Pediatric Rheumatology is one of the newest and smallest of the pediatric subspecialties. The specialty focuses on musculoskeletal and autoimmune diseases of childhood, of which the most common is juvenile rheumatoid arthritis. Serving this population of children are fewer than 200 board-certified pediatric rheumatologists in the United States. All but a handful of these are clinicians who do not engage in research. There are only five centers with three or more faculty;at least 60 medical schools have no pediatric rheumatologist on their faculty. Although there is a well-recognized need to train more pediatric rheumatologists, especially physician scientists, there exists only one NIH-funded training program in pediatric rheumatology, to our knowledge. As a result, few pediatric rheumatologists have had research mentorship and academic role models and they lack the skills to perform cutting edge research. The Division of Pediatric Rheumatology at the Children's Hospital of Pittsburgh, with substantial and sustained institutional support, has as its goal the creation of a national center of excellence for Pediatric Rheumatology offering comprehensive, state-of-the-art clinical care, educational programs, and competitive research involving clinical, translational, and basic sciences. One of our central missions is to educate a new generation of academic pediatric rheumatologists who can play a leading role in the specialty as physician scientists. We intend to do so by providing, within a single center, the research role models, mentorship, and rich environment necessary for nurturing such individuals and ensuring their success. The Program seeks to train 2 fellows in each year of training. While many of the pediatric rheumatic diseases are distinct from those seen in adults, there are pathophysiologic pathways common to both, as well as to other autoimmune diseases and other processes involving aberrant immune responses. Therefore, our philosophy has been to pursue a multidisciplinary approach. This strategy has been successful and productive in the past. The proposed Training Program is structured to offer trainees the opportunity to interact with research faculty in the pediatric and adult rheumatology divisions and the broader immunology community within the medical center. Program Faculty have been chosen who have external funding, who excel in mentoring trainees, and whose research falls into one of four categories: (1) studies in pediatric rheumatic diseases, (2) studies in rheumatic diseases in general (both pediatric and adult), (3) studies in animal models of autoimmunity, and (4) immunobiological studies judged to be of relevance to the pathophysiology of pediatric rheumatic diseases. A number of faculty are involved in research spanning more than one of these categories.
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