Welcome

The Rheumatology Musculoskeletal Ultrasonography Fellowship at St. Joseph's
Healthcare/McMaster Hamilton is a mentored training program of one year for physician
investigators who have a strong interest in rheumatological ultrasonography and wish to pursue
a period of specialized training.

With an emphasis on clinical utility of POCUS, the fellow will have access to approximately 50
patients per week.
During the fellowship the fellow will participate in all aspects of the Rheumatology POCUS
program including: running clinics alongside the supervising staff; learning the basic and more
advanced skills of ultrasonography; develop a research question to investigate aspects of
ultrasonography in inflammatory arthritis using prospective patient enrollment or prospective
reviews of data already collected; develop educational materials and programs to assist with
rheumatology and internal medicine trainees education.
The trainee will undertake the Fellowship between July 1, 2021 to June 30, 2022 at St. Joseph's
Healthcare/McMaster University, which has the availability of senior faculty mentors.

The goals and specific objectives of the R-POCUS Fellowship are to:

• Acquire expertise in the basic skills of ultrasonography in healthy individuals with the
        goal of understanding normal MSK anatomy
• Become familiar in recognizing ultrasonography features of inflammatory arthritis,
        tendonitis, bursitis, synovitis, erosions and enthesitis
• Become proficient in reporting US images
• Learn the technique of US-guided joint injections
• Understand the utility of US in treating to target and in patient education and compliance
        to medications
• Become more familiar with the major unmet research needs in rheumatology POCUS
The achievement of each will be assessed through ITERs

Certification Outcome

Successful completion of the fellowship will be recognized with a Fellowship McMaster Certification.

Entry Requirements

Application Deadline

Six Months prior to start date

Goals of Training

The overall training objectives for the Hospitalist Fellowship Program are:

Medical Expert Role:
By the end of the fellowship program, learners should be able to
• Appreciate the role of musculoskeletal ultrasound to optimize clinical decision-making
and therapeutic management.
• Understand principles of US technology and knowledge of ultrasound equipment to
optimize image quality.
• Know joint anatomy. Perform a standard grey scale and power Doppler ultrasound
scan of the hands, wrists, elbows, knees, ankles, and feet (shoulders, hips). Employ
ultrasound guidance aspiration and injection techniques.
• Recognize typical ultrasound pathology of: Joint effusion; Synovial hypertrophy;
Bone erosion; Tenosynovitis; Enthesopathy; Bursitis; Osteoarthritis; Crystalline
arthritis; Focal Nerve entrapments-median nerve.
• Seek appropriate consultation from other health professionals, recognizing the limits
of their expertise.

Communicator Role:
The learner will have skills to establish rapport with the patients and manage an encounter
The learner will obtain and provide information and explanation in oral and written form to
the patient, families and colleagues.

Collaborator Role:
The learner will participate effectively and appropriately in the interprofessional health care
team and effectively work to prevent, negotiate and resolve interprofessional conflict

Leader Role:
The learner will manage their time to effectively integrate musculoskeletal point of care
ultrasound in their practice.
The learner will allocate finite health care resources appropriately and make decisions that
contribute to a sustainable practice and health care system.

Health Advocate Role:
Learners will develop expertise to advocate for patients to obtain MSK point-of-care
ultrasound to advance the health and wellbeing of patients

Scholar Role:
Learners will demonstrate lifelong commitment to maintain and enhance their
musculoskeletal ultrasound skills. This is done through ongoing practice, reflective learning,
courses/ workshops, critical evaluation of information and its sources.
The learner will facilitate learning of patients, families and other health professionals on
MSK point-of-care US. They may contribute to creation, dissemination, application and
translation of future MSK ultrasound teaching and practices.

Professional Role:
Learners will demonstrate a commitment to ethical practice of MSK ultrasound to their
patients, profession and society.

Additional skills:

• The implementation and completion of an academic research project that includes a literature
review related to a commonly encountered problem, and the implications and the application
of the findings to both the fellow’s current clinical setting and to the practice to which they
will be returning.

• Opportunities to become involved in teaching medical students and clinical clerks

Length of Training

The fellowship program is 12 months in duration, and includes experiential and structured educational components.

Curriculum Highlights

Supervision & Feedback

Associated Programs

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