Nephrology and Hypertension

Fellowship Information

The mission of the Division of Nephrology and Hypertension and The Kidney Institute is to educate and train physicians to become clinical skilled Nephrologists and Physician Scientists.

The Division of Nephrology & Hypertension offers two training options: 1) A two-year clinical fellowship and 2) a three-year combined clinical and research fellowship. The Fellowship Program is accredited by the ACGME (Accreditation Council for Graduate Medical Education).

Two-year Fellowship Track.

This program comprises twenty-four months of clinical training and research experience, which allows the physicians the choice to pursue Nephrology in either academic or clinical settings.

The rotations in Nephrology are divided between the University of Kansas Medical Center and the Kansas City Veterans Affairs Hospital. These include inpatient and outpatient, renal dialysis, transplant and research. The first year is almost entirely clinical in orientation, during which time the Nephrology trainee learns skills related to salt and water, acid-base metabolism, dialysis methodology, renal biopsy and histology interpretation, renal consultation and general nephrology.

Upon successful completion of the first year, the fellows are invited to spend a second year engaged in both consultative Nephrology and research activities. The exact blend of time in each activity is tailored to meet the individual fellow's career goals. These clinical experiences provide excellent learning opportunities for physician-scientists in their clinical year of training, as well as the occasion to see interesting Nephrology problems, follow patients for prolonged periods and recruit patients for research studies. The success of the clinical training program is evidenced by the 100% pass rate for national board examinations in Nephrology for all clinical trainees in our program taking the ABIM certifying examination.

The Division of Nephrology has 6 full-time faculty members at the KU Med Center and two faculty at the Kansas City Veterans Affairs Hospital. Four of the KUMC staff nephrologists have been chosen Outstanding Doctors of America. KUMC also has the highest 3-year success rate for kidney transplant survival among all of the transplanting centers in Kansas, Missouri, Nebraska and Iowa.

Malpractice insurance, Nephrology textbooks, parking, trips to meetings, as well as three weeks vacation are provided each Renal Fellow.

The primary objective of the research track is to train clinical and academic nephrologists.

Three-year Research Program

The research track is designed to provide a multidisciplinary environment and training opportunities for postdoctoral trainees who wish to develop excellence in biomedical research in Nephrology and to purse a career in academics.

Clinical Year. For physicians the training program will include one year of clinical training (not supported by a National Research Service Award) in Nephrology and 2-3 years of training in investigative nephrology. The clinical training year will consist of 12 monthly rotations devoted to acquiring skills in the diagnosis and management of clinical problems in Nephrology and kidney transplantation in accord with the appointment of the trainee as a clinical fellow in the Division of Nephrology.

Research Years. During this time, M.D. trainees will have 85-90% of their time protected to pursue research initiatives. Trainees in the 2nd and 3rd years of the program are expected to spend approximately ½ day/week in clinics or the outpatient hemodialysis units to maintain clinical skills and, where appropriate, attract a population of patients for clinical research activities. During this period of time, however, they will not participate in the management of the inpatient or consultative services at KUMC or at the VA. A small clinical commitment (10-15%) is important to allow them to maintain their clinical nephrology skills, to facilitate the translation of ideas to and from the bench to the bedside, to maintain a continuity clinic as required by the ACGME, and to allow contact with nephrology colleagues, the latter being especially important for trainees working with preceptors in other departments.

There are two distinct programs for the research years:

1. Clinical research/outcomes-Masters degree program
   
   For trainees interested in clinical research, our program will interface with the degree-oriented training program in the area of health services research, and we will take advantage of the existing strong clinical research programs and initiatives at KUMC. Central to the Nephrology Clinical Research Training program is the core didactic curriculum for postdoctoral trainees leading to a Master's of Science in Clinical Research degree conferred by the University of Kansas. This program is directed by Dr. Jasjit S. Ahluwalia, one of our training program faculty.
   
   The Clinical Research Training Program provides formalized academic training in the quantitative and methodologic principles of clinical and health services research. The program offers formal courses in research design, advanced epidemiologic methods, grant writing, research ethics, statistical analysis, decision analysis, research ethics, and research management (see Appendix for detailed course description). Additional courses are offered in nonparametric analysis, statistical computing using SAS and Clinical Trials. We will strongly encourage M.D. fellows without prior Master's degrees to obtain the Master's in Clinical Research. Requirements for the degree include 33 hours of course work, some of which can be taken on-line. The program is designed for part-time study, allowing the trainee to integrate the program's academic training with their clinical research training. A thesis is required for the MS degree.
   
   The Master's in Public Health Program is directed by Dr. Won S. Choi, one of our training program faculty. The MPH program is nationally accredited by the Council on Education for Public Health. The program is designed to prepare fellows to develop and apply individual and population-based approaches as a basis for academic evaluation of clinical issues related to nephrology. MPH skills may be used to assess health characteristics and risk factors in populations; plan, implement and evaluate an intervention to improve the health of a population; conduct research and evaluate health outcomes; incorporate preventive practices into care of individual patients; investigate outbreaks of disease or symptoms in populations; and use appropriate data to formulate public policy. A Practicum is required for the MPH degree.
   
   
2. Traditional basic science research track. The traditional strength of our training program resides in our exceptional basic science research opportunities. Prospective fellows will interview with the senior/lead preceptors during their clinical year and select a specific project and mentor to work with during their second and third years of training. The general training plan for each fellow will be tailored to their area of interest. Research projects are chosen with guidance from the lead preceptor and the specific mentor, and generally reflect an aspect of basic research that is directly applicable to the clinical interests of the fellow. Current areas of opportunity include mouse genetic models of human diseases, transcriptional control mechanisms, hereditary kidney diseases including Polycystic Kidney Disease and Focal Segmental Glomerulosclerosis, hormonal abnormalities in CKD including investigations of FGF23 and calcium sensing receptor function, biochemistry and signal transduction, disorders of mineral metabolism, transport physiology, renal development and podocyte biology.
   
   The basic research training occurs in the Kidney Institute (KI). The KI, established in 2000, provides just such an interdisciplinary environment. With 32 faculty members the training environment is rich and diverse and fosters cross-training of biomedical researchers and translational research programs. The KI is closely linked to the Division of Nephrology in the Department of Medicine and serves, on the one hand, as the research component of the Division as well as providing an organizational structure reporting to the Dean that coordinates kidney-related research at the institutional level. The success of this organizationis reflected by the significant growth of research funding within the Kidney Institute over the past several years.