ACGME Fellowship Training Tracks


The rheumatology fellowship training program at NIAMS is uniquely focused on research. Our program is comprised of tracks emphasizing either clinical or basic science research.   Our integrated emphasis on discovery, spanning from the bench to bedside, exposes trainees to a true translational experience. While the program fulfills ACGME requirements for adult rheumatology in its first two years, fellows accepted into the program are fully funded for three years and are expected to commit to at least a three year duration of training along either the Physician Scientist or Clinical Investigator pathways.

Training within NIAMS is highly individualized, and plans can be designed depending on a trainee's unique experiences, background and interests. This training program may not be appropriate for those intending to become clinical rheumatologists without a significant research component to their careers.

As is the case with other positions at the NIH, fellowship positions are open to U.S. citizens, permanent residents, and international trainees who are graduates of U.S. internal medicine programs.  Because of the duration of our training programs, J-1 visa holders are discouraged from applying, and NIAMS does not sponsor fellows or other trainees for permanent residency applications.

Fellows receive a generous salary according to the NIH PGY pay scale with government benefits and accrued paid vacation. Three weeks of paid vacation are pre-scheduled in the first year and second years. For more information on terms of employment see ACGME Salaries, Benefits, Terms and Conditions [PDF - 57 KB].

We understand that innovative research takes time, especially when clinical research is involved, and we intend to support successful fellows who want to obtain additional training beyond the third year of their fellowship through the NIAMS Scholars in Translational Medicine Program, with more senior scholars advancing to assistant clinical investigators, who have their own laboratory research resources and assistants.

Salaries, research and clinical resources for these experiences, which can last up to eight years, are fully funded by the Federal government, providing NIAMS trainees with unparalleled support designed to promote their development into physician- investigators who are able to obtain independently funded faculty positions in academia, at the NIH or other leadership roles.

training tracks

General First Year Fellowship Training

The first year is intentionally filled with varied clinical experiences, including the NIH clinical center inpatient service and outpatient clinics at the NIH focused on patients in clinical research protocols. The consultation service exposes fellows to a wide variety of rheumatologic problems experienced by patients at the NIH clinical center, including those undergoing innovative experimental therapies. Fellows also play a major role in evaluating patients referred to the NIH’s Undiagnosed Diseases Program, which admits patients whose medical conditions have eluded diagnosis by others. A month at Johns Hopkins University inpatient service adds experience in academic tertiary care rheumatology. First year fellows also participate in the NIAMS Community Health Outreach Clinic—a unique rheumatology subspecialty referral care center for underserved patients. For a typical weekly schedule of a first-year fellow, see our program activities.

First year fellows’ experiences include the following:

  • Inpatient and Consultative Care at the NIH Clinical Center (4 months)
  • Three half-day continuity care clinics per week:
  • Didactic sessions (approximately 4 hours/week):
    • Core lectures, Immunology Lectures, Radiology lectures, research conferences
    • Course - Introduction to the Principles and Practice of Clinical Research
    • Weekly Grand Rounds, Attending Rounds, translational journal club
    • Two days hands-on seminar for musculoskeletal ultrasoundography
  • Additional Rotations:
    • Once a month inpatient rotation at Johns Hopkins University
    • Weekly Scleroderma Clinic at Georgetown or other clinical electives
  • Begin working with research mentor to establish your project

Second and Third Year Training

The centerpiece of fellowship training at the NIH is a research project mentored by one of the faculty in NIAMS or associated faculty in other institutes in the NIH’s intramural research program. A listing of NIAMS and affiliated faculty can be found here, but fellows are free to choose from any faculty member in the NIH intramural research program. Fellows are required to select research mentors and begin designing a long-term research project by the Spring of their first year, and then assemble a mentoring committee to which they present their progress at least annually.

Physician Scientist Track

Trainees in this pathway are provided an intensive mentored research experience and tools needed to pursue a laboratory-based career as a physician-scientist.

Second Year

  • One half-day continuity care clinic
  • 80% dedicated time for research activities
  • Weekly meetings with research mentor
  • Didactic sessions:
    • Core sessions, immunology lectures
    • Weekly Grand Rounds and translational journal club

Third Year

Clinical Investigator Track

The emphasis in this track is to provide mentorship to allow the trainee to become proficient in clinically-based investigation into the pathogenesis and treatment of rheumatic diseases. A mixture of laboratory and clinical research training can be undertaken depending on the specific project. Most trainees in this track will enroll in the NIH-Duke Program in Clinical Research, which leads to a Master of Health Sciences in Clinical Research.

Second Year

  • One half day continuity care clinics
  • 50-75% dedicated time for lab research activities
  • Weekly meetings with research mentor
  • Plan clinical or translational research project and participate in ongoing clinical protocols
  • NIH-Duke training program in Clinical Research (first year)
  • Didactic sessions:
    • Core sessions, immunology lectures
    • Weekly Grand Rounds and translational journal club

Third Year

  • NIH-Duke training program in Clinical Research (second year)
  • Establish or take on major role in a Clinical Research Protocol
  • Apply to NIAMS Scholars in Translational Research Program for more advanced training
  • May elect to continue one half-day of continuity care clinic or spend clinical time with patients in their research protocols

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