A respected rheumatologist for more than 44 years who helped found Touro University Nevada College of Osteopathic Medicine, serving as its dean for 12 years, Dr. Mitchell Forman has pretty much seen and done it all. So, when he says he’s extraordinarily proud of the Kirk Kerkorian School of Medicine at UNLV’s new rheumatology fellowship, you’d better believe it’s a pretty big deal.
“Every time I say this, it gives me a little shiver,” says Forman. “This is the first ever rheumatology fellowship in Nevada, that sentence is just amazing to me.”
As rheumatology fellowship director, Forman, with the help of several key people, developed the infrastructure and helped navigate the program through the accreditation process. In January, it received approval from the Accreditation Council for Graduate Medical Education (ACGME). Critical documents and multiple agreements had to be hammered out, the process took 14 months. But with the ACGME’s approval, the first two rheumatology fellows in Nevada history can begin work in July.
Both Forman and Dr. Kate Martin, associate dean of graduate medical education (GME), credit staff members, as well as people in the community, for making it possible. “Ultimately, what made this fellowship program happen was all of us,” says Martin. “And that is exactly what will keep it going for years to come.”
The fellows (two the first year, and two more the second year) will rotate at the school of medicine’s affiliated hospitals, including VA of Southern Nevada Healthcare System in specialties including dermatology, physical medicine and rehabilitation, orthopaedics, and radiology/ultrasonography. “They have a different patient population than we typically see, which will allow the fellows to become very well rounded. The VA also has a history of being involved in our residency programs, so we have a connection with them.”
The fellows will also work alongside local pediatric rheumatologist Dr. Robert Lowe, one of only two full-time pediatric rheumatologists in the state. “Dr. Lowe is an extraordinary individual who’s very happy to become part of this program,” says Forman. “Our fellows will rotate with him for about a month in his office under his supervision, and see patients so they become familiar with the more specific issues addressing children who develop rheumatic diseases.”
Rheumatologists typically treat people living with many different types of arthritis, including the crippling effects of rheumatoid arthritis and psoriatic arthritis. They are also specially trained to diagnose and treat autoimmune diseases such as systemic lupus erythematosus (SLE). “I recently looked, and it’s hard to believe the numbers,” says Forman. “We have 29 rheumatologists in Clark County, serving a population of more than 2.3 million people. Some of my patients have had to wait six to eight months to be seen … that is absurd.”
One of the reasons Southern Nevada lacks specialists in many different areas is a lack of residency and fellowship training programs. The school of medicine currently operates more than 20 graduate medical education programs, but in Nevada, there are no programs for dermatology, ophthalmology, neurosurgery, urology, or hematology/oncology. As Forman puts it, the new rheumatology fellowship “will allow us to attract, train, and retain more physicians … I like to say: we can grow our own.”
“This fellowship is a drop in the bucket, but it shows that we can do this,” Forman says. “Good people get together, supported by a very active administration, they can make this happen.”
Forman, now in the midst of his second term as president of the Clark County Medical Society, is quick to give credit to the recently hired chief of rheumatology at UNLV Health. “When Dr. Winn Chatham arrived, he was very helpful, adding a level of experience in submitting a document that really expressed the quality of our soon-to-be program. Also, the Governor's Office of Science, Innovation, and Technology brought this program to life with their financial support and belief in the value of our program. And the VA leadership of Southern Nevada pledged their future support of the fellows' training when grant funds end. Additionally, residency program director Dr. Aditi Singh played a critical role, along with Ms. Katina Shehie.”
But it all began with a timely donation from a generous member of the community. “The donor that got the grant started provided funding to move us forward before other funding sources became available, and that was vital,” Forman says. “Having more people get involved in this way would make it feasible for many other fellowship programs that we desperately need.”
