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Penn Nephrology Fellowship

Overview

Our fellowship training program provides a comprehensive experience of the full spectrum of clinical nephrology. Our fellows have tremendous opportunities to learn nephrology. They care for patients with a variety of kidney and fluid-electrolyte disorders in diverse clinical settings alongside faculty who are truly committed to fellow education. We accept six or seven fellows each year, with applicants choosing between a two-year clinical track and a three-year research track. The clinical track prepares fellows for a career in clinical nephrology, whether in private practice or in an academic clinical position. The research track is designed for fellows who want to pursue research-oriented careers in academic nephrology. The goal of the research track is to provide fellows with the knowledge and skills to become independently funded investigators in basic science, translational, or patient-oriented research, clinical epidemiology, or public policy.

First Fellowship Year

All first year fellows, regardless of track, rotate through inpatient services at the Hospital of the University of Pennsylvania (HUP), Penn Presbyterian Medical Center (PPMC), and the Philadelphia VA Medical Center (PVAMC), each of which provides a diverse clinical experience spanning the spectrum of clinical nephrology and dialysis. There is ample opportunity to gain experience in performance of kidney biopsies and placement of dialysis catheters. Fellows also spend one-half day per week in a supervised continuity clinic, gaining experience and expertise in the care of ambulatory patients with a wide variety of kidney diseases. Each fellow also has four weeks of elective/ambulatory time during the first year, one week of which is devoted to the HUP

Plasmapheresis Service. This elective time gives fellows an opportunity to spend time in any of the HUP specialty clinics (Stone Clinic, Lupus/GN Clinic, Complex Hypertension Clinic, Transplant Clinic, etc.), in GU Radiology, at Children’s Hospital of Philadelphia (CHOP), or in our out-patient dialysis facilities, which include experience in in-center hemodialysis (including nocturnal hemodialysis), peritoneal dialysis, and home hemodialysis.  This time is also used to meet with faculty to begin planning for research activities during the 2nd and 3rd years of training. Specific rotations during the first year are shown below:

First Year Fellowship
Inpatient Service HUP - ICU 14-16 weeks
Inpatient Service HUP - Consult/Primary 8-10 weeks
Inpatient Service HUP - Transplant 8 weeks
Inpatient Service PPMC 6-8 weeks
Inpatient Service VA 4-6 weeks
Continuity Clinic HUP 1/2 day weekly for the year
Outpatient Elective (includes one week on HUP Plasmapheresis Service) HUP/other locations 4 weeks
Vacation   4 weeks

Second Fellowship Year

All second year fellows, regardless of track, continue with their one-half day per week continuity clinic and have dedicated ambulatory experiences in out-patient hemo- and peritoneal dialysis and kidney transplant clinics, including both pre-transplant evaluation and post-transplant follow up. Details of some of the clinical experiences for all second year fellows are below:

Second Year Fellowship
Continuity Clinic (HUP) 1/2 day weekly for 1 year
Outpatient HD 1/2 day weekly for 6 months
Outpatient PD 1/2 day monthly for 6 months
Post-transplant Clinic 1/2 day weekly for 3 months
Vacation 4 weeks

Clinical Track

The second year of training for fellows in the Clinical Track allows fellows to refine their clinical skills and expertise and prepares them for independent practice. Fellows continue on the in-patient services for part of this year, with increasing independence, and have opportunities to gain additional experience in performance of kidney biopsies and in a variety of ambulatory settings. Clinical track fellows are also expected to participate in one or more scholarly and Quality Improvement projects with faculty mentors.

Clinical Fellows
Inpatient Service 10-14 weeks
Scholarly and QI Projects 25-30% time
VA Ambulatory Clinic 1/2 day weekly
Interventional Radiology 1 week
Clinical Fellows (Electives)
  • Lupus/GN Clinic

  • Home Hemodialysis

  • Peritoneal Dialysis

  • Pediatric Nephrology (CHOP)

  • GU Radiology

  • Complex Hypertension/Endocrine

  • Hypertension Clinic

  • Transplant Clinic

  • Stone Clinic

Research Track

Research track fellows spend two (or more) years developing research skills and working on their research projects under the mentorship of Penn Nephrology faculty mentors. Many research track fellows will also have mentors outside the Division from among the Penn medical and scientific community. Research areas of Division faculty members include basic and applied immunology, podocyte biology, renal genetics and cancer, transplantation, hypertension, kidney development and structural biology, and cardiovascular disease in CKD. There are ongoing clinical and clinical epidemiology/outcomes research programs in CKD, hypertension, and renal transplantation. Research track fellows who do not choose to work in a basic science laboratory apply for the Master

of Science in Clinical Epidemiology (MSCE) program http://www.cceb.upenn.edu/education/epi-degree/msce.php.

Research track fellows continue to participate in general nephrology continuity clinic and to a limited extent in inpatient services (see below):

Research Fellows
Inpatient Service 2-4 weeks
Research Classes/Projects 75-80% time
VA Ambulatory Clinic None
Interventional Radiology 1 week (optional)

Conferences

The fellowship year begins with a two day seminar in early July for first year fellows from Penn and other programs in the Philadelphia region that provides some of the basic "nuts and bolts" concepts that are important for beginning fellows in areas of hemodialysis, continuous dialysis, peritoneal dialysis, dialysis access, acid-base and fluid-electrolyte disorders, CKD management, nephrotic syndrome and other glomerular diseases. This is followed by our Summer Physiology, Pathophysiology, and Histopathology program. After the summer, our regular conference schedule includes Renal Grand Rounds, Physiology Conference, Core Topics Conference, Dialysis Conference, Research Conference, Journal Club, Fellows Case Conference, and Transplant Conference.

DIVERSITY

The Renal-Electrolyte and Hypertension Division at the University of Pennsylvania is committed to the highest quality of patient care, research and education.  We recognize the need for and importance of recruiting qualified women and individuals from underrepresented minority groups in biomedical sciences generally, and in academic nephrology in particular, where there is a well-documented disproportionate impact of renal disease on minority populations. We strive to recruit and retain physicians and other health care professionals who represent our diverse patient population and who will strengthen the quality of our program and enhance our overall clinical, research and educational mission.  We are committed to recruiting and training women and underrepresented minorities who will assume faculty positions and become leaders in academic medicine. If you are an underrepresented minority or a disabled applicant or culturally, socially and/or economically disadvantaged applicant, we strongly encourage you to apply to our fellowship program.  To ensure long-term success, we provide a supportive, inclusive environment for training that includes one-on-one mentoring.  If you have any questions or concerns about your application or eligibility, please do not hesitate to contact our Fellowship Program Director, Dr. Jeffrey Berns, or the Fellowship Program Coordinator, Nancy Wells, or the Division Chief, Dr. Larry Holzman.  We want to make every effort to include you in the group that we interview and consider you for the fellowship match.  Contact information for Dr. Berns, Nancy Wells and Dr. Holzman are as follows:

Dr. Jeffrey Berns

Phone:  215-662-2638

Fax:  215-615-0349

Jeffrey.berns@uphs.upenn.edu

Nancy Wells

Phone:  215-615-1677

Fax:  215-615-1688

Nancy.Wells@uphs.upenn.edu

 Dr. Lawrence Holzman

Phone: 215-573-1840

Fax:  215-898-0189

lholzman@mail.med.upenn.edu

Diversity in the Renal-Electrolyte and Hypertension Division

Objectives:

The Renal-Electrolyte and Hypertension Division at the University of Pennsylvania is committed to the highest quality of patient care, research and education. We recognize that in order to achieve these objectives it is necessary to recruit and retain physicians and other health care professionals who represent our diverse patient population.  With this recognition in mind we are committed to:

  • The recruitment and retention of underrepresented minorities at all levels in the Renal-Electrolyte and Hypertension Division
  • Career development and mentorship of current underrepresented minority fellows and faculty
  • Establishment of a “pipeline” to ensure that underrepresented minority students and residents, clinical fellows, post-doctoral research fellows and junior faculty have appropriate mentorship and guidance for career advancement
  •  Fostering research in multicultural Renal related health issues, outcomes and policy;
  • Coordinating efforts with the university, medical school and hospital to increase and retain underrepresented minority faculty

University of Pennsylvania Links:

The Office for Diversity and Community Outreach in Undergraduate Medical Education (http://www.med.upenn.edu/diversityume/)

Office of Diversity and Community Outreach (http://www.uphs.upenn.edu/internal-medicine-residency/)

The Biomedical Postdoctoral Council Diversity Committee (http://ldi.upenn.edu/sumr)

University Council statement regarding Recruitment and Retention of Minority Faculty and Students (http://www.upenn.edu/almanac/v45/n25/minority.html)

Ernest E Just Biomedical Society (http://www.med.upenn.edu/eejust/about.shtml)

Penn Center of Excellence for Diversity in Health Education and Research (http://www.med.upenn.edu/pcedher/)

External Links:

Association of American Medical Colleges (URM Definition) (https://www.aamc.org/initiatives/urm/)

Suggested Reading Material:

Science 2011 Aug; 333: 1015-1019 (https://www.med.upenn.edu/gastro/documents/RaceEthnicityandNIHResearchAwards.pdf)

J Natl Med Assoc. 2008 Sep;100(9):1084-7 (http://www.ncbi.nlm.nih.gov/pubmed/18807440)

JAMA. 2000 Sep 6;284(9):1085-92 (http://www.ncbi.nlm.nih.gov/pubmed/10974686)

J Womens Health Gend Based Med. 2001 Jul-Aug;10(6):541-50 (http://www.ncbi.nlm.nih.gov/pubmed/11559451)

J Natl Med Assoc. 2006 Sep;98(9):1435-40 (http://www.ncbi.nlm.nih.gov/pubmed/17019910)

Basken, Pau. "NIH Considers Anonymity for Grant Applicants" The Chronicle of Higher Education.10 Dec 2012. (http://chronicle.com/article/NIH-Considers-Anonymity-for/136227/ )

Pololi L et al. The Experience of Minority Faculty Who Are Underrepresented in Medicine, at 26 Representative US Medical Schools. Academic Medicine Vol. 88, No. 9 September 2013. (http://journals.lww.com/academicmedicine/Abstract/2013/09000/The_Experience_of_Minority_Faculty_Who_Are.36.aspx

Sanchez JP et al. Racial and Ethnic Minority Medical Students' Perceptions of and Interest in Careers in Academic Medicine. Academic Medicine Vol. 88, No. September 2013. (http://journals.lww.com/academicmedicine/Abstract/2013/09000/Racial_and_Ethnic_Minority_Medical_Students_.35.aspx

River-Nieves J and Abreu MT. A Call for Investment in Education of US Minorities in the 21st Century. Gastroenterology. 2013 May; 144(5): 863-867 (https://www.med.upenn.edu/gastro/documents/ACallforInvestmentinEducationofUSMinoritiesinthe21stCentury.pdf

 

   


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