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The Division of Nephrology is dedicated to providing the highest-quality care to patients, advancing nephrology research and training future physicians and investigators to become leaders in the field.
Decades before Boston's Beth Israel and New England Deaconess hospitals came together as Beth Israel Deaconess Medical Center, each was a leader in health care with a long history of personalized patient care and community service. In 1996, the two hospitals merged to form BIDMC. Today, with nearly three quarters of a million patient visits each year in and around Boston, BIDMC is rated among the top hospitals in the country in patient care and National Institutes of Health funding. Like BIDMC, the Division of Nephrology has a rich and remarkable history, boasting an impressive lineage of members and leaders.
When the Harvard Medical Service at Boston City Hospital closed, nephrologists at the Thorndike Laboratory—led by Franklin Epstein, one of the “fathers of nephrology”—joined the Beth Israel Hospital Renal Unit, then directed by Howard Frazier. When Dr. Epstein became Chief of Medicine in 1975, the unit grew considerably under his leadership and that of Robert S. Brown and Patricio Silva (Acting Chiefs of clinical and research activities, respectively). In 1981, Dr. Epstein returned to his nephrology roots as the Chief of the Division. Vikas Sukhatme took his place in 1992, and four years later guided Nephrology through the merger between Beth Israel and New England Deaconess Hospitals. The current division formed in 1999, when Joslin Diabetes Center’s Renal Division joined BIDMC’s. After Mark Zeidel, Chairman of Medicine, served as Acting Chief from 2007 to 2010, Martin Pollak became Chief of Nephrology; and, in 2014, following Robert Brown’s 40 years of service, Bradley Denker assumed the position of Clinical Chief. Our training program in academic nephrology, led by Stewart Lecker since 2008, is supported in part from an NIH T32 grant that has been active for the past 40 years.
Our educational programs are among our program's greatest strengths. Our faculty are recognized locally, nationally and internationally for their excellence in medical education. They serve as core educators in our fellowship program, BIDMC's Internal Medicine Residency Program and at Harvard Medical School. Our educational mission is to train the future leaders of nephrology. The nephrology training program at BIDMC offers a dynamic mix of clinical care as well as basic and translational research, using novel educational approaches in a warm and nurturing environment. Whether our trainees provide superlative care, perform clinical or laboratory research or take on educational roles, our fellowship program provides the tools necessary to chart the future of our specialty.
All clinical training takes place at the Beth Israel Deaconess Medical Center in Boston, MA. During the first year of training, each of the four 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 a renal division faculty member, the fellow coordinates the care of patients with a wide variety of nephrology disorders (acute kidney injury, electrolyte abnormalities and glomerulonephritis, to name a few), provides acute and chronic dialysis to those with urgent or ongoing indications, and manages immunosuppressive medications and potential complications of renal and/or 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. Throughout the first two years of fellowship, the fellow cares for ambulatory outpatients in a weekly nephrology continuity clinic and participates in transplant clinic while on the transplant service. There are four weeks of vacation in the fellows' first clinical year.
In the first year of the fellowship, a broad array of didactic programs and renal conferences are an integral part of the educational curriculum. These include an introductory summer lecture series in conjunction with the other Harvard hospital-based renal fellowship programs, a weekly clinical nephrology conference, a clinical and research transplant conference, Journal Club, research and renal grand rounds with renowned invited speakers and “Professors’ Rounds” with Drs. Lecker, Brown, Denker, Pollak or the research faculty to discuss interesting cases and career plans.
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. The clinically oriented (two-year) fellow spends about eight 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/QI/educational research supervised by one of the renal division faculty members. During the second year, all of the fellows spend increasing amounts of time in the outpatient dialysis setting. Second-year fellows may also choose to rotate through experiences in urology, diabetic kidney care, kidney radiology, transplant and pediatric nephrology. A rotation at our outpatient vascular access center is also part of the curriculum. There is a four-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. There is also 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.