Rheumatology Milestones 2.0: A Roadmap for Competency-Based Medical Training of Rheumatology Fellows in the 21st Century.

Objective: Since 2014, rheumatology fellows have been assessed not only based on their ability to provide patient care and possession of medical knowledge but also on their skill in serving as patient advocates, navigators of health systems, and members of a health care team. Such assessments have been carried out through the use of competency-based milestones from the Accreditation Council of Graduate Medical Education (ACGME). However, a needs assessment has demonstrated interest in more context validity and subspecialty relevance since the development of the ACGME internal medicine (IM) subspecialty reporting milestones.

Pauci-immune Glomerulonephritis in Systemic Lupus Erythematosus (SLE).

Glomerulonephritis (GN) in lupus is generally an immune complex glomerulonephritis from the deposition of immunoglobulin and complements. Pauci-immune GN is the most common cause of rapidly progressive GN and is frequently associated with an anti-nuclear cytoplasmic antibody (ANCA). We report a patient with a history of systemic lupus erythematosus who presented with worsening proteinuria and was subsequently diagnosed with pauci-immune GN on renal biopsy, in the absence of ANCA.

Outcomes of hydralazine induced renal vasculitis.

Objective: Hydralazine has been implicated as an etiologic agent for lupus-like syndrome and vasculitis. Hydralazine-induced vasculitis frequently affects the kidney, but the long-term renal outcomes in these patients have not yet been studied.

Methods: Patients who had a diagnosis of ANCA-associated vasculitis (AAV) and were on hydralazine at the time of AAV diagnosis were included in this retrospective cohort study.

Moral erosion: how can medical professionals safeguard against the slippery slope?

The extensive participation of German physicians in the atrocities of the Holocaust raises many questions concerning the potential for moral erosion in medicine. What circumstances and methods of rationalisation allowed doctors to turn from healers into accomplices of genocide? Are physicians still vulnerable to corruption of their guiding principles and, if so, what can be done to prevent this process from occurring? With these thoughts in mind, the author reflects on his experiences participating in the Fellowships at Auschwitz for the Study of Professional Ethics program and offers a medical student's perspective on the ethical issues encountered in clinical training and the practice of medicine.