During fellowship, fellows will be expected to present at least once during the annual ACR conference and have at minimum one published peer-reviewed article in a rheumatology journal of their choice. Case reports are encouraged; however, they may not be a substitute towards the above requirements. The program values strong understanding of quality improvement methodology and continuous improvement through data driven feedback. QI projects are encouraged; however, the program acknowledges near universal institutional systemic limitations of sustained project implementation and are not a strict requirement for graduation. Fellows will have the opportunity to work with faculty and will work closely with Delaware ACCEL CTR (https://www.de-ctr.org/) for grant funding and collaboration. Fellows will be integrated into Delaware’s research community and engage with research talent with University of Delaware, Nemours Children’s, and Delaware State University.