Nephrology Fellowship Program

2007-2008 Nephrology Fellows
 

 (First row L-R): Margaret Chen, Cara Oliver, Alice Bankson Chang, Irina Vancea
 (Second row L-R): Amy Sussman, Madhavi Mallareddy, Fionnuala Cormack-Aboud, Jimmy Wu
(Third row L-R): Vijay Reddy, Bob Winrow, Michael Tasch, Rudy Rodriguez (Program Director)

PATHWAYS

The Division of Nephrology at the University of Washington offers three training pathways that lead to board eligibility in nephrology:

Advanced Clinical Training
Subspecialist Basic Scientist
Subspecialist Clinical Scientist

We typically accept five first-year fellows, although there is no fixed number of candidates that are accepted into a specific pathway each year. We accept J-1 visa holders into the program but not those holding H-1B visas. Applicants will be asked to indicate on the application which pathway they are applying for. The advanced clinical pathway is a two-year clinical program. The basic and clinical science pathways are three-year programs with a first clinical year followed by two research years. Fellows in all pathways participate in clinical rotations and mentoring. The fellows' weekly schedules list conferences, clinics, and other activities at different training sites.

Candidates are considered and accepted on the basis of their overall qualifications.

The great majority of our graduates of the past ten years now hold academic appointments around the country. A few of them are listed on our Alumni page.

Fellowship Pathways

Advanced Clinical Training

Individuals accepted into this pathway will complete two years of clinical nephrology, including both general nephrology and kidney-pancreas transplantation.  The purpose of this pathway is to train fellows who want to pursue a predominantly clinical and teaching career. During the second fellowship year, a two- to three-month elective period is offered, to focus on topics such as research, radiology, pediatrics, pathology, and community office practice. Upon completion of the program, trainees will be prepared to function effectively as independent nephrologists in an academic or community practice or can pursue a subspecialty fellowship such as Transplant Nephrology or Dialysis.

Subspecialist Basic Scientist

Expectations and benchmarks for trainees
Coursework

Individuals accepted into this pathway undergo one year of intensive clinical training followed by two to three years of basic research training. Most individuals undertaking laboratory research training are supported in their research years by an NIH training grant (Research Training in Renal Disease, Dr. Stuart Shankland, director) and must be U.S. citizens or permanent residents.

Laboratory research training requires two years of basic science training with researchers in the Division of Nephrology and allied divisions and departments in the School of Medicine. Training may be followed by an additional one- to two-year period of basic science training in the laboratory of an alternate basic scientist in the School of Medicine.

Most individuals completing basic science research training seek to pursue academic careers as physician-scientists with independent research laboratories and funding.

The Basic Science Training Program generally follows one year of training in clinical nephrology and consists of:

• Options for formal course work in basic science including molecular biology, statistics, mechanisms of disease, etc. Other topics in related or unrelated fields may be pursued depending on trainee interest.

• Renal research experience. Trainees will work initially under the direct supervision of a faculty member in nephrology doing basic laboratory studies related to mechanisms of renal disease. Emphasis will be on acquisition of basic research laboratory skills, experimental design, data analysis, and an in-depth understanding of the relevant research literature.

• Basic science research experience. There will be the opportunity to supplement renal research training with experience in a basic science department (Immunology, Biochemistry, Pathology, Biologic Structure, and other departments).

• Biomedical research integrity training. In order to retain NIH training grant support, all research fellows at the UW are required to have documented attendance at a series of lectures and workshops on the principles and ethics of research.

Upon completion of the program, trainees will be prepared to function effectively as independent investigators in academic departments and to compete for independent research grant support. Of those who completed training in this track during the past 10 years, 88% are currently in academic positions.

The Division of Nephrology at the University of Washington is internationally recognized for its expertise in a wide range of areas including immunologic renal disease, progressive renal disease, acute renal failure, diabetic nephropathy, and glomerular disease.

Subspecialist Clinical Scientist

Expectations and benchmarks for trainees
Coursework

Individuals accepted into this pathway complete one year of intensive clinical training followed by two to three years of formal training in clinical research. During their research years, most individuals in this pathway are supported by an NIH training grant, available only to U.S. citizens or permanent residents. Clinical research training includes a two-year formal degree program in the UW School of Public Health and Community Medicine leading to either a master's degree in epidemiology (MS) or a master's in public health (MPH). Didactic coursework is combined with a clinical research project under the joint mentorship of a nephrology faculty member and a faculty member in the School of Public Health. Most individuals completing clinical research training seek to pursue academic careers with an emphasis on clinical research and outcomes research.

Several large clinical research projects and trials utilize data from major epidemiology health studies that are headed by faculty at the UW and are currently used by faculty and trainees in our training program. These include the Epidemiology of Diabetes Intervention and Complications (EDIC) study; the Women’s Health Initiative (WHI); and the Multi-Ethnic Study of Atherosclerosis (MESA) to examine diabetes-related dyslipidemia, central obesity related to intensive insulin therapy, and the potential role of vitamin D metabolism in the prevention of diabetes; the Diabetes Prevention Program Outcomes Study (DDOPS); the long-term follow up of the Diabetes Prevention Program (DPP) cohort; the Look Ahead (Action for Health in Diabetes); and the database for the Japanese-American Community Diabetes Study. Faculty are well funded, with a broad range of research interests to help trainees launch research careers in diabetic kidney disease.

The Clinical Science training program will follow one clinical year of largely inpatient nephrology training and consists of:

• Formal coursework leading to a master's degree in epidemiology (MPH or MS) with emphasis on epidemiology, biostatistics, data management, and research design. Topics in other fields may be pursued depending on trainee interest (e.g., pharmacokinetics). 

• Hands-on clinical research experience. Under the combined mentoring of an epidemiologist and a nephrologist, the trainee will design and carry out a clinical study on an important nephrologic topic. Present trainees are pursuing topics in atherosclerosis and cardiovascular disease in renal failure, the effects of uremia and bone disease, and other areas.

• Seminars and tutorials in research design, research methodology, and statistical methods will focus on the specific studies the trainees are conducting to provide immediate and ongoing review of projects in progress.

• Biomedical research integrity training. In order to retain NIH training grant support, all research fellows at the UW are required to have documented attendance at a series of lectures and workshops on the principles and ethics of research.

Given the current high level of interest in clinical research training, the faculty within the School of Public Health and Community Medicine is a critical resource for our program. The School is the only accredited school of public health in the Northwest and is highly regarded nationally. There are five departments within the School: Biostatistics, Environmental and Occupational Health Sciences, Epidemiology, Health Services, and Pathobiology. Extensive interdepartmental and inter-school collaboration for research and training provides students with expertise in a broad range of public health problems. The School has 248 regular faculty. In Autumn Quarter 2004, the School had 785 enrolled students in all its programs. It offers both master’s and PhD-level training in epidemiology and biostatistics. Courses in the Department of Epidemiology provide a rigorous introduction to both observational studies and randomized controlled trials, primarily as they relate to investigation of disease etiology, evaluation of diagnostic and screening tests, therapeutic intervention, and disease prognosis. Courses in the Department of Biostatistics cover quantitative techniques for analysis of data from medical studies: statistics, principles of estimation and hypothesis testing, sample size, evaluation of statistical significance, and survival analysis.

Integration with the renal training program: The clinical science fellows in the renal division have a well-defined pathway how they are integrated into the School of Public Health for their Master’s degree. To date, 18 renal trainees have entered this program. Several faculty have served as mentors for renal trainees, such as Noel Weiss, PhD, Scott Davis, PhD, Scott Emerson, PhD and Bruce Psaty, MD.

Upon completion of the program, trainees will be prepared to function effectively as independent investigators and teachers in clinical research and epidemiology, in nephrology, and in academic or public health environments. Of those who completed clinical science training, 88% are currently in academic positions. One hundred percent our trainees have obtained an MS or MPH degree during their training.