Program Overview

Nephrology Pathways

The fellowship program consists of 7 fellows; each year we match 3-4 fellows. All fellows match into the clinical pathway. After six months of training, selected individuals may quality for the research pathway. On average, one research trainee is selected each year.

Clinical Pathway

The clinical pathway is appropriate for individuals interested in clinical nephrology in either the private or academic setting. Fellows who have completed this track have pursued further training in transplantation, glomerular disease, and interventional nephrology. This track is also appropriate for those interested in a career as a clinician educator.

Research Pathway

The research pathway is dedicated to candidates who are committed to a research career and are deemed by faculty to have great potential to succeed in the scientific arena. Two years of research are required after completing one year of intensive clinical training. A half-day per week continuity clinic is maintained throughout the fellowship. Trainees on this track must qualify for research funding, often through a T32 NIH training grant.

Individuals may pursue either clinical or basic science research in molecular and cell biology, immunologic, genetic, and translational aspects of kidney disease. Fellows interested in clinical research may pursue the Masters of Public Health degree through the UNC Gillings School of Global Public Health.

Clinical Training

Clinical training consists of 5 rotations and a weekly continuity clinic.

Hospital consultative nephrology

This is the core rotation of the fellowship, comprising about 40% of the clinical training. Two fellows are assigned to this rotation at any one time. One fellow primarily sees new consults and ICU patients, and the other fellow sees hospitalized patients on services other than the inpatient nephrology service outside the critical care setting.

Subspecialty rotation

This is an outpatient rotation consisting of experience in the hypertension, transplant, kidney stone, vasculitis and glomerular diseases clinics.

Outpatient dialysis/Interventional Nephrology

Fellows rotate with an attending nephrologist through outpatient dialysis units usually in 2 week blocks. Fellows see patients in the Peritoneal Dialysis Clinic one day per week, where approximately 15 patients are seen each clinic session. Fellows evaluate and manage patients at the outpatient interventional nephrology clinic once weekly at Carolina Vascular Access.

Kidney biopsy rotation

This rotation is integrated with subspecialty rotations. One to two days per week during these rotations are devoted to performing biopsies in native and transplanted kidneys.

Research/Elective

This experience is generally limited to fellows in the clinical training pathway as research trainees will devote 2 years to research. 8-10% of the clinical fellowship is devoted to time for clinical fellows to complete projects that may range from case reports or review articles to analysis of clinical data, presented as an abstract or original research manuscript.

Continuity clinic

Fellows see approximately 8 patients per session (6 return and 2 new patients). This occurs weekly throughout the fellowship.

Call

Clinical fellows take every other day overnight home call only when on the inpatient consult service (average of 16 weeks/year), with each block lasting 1-2 weeks at a time. The inpatient consult service is made up of two fellows who cover the ICU and Floor patients respectively. A third fellow covers inpatient transplant consults Monday through Friday, but does not take any call. During all other rotations, there are no weekday or weekend call responsibilities.

Research fellows will take approximately 18-20 weeks of call during their clinical year and do not have any call responsibilities during their subsequent two research years.

Curriculum

• Acid-base disorders
• Basic renal immunology
• Basic renal physiology
• Diabetes mellitus and diabetic nephropathy
• Dialysis
• Divalent cation metabolism, renal osteodystrophy, nephrolithiasis
• Ethics and professionalism
• Fluid and electrolyte disorders
• Glomerular diseases
• ICU nephrology
• Inherited diseases of the kidney
• Kidney transplantation
• Obstructive nephropathy
• Pathophysiology and epidemiology of hypertension
• Pharmacology of drugs and renal disease
• Regulatory and business issues in nephrology practice
• Renal disease and pregnancy
• Renal function testing
• Research design and methods
• Tubular interstitial disease
• Urinary infection

Conferences

Weekly Divisional Journal Club

Faculty and fellows are assigned to present one article two times per year on a rotating basis.

Hypertension Journal Club

Hypertension faculty meet with fellows bimonthly to review and discuss the literature in the field of hypertension.

Nephrology Fellows Conference

This is a weekly conference devoted to fellow education covering the full spectrum of clinical nephrology.

Clinical Case Management Conference

A bimonthly conference during which interesting or challenging cases are reviewed by fellows and clinical faculty.

Professional Development Seminars

These are monthly meetings devoted to exploring issues in professional development such as end of life care, ethics, considerations in choosing a private practice, the business of medicine, patient safety, CV preparation, and shared career experience.

Nephropathology Conference

The Division of Nephropathology meets with faculty and fellows on a weekly basis to review both internal and referred kidney biopsy cases.

Conference Schedule