Clinical and Laboratory Experience
Our fellowship program of training in nephrology is a combination of clinical and laboratory experience. Our research-oriented program consists of a year of clinical renal medicine followed typically by two years of research fellowship. Our clinically-oriented fellowship consists of two years of clinical renal training, including time allotted to clinical research.
Our clinical fellows provide renal consultations at the Beth Israel Deaconess Medical Center, a 556 bed general hospital that is one of the major teaching hospitals of Harvard Medical School.
During the first year of training, each of the 4 fellows spends six months on the Consult service, three months on the Dialysis Service and three months on the
Transplant Service in alternating one-month rotations. Under the supervision of the renal faculty member who is on each service, the fellow sees patients with renal and electrolyte disorders and cares for patients requiring hemodialysis, hemofiltration, home and in-center peritoneal dialysis, and renal or renal and pancreas transplantation. The fellow performs percutaneous kidney biopsies of native and transplant kidneys, places central venous catheters for dialysis and learns to interpret renal pathology and radiology. A Simulation Center is used to ensure skill in performance of invasive procedures. The fellow cares for ambulatory patients in a weekly Nephrology Continuity Clinic throughout the year and participates in Transplant Clinic while on the Transplant Service. There is 4 weeks of vacation in the fellows' first clinical year.
A broad array of didactic programs and renal conferences are an integral part of the fellowship curriculum. These include an introductory summer lecture series in conjunction with the other Harvard hospital-based renal programs, a weekly clinical nephrology conference, a clinical and research transplant conference, Journal Club, Research & Renal Grand Rounds with renowned invited speakers, and a weekly meeting with Drs. Lecker, Brown, Zeidel or the research faculty to discuss interesting cases and career plans. A weekly conference with Dr. Burton Rose, the Editor of
UpToDate, teaches the first year fellows how to assess the medical literature.
Faculty of the renal division play a major role in teaching renal physiology and pathophysiology to students at Harvard Medical School both in the preclinical and during the clinical years. Drs. Hoenig and Stanton are the HMS course directors for these programs. The majority of the coursework is taught through "Problem Based Learning" in small tutorial groups. During their second year of fellowship, renal fellows are encouraged to participate in leading these groups. This experience provides a unique opportunity to solidify and refine concepts integral to the understanding of renal physiology and pathophysiology.
Fellows have a travel and educational allowance for attendance at the annual meeting of the
American Society of Nephrology or other scientific meetings, textbooks, or other educational needs.
In the second year, the research-oriented fellows spend four weeks on the clinical service and the remaining time in a research laboratory of their choice throughout the rich Boston scientific community. The clinically-oriented fellow spends about 8 months on various clinical rotations of their choosing (Consult, Transplant or Dialysis service, Pathology and Radiology, Children's Hospital or
Vascular Access electives) and four months of clinical research supervised by one of the renal faculty members. During the second year, all of the fellows attend two renal clinics of their choosing (including Outpatient Peritoneal Dialysis & Hemodialysis, Urology, Diabetic Renal Clinic, Transplant, Children's Hospital, and various general nephrology clinics). A rotation at our outpatient vascular access center is also available. There is a 4 week vacation allowance in the second year as well.
For fellows in the research track, a third year of full-time bench or clinically-oriented research is expected, funded by our NIH Training Grant. During this year, there are no clinical requirements, however most fellows have elected to serve as Junior Attending Physicians on the Renal Consult Service under the supervision of a senior nephrologist. Also, there is an opportunity to apply for a third year of clinical and research training as the medical transplant fellow in our program certified by the
American Society of Transplantation.