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Clinical Service

Rheumatology Clinical Activities at the University of Michigan

The University of Michigan Hospitals and Health System has established a series of Primary Care and General Internal Medicine satellites in South-Eastern Michigan that generate a large volume of referrals to our ambulatory clinics and hospital. In addition we serve as the tertiary referral center for our entire region of approximately 10 million residents. Patients are also referred from more distant parts of the United States.  This combination of a local and regional referral pattern ensures that we are able to offer our Fellows exposure to the entire spectrum of clinical Rheumatology from prevalent rheumatic diseases to rare and complex multi-system autoimmune diseases.

We operate ambulatory care clinics both at our central medical campus location as well as in several satellite clinics in Ann Arbor and other locations, seeing over 20,000 outpatients annually. We manage the complete spectrum of joint-based diseases, regional and non-inflammatory musculoskeletal disorders, as well as patients with complex systemic diseases. We also staff a weekly clinic at the Ann Arbor VA Medical Center (2000 visits per year). The VA hospital clinic offers a somewhat different disease spectrum than the University Clinics, assuring familiarity with patients of all demographic groups.

We provide inpatient care through a busy consultation service, seeing patients admitted to General Internal Medicine and other clinical services. Most patients are seen in the 565-bed adult acute care general University Hospital but we also see patients at the nearby Ann Arbor VA Hospital. We evaluate approximately 20 new inpatients per week and maintain a census of 10-15 patients that are seen each day.

Examination of synovial fluid by polarized-light microscopy is performed using our own equipment and is encouraged for all specimens aspirated. Fellows are also trained in nail-fold capillary microscopy and have the opportunity to become trained in needle muscle biopsy, minor salivary gland biopsy and musculoskeletal ultrasound using our own equipment (ATL/Phillips HDI 4000) in a dedicated clinic through which Fellows rotate.

Pediatric Rheumatology

There is a very active pediatric Rheumatology unit at the Univ. Michigan directed by Barbara Adams, M.D. We work closely with our pediatric colleagues, including sharing educational activities and giving our Fellows experience in the pediatric Rheumatology outpatient clinics. We also offer combined training in both adult and pediatric Rheumatology and have successfully trained several dual-program graduates. This requires considerable co-ordination and if you are interested in dual adult/pediatric rheumatology training we urge you to contact us directly as early as possible.