research, clinical rheumatology, and the epidemiology and outcomes of rheumatic diseases. The Division of Immunology and Rheumatology has excellent research and clinical facilities, an educational focus on the professional development of physician investigators who are also skilled clinical rheumatologists, and outstanding opportunities for intellectual growth. With 11 primary faculty members, over 20 affiliated faculty members, and three hospital sites, the division provides fellows extensive exposure to current theory and clinical practice.

The goals of the fellowship program are to provide physicians qualified in Internal Medicine with the training to become excellent clinical rheumatologists and to prepare them for investigative careers in immunology, clinical rheumatology, or clinical epidemiology related to rheumatic diseases. The fellowship program is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME). On successful completion of the program, graduates with prior certification in Internal Medicine by the American Board of Internal Medicine will be eligible for certification in the subspecialty of Rheumatology.

The fellowship program is 2 years in length. Additional years of research may be arranged under the supervision of a faculty mentor. All fellows complete a common clinical core experience in the first year. The second year includes both additional clinical experience and investigative work, with the mix determined by the interests of the fellow. Two fellowship positions are available each year.

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The Clinical Experience

Fellows gain experience in the diagnosis and treatment of patients with the full range of rheumatic diseases and musculoskeletal conditions, as well as technical skills in the musculoskeletal exam, joint aspiration and injection, and interpretation of musculoskeletal radiographs. Longitudinal clinical care allows fellows to gain experience in the management of patients with rheumatic diseases over time, and in the assessment of changes in clinical status and responses to treatment.

The Rheumatology fellowship program uses three main sites: Stanford University hospital and clinics, the VA Palo Alto Health Care System hospital and clinics, both in Palo Alto, and the Santa Clara Valley Medical Center, in San Jose, CA. The diversity of patients at the three sites complement each other well.

During the first year, fellows spend 6 to 8 months on the in-patient consultation service at either Stanford/VA or Santa Clara Valley Medical Center. During the second year, fellows may spend from 2 to 6 months on the in-patient consultation service. During the first year, fellows spend 5 to 6 half-days per week in out-patient clinics. During the second year, 1 to 4 half-day per weeks are spent in this activity. Elective rotations are available in Pediatric Rheumatology, Dermatology, Ophthomology, Radiology, Rehabilitation Medicine, and Sports Medicine.

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The Instructional Experience

Formal instruction in the scientific basis and clinical practice of rheumatology occurs in three weekly sessions: a core curriculum lecture series, Rheumatology grand rounds, and Journal Club. The core curriculum presents an organized series of lectures on the principles of rheumatology, including basic and clinical immunology, the investigation of patients with rheumatic complaints, pathophysiology, presentation, and prognoses of rheumatic diseases, treatments, and methods of investigation. These lectures are presented by the faculty, with occasional topics reviewed by fellows or guest speakers from other divisions or departments in the School of Medicine. A musculoskeletal radiology conference is held monthly.

Rheumatology Grand Rounds is designed for the presentation and discussion of interesting or complex cases from the outpatient clinics or in-patient consultation services. Whenever possible, patients with interesting clinical findings are invited to attend these conferences.

Journal Club provides a forum for the review of 2 papers per week from the current literature on topics of relevance to rheumatology or immunology. The goal of these sessions is not only to be made aware of important current research findings, but also to learn how to review critically the medical literature.

In addition to these formal sessions, instruction occurs in attending rounds, pre-clinic conferences, and in informal sessions throughout each week. Fellows are encouraged to attend, and often participate in, educational activities in the Department of Medicine, including Morning Report, Grand Rounds, and Morbidity and Mortality Conference.

Fellows are encouraged to attend the weekly Immunology Seminar, and to participate in a series of non-credit, non-degree courses in biostatistics and clinical research design organized by the School of Medicine specifically for post-doctoral fellows. Opportunities also exists for fellows to audit classes in clinical epidemiology, biostatistics, and immunology.

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The Research Experience

It is anticipated that fellows will engage in investigative activities during their fellowship. This research may be basic or applied laboratory research relevant to the rheumatic diseases, clinical epidemiologic or health services research, research in psychosocial aspects of rheumatic disease, or investigations of new treatments.

This research most often will be conducted with a faculty mentor within the division, but arrangements may be made for fellows to work with faculty in other divisions or departments on research that is related to rheumatology. Fellows are encouraged to meet with faculty members during their first year to explore the research opportunities that are available, and make plans to begin their research late in their first year or at the start of their second year.

To Apply

For application information, please write to:
Halsted Holman, M.D., Rheumatology Fellowship Program, Stanford University, 1000 Welch Road, Suite 203, Palo Alto, CA 94503 e-mail:

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