LSU Program Offers Novel Approach to Combat Rheumatology Workforce Shortage
A new training program at Louisiana State University is pioneering a solution to the growing shortage of rheumatologists, particularly in underserved rural areas.
CHICAGO — A novel program at Louisiana State University (LSU) is offering a potential pathway to address the critical shortage of rheumatologists, especially in rural communities, according to presentations at ACR Convergence 2025. The program focuses on securing financial support from rural hospitals in exchange for a commitment from fellows to practice in those areas post-training.
“What we tried to do was look at a different way of improving the number of rheumatologists,” explained a senior official from LSU Health Science Center New Orleans.
To tackle the ongoing scarcity of rheumatologists in rural regions, LSU has expanded its fellowship program by adding one fellow to its existing two ACGME-accredited slots each year. This expansion is funded through contracts with rural hospitals – both domestically and internationally – which provide financial backing for the fellow’s training. In return, the fellow pledges to practice at a sponsoring institution for a predetermined period.
The initiative stemmed from a specific need identified in Louisiana. “I got called by one of the rural hospitals in Louisiana where they had a wait time of 18 months,” recounted a program leader. “There was a woman there in an internal medicine program who wanted to go to rheumatology, and they were asking if there was some way I could get her into our program.”
Working with university administrators, a deal was struck: the woman would complete a two-year fellowship at LSU and then commit to practicing at her local clinic for at least three years. “That worked,” the leader stated. “She is now seeing patients and helping that community. They paid for it instead of working with CMS.”
LSU has since replicated this model with an internal medicine student destined for a rural area of Idaho, where the nearest rheumatologist is over 200 miles away. “We have a need, we identify a person who is from the area who wants to help, and we train them,” the leader said. “In this way, we can help our rheumatology workforce.”
A retrospective cohort study was conducted to assess the program’s impact on patient care. The results, presented at ACR Convergence, revealed a 3.7-fold increase in yearly referrals to the LSU clinic, rising from 1,139 in 2015 to 4,218 in 2024 (P < .05).
Between 2023 and 2025, LSU trained five rheumatology fellows, enabling them to see a total of 8,052 patients. This represents a significant increase compared to the 4,568 patients seen by four fellows between 2019 and 2021, and the 6,125 patients seen by four fellows between 2021 and 2023.
Notably, the clinic doubled the number of new patient consults from 1,072 (2019-2021) to 2,134 (2023-2025) during the period with five fellows (P < .05). “When we had five fellows, we markedly improved our local community in New Orleans,” the leader emphasized.
Researchers also observed increased trends in outpatient prescriptions, corticosteroid injections, and infusions during the years with five fellows. Furthermore, the average wait time for a patient appointment was significantly reduced, from 118 ± 16 days before 2017 to 47 ± 13 days (2017-2019) and 53 ± 15 days (2023-2025) (P < .001).
Pavana Sakhamuri, MD, of the LSU Health Sciences Center in Lafayette, was the first fellow to participate in the program.
“I never expected this,” she shared. “I thought it would be a big process and take a long time.” However, with the support of program leadership, the necessary arrangements were made quickly, she noted.
Dr. Sakhamuri offered encouragement to medical students interested in rheumatology who may face obstacles to entering the field. “It is possible,” she advised. “You just have to call your program director and tell them you would like to stay back and practice in your area. Let them know there is a plan for this.”
Looking ahead, the program leader expressed optimism about expanding the model. “I think we can expand it,” he said. “I think we can find 10 programs around the country who would be willing to do this.”
For more information, Stephen Lindsey, MD, MACR, can be reached at [email protected], and Pavana Sakhamuri, MD, can be reached at [email protected].
Source: Lindsey S. Abstract 1069. Presented at: ACR Convergence 2025; Oct. 24-29, 2025; Chicago.
Disclosures: Lindsey and Sakhamuri report no relevant financial disclosures.
