Division of Nephrology Fellowship Program Guide 2020-2021 - University of Utah ...

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Division of Nephrology Fellowship Program Guide 2020-2021 - University of Utah ...
Division of Nephrology Fellowship Program Guide

                  2020-2021
University of Utah Nephrology Fellowship Program

Table of Contents
Introduction ..............................................................................................................................................3
Fellow Selection Policy/Process .................................................................................................................3
Nephrology Fellowship Program Training Sites ..........................................................................................4
Inpatient Sites ...........................................................................................................................................4
Outpatient Sites ........................................................................................................................................4
Nephrology Training Program Schedule .....................................................................................................5
Division of Nephrology Faculty Members ...................................................................................................9
Clinical Curriculum Introduction .............................................................................................................. 12
Core competencies .................................................................................................................................. 12
Patient Care............................................................................................................................................. 12
Progressive objectives ............................................................................................................................. 15
Nephrology Research Training Program ................................................................................................... 16
Clinical research curriculum as part of 2-year clinical fellowship .............................................................. 16
Research fellowship curriculum for fellows on 3-year research fellowship ............................................... 17
Training program in clinical research curriculum ...................................................................................... 18
Guidelines for Promotion and Graduation ............................................................................................... 22
Nephrology Fellowship Work, Duty Hours, Moonlighting and On-Call Policy ............................................ 23
Nephrology Fellow Stipend and Benefits.................................................................................................. 24
Nephrology Fellows: Current & Graduates ............................................................................................... 26

                                                                             2
Introduction                                                               (RETURN TO TABLE OF CONTENTS)
The University of Utah Nephrology Fellowship Program is dedicated to providing the highest quality clinical
and research training in the subspecialty of Nephrology. It is accredited by the Graduate Medical Education
Committee of the University of Utah and by the Residency Review Committee of the ACGME. There are
two programs:
    1) The two-year Clinical Program - based at the University Hospital, Huntsman Cancer Hospital and
the George E. Wahlen Veteran Affairs Medical Center. Upon completion, Fellows are board eligible in
Nephrology. This program provides primarily clinical training; however, in addition to excellent clinical
training, the University of Utah Nephrology Clinical Fellowship Program is designed to provide experience
in clinical research. Fellows m a y o p t t o p a r t i c i p a t e i n e i t h e r on-going faculty clinical research
projects o r develop related research interests of their own.
    2) The three-year Research Program - involves one year of clinical training and two years of basic or
clinical research. The clinical year may be done at the beginning or the end of the fellowship and is structured
identically to the clinical experience of a year in the two-year clinical fellowship. The two years of research
are spent under the direction of a faculty member within the Division of Nephrology.

 This guide provides comprehensive information about all aspects of the Program, including:
   ¨ Goals and objectives
   ¨ Nature of sites where training is performed
   ¨ Types of clinical encounters
   ¨ Patient case-mix characteristics
   ¨ Procedures and services
   ¨ Educational activities and resources, including didactic training and conferences
   ¨ Nature of supervision and evaluation of fellow’s performance
   ¨ Faculty research activities
   ¨ Fellow research opportunities and policies
   ¨ On-call and vacation policies
   ¨ Former Fellow information
   ¨ Fellow selection policy

Fellow Selection Policy/Process                                   (RETURN TO TABLE OF CONTENTS)
To be eligible for a fellowship in the Division of Nephrology at the University of Utah School of
Medicine, an applicant must:
    1. Be a graduate of a U.S. or Canadian medical school accredited by the Liaison Committee on
       Medical Education (LCME) and have 3-years residency in an ACGME-approved program, OR
    2. Be a graduate of a college of osteopathic medicine in the United States accredited by the American
       Osteopathic Association (AOA) and have 3-years residency in an ACGME-approved program, OR
    3. Be a graduate of a medical school outside of the United States who meets the following
       qualifications:
          ¨ Has a currently valid ECFMG certificate plus at least have 3-years residency in an ACGME-
               approved program.

 The Division of Nephrology requires the following documentation for application:
    1. Completed fellowship application through ERAS
    2. Curriculum Vitae and Personal Statement through ERAS
    3. Three letters of recommendation through ERAS
    4. International Medical Graduates must include the following in addition to the above:
         a. Copy of green card, visa (J-1), or documentation of U.S. citizenship
         b. Valid ECFMG certificate with Clinical Skills Assessment certification
         c. Evidence of previous training in the United States
                                                          3
Selection Criteria for Interviewing Applicants
 The Nephrology faculty, in a joint meeting, reviews applicants who meet the criteria. Based on the quality
 of the application and academic credentials, the applicant is subsequently invited for an interview. On the
 interview day, applicants receive an information packet and interview with members of the Division of
 Nephrology and current Nephrology fellows. At the conclusion of the interview, the interviewers complete
 a standard evaluation form for each applicant they interviewed. The results are tallied and form the basis
 of the preliminary rank order. The University of Utah Nephrology program participates in the National
 Residency Matching Program (NRMP, aka “the Match”) for all entering fellows. We do not offer out-of-match
 positions.

Nephrology Fellowship Program Training Sites                         (RETURN TO TABLE OF CONTENTS)
Inpatient Sites
    1. University Hospital (UH) - This is a tertiary care facility with 528 operating beds located on the
        University of Utah Health Sciences Center Campus. It contains surgical, neurosurgical, burn, and
        medical intensive care units; a newly remodeled 5-station acute dialysis unit with support for
        hemodialysis, peritoneal dialysis, therapeutic apheresis and continuous renal replacement
        therapies; radiologic services with modern renal-related procedures and diagnostic vascular and
        radionucleotide imaging; electron microscopy for renal biopsy material; biochemical and serologic
        laboratories; a nutrition support service; and relevant social services. A close working relationship
        exists with other services including surgery, urology, obstetrics, gynecology, neurology, cardiology,
        rheumatology, pediatrics and psychiatry.
    2. George E. Wahlen Veteran Affairs Medical Center (VAMC) – This is a tertiary care facility with
        121 operating beds located adjacent to the University of Utah Lower Campus and approximately
        one-half mile from University Hospital. It contains surgical and medical intensive care units, a 10-
        station newly remodeled dialysis unit that performs acute and chronic hemodialysis and supports
        continuous renal replacement therapies and peritoneal dialysis, radiologic services with modern
        renal-related procedures and diagnostic vascular and radionucleotide imaging, electron
        microscopy for renal biopsy material, biochemical and serologic laboratories, a nutrition support
        service, and relevant social services. A close working relationship exists with other services
        including surgery, urology and psychiatry.
    3. Huntsman Cancer Institute (HCI) – This tertiary care facility has been designated as a
        Comprehensive Cancer Center by the National Cancer Institute and is among the top cancer centers
        in the world. A close working relationship and collaboration exists with the hematology/ oncology
        services.

Outpatient Sites
    1. University Hospital Renal Clinic – Located on the A level of the University Hospital, this 11-room
        clinic is the site for all general nephrology, nephrolithiasis, post-transplant and pre-transplant
        patients associated with the University of Utah.
    2. University of Utah Peritoneal Dialysis Clinic – Located in Research Park
    3. VAMC General Nephrology Clinic – Located on the 4th floor of Building 1 (main hospital
        building) at the VAMC, this clinic is the site of ambulatory care for VA general nephrology, pre- and
        post-transplant patients.
    4. VAMC Dialysis Clinic – Located within the dialysis unit, this clinic is the site of outpatient follow-up
        of VA hemodialysis, peritoneal dialysis and post-transplant patients.

                                                       4
Nephrology Training Program Schedule                                  (RETURN TO TABLE OF CONTENTS)
The two-year clinical fellowship and the one clinical year of the research fellowship are comprised of four
major rotations that cycle throughout the year. The following schedules are based on the Program’s
current policy of having four fellows (A through D below) doing clinical service together.

Yearly schedule for fellows on clinical service (only 1 year for research fellows)

Year 1 (1 block = 4 weeks) U=University Hospital; VA=VA Hospital; OP=Outpatient; TP=Transplant

  Block     1     2       3        4       5      6       7       8     9         10      11    12     13
  U         A     B       C        D       A      B       C       D     A         B       C     D      A
  VA        B     C       D        A       B      C       D       A     B         C       D     A      B
  OP        C     D       A        B       C      D       A       B     C         D       A     B      C
  TP        D     A       B        C       D      A       B       C     D         A       B     C      D

Year 2 (1 block = 4 weeks) U=University Hospital; VA=VA Hospital; OP=Outpatient; TP=Transplant

  Block     1      2       3       4        5      6      7       8      9        10      11    12     13
  U         A      B       C       D        A      B      C       D      A        B       C     D      A
  VA        B      C       D       A        B      C      D       A      B        C       D     A      B
  OP        C      D       A       B        C      D      A       B      C        D       A     B      C
  TP        D      A       B       C        D      A      B       C      D        A       B     C      D

University Hospital

                                               University Hospital – 3 Months Yearly
                 Monday                Tuesday           Wednesday           Thursday             Friday
      8 am
      9 am
     10 am
                                                                                                    Ward
                    Ward                                                         Ward
                                                                                                Duties/Rounds
     11 am      Duties/Rounds                                                Duties/Rounds
                                                           Ward
                                                       Duties/Rounds
     Noon
                                                                                                 Pathology
     1 pm                                                                                       Conference
                                       Ward
                                                                                                12:30-1:30
     2 pm                          Duties/Rounds
                    General           (All day)                                  General
                  Nephrology                                                   Nephrology
     3 pm
                   Continuity                               Didactic            Continuity
                Clinic at U of U                          Conference         Clinic at U of U       Ward
                     (Fellow                              (3:30-4:15)             (Fellow       Duties/Rounds
     4 pm           Group A)                                Clinical             Group B)          Sign-out
                 1:00-5:00 pm                             Conference          1:00-5:00 pm
                                                          (4:15-5:00)
     5 pm                                                   Clinical
                                                          Conference
     6 pm
                                                          (5:00-6:00)

                                                              5
VA Hospital

                                                     VA Hospital – 3 Months Yearly
               Monday                      Tuesday                   Wednesday        Thursday            Friday
     8 am
     9 am                                                            Transplant
                                                                        Clinic           Ward
                  Ward
                                                                    (Outpatient      Duties/Rounds
              Duties/Rounds
                                                                       Fellow)
     10 am
                                                                      (1st & 3rd
                                                                       Weeks)
              Nephrology                                                             Nephrology
              Urgent Care                     Ward                                   Urgent Care            Ward
                 Clinic                   Duties/Rounds                                 Clinic          Duties/Rounds
              (VA Fellow)                                                            (VA Fellow)
              10:30-11:30                                                            10:30-11:30
     11 am

                  Ward                                                                   Ward
              Duties/Rounds                                             Ward         Duties/Rounds
                                                                    Duties/Rounds
     Noon
                                                                                                         Pathology
                                                                                                        Conference
     1 pm
                                                                                                        12:30-1:30

     2 pm
                                                      VA
                                      VA
                  General                        Nephrology                              General
     3 pm                        Nephrology
                Nephrology                        Follow-up             Didactic       Nephrology
                                   Consult
                 Continuity                         Clinic            Conference        Continuity
                                    Clinic
              Clinic at U of U                   (Outpatient          (3:30-4:15)    Clinic at U of U       Ward
                                 (VA Fellow)
                   (Fellow                         Fellow)                                (Fellow       Duties/Rounds
                                  12:30-5:00
                  Group A)                        12:30-5:00            Clinical         Group B)          Sign-out
     4 pm
               1:00-5:00 pm                                           Conference      1:00-5:00 pm
                                                                      (4:15-5:00)

     5 pm                                                               Clinical
                                                                      Conference
                                                                      (5:00-6:00)
     6 pm

                                                        6
Outpatient Nephrology and Research

                                Outpatient Nephrology and Research – 3 Months Yearly
              Monday             Tuesday          Wednesday          Thursday            Friday
      8 am                      Research/QIP    VA Transplant
      9 am                          U of U            Clinic
     10 am                       Transplant       (Outpatient
                                  Follow-up         Fellow)
     11 am                                       (1 & 3rd Weeks)
                                                   st
                                    Clinic
                                                                                        GN Clinic
             Research/QIP                                           Research/QIP
                                                                                       8:00-12:00

    Noon

                                                  Research/QIP

    1 pm                             VA                                                 Pathology
                                Nephrology                                             Conference
    2 pm         General                                               General
                                 Follow-up                                             12:30-1:30
               Nephrology                                            Nephrology
                                   Clinic
    3 pm        Continuity                                            Continuity
                                12:30-5:00           Didactic
             Clinic at U of U                                      Clinic at U of U
                                                   Conference
                  (Fellow                                               (Fellow
                                                   (3:30-4:15)                         Research/QIP
                 Group A)                                              Group B)
    4 pm                                             Clinical                            Sign-out
              1:00-5:00 pm                                          1:00-5:00 pm
                                                   Conference
                                                   (4:15-5:00)
    5 pm                                             Clinical
                                                   Conference
    6 pm
                                                   (5:00-6:00)

                                                     7
Transplant Nephrology at University Hospital

                            Transplant Nephrology at University Hospital – 3 Months Yearly
              Monday            Tuesday          Wednesday            Thursday             Friday
     8 am                                            Inpatient
                                                    Transplant
     9 am
                                                 Service/Rounds
                                                    U of U
     10 am                                                                                  Inpatient
                Inpatient                       Pre-Transplant           Inpatient
                                                                                           Transplant
               Transplant                         Evaluation           Transplant
                                                                                        Service/Rounds
     11 am   Service/Rounds                          Clinic          Service/Rounds

     Noon
                                   Inpatient
                                                    Inpatient                           Pathology
     1 pm                         Transplant       Transplant                          Conference
                                Service/Rounds
                                                 Service/Rounds                        12:30-1:30
     2 pm                           (All day)
                 General                                                General
     3 pm      Nephrology                                             Nephrology
                                                     Didactic
                Continuity                                             Continuity
                                                   Conference                             Inpatient
             Clinic at U of U                                       Clinic at U of U
                                                   (3:30-4:15)                           Transplant
                  (Fellow                                                (Fellow
     4 pm                                            Clinical                          Service/Rounds
                 Group A)                                               Group B)
                                                   Conference                              Sign-out
              1:00-5:00 pm                                           1:00-5:00 pm
                                                   (4:15-5:00)
                                                     Clinical
     5 pm
                                                   Conference
     6 pm                                          (5:00-6:00)

                                                     8
Division of Nephrology Faculty Members                 (RETURN TO TABLE OF CONTENTS)

 Name                                          Interests
 Jo Abraham, MD, MPH                           Clinical trials in hypertension
 Associate Professor                           glomerulonephritis and CKD
 Director, Nephrology Fellowship Program

 Adhish Agarwal, MD                            Clinical care & Outcomes Research
 Associate Professor

 Laith Al-Rabadi, MD                           Glomerular Diseases, Clinical care
 Clinical Assistant Professor                  Clinical transplant nephrology
                                               Alport Syndrome

 Srinivasan Beddhu, MD                         Randomized trials and epidemiology
 Professor                                     of CKD and dialysis patients

 Alfred K. Cheung, MD                          Clinical trials in CKD, dialysis and
 Professor                                     hypertension; vascular access basic science lab
 Chief, Division of Nephrology                 Epidemiology in CKD and dialysis
 Vice Chair for Research, Dept of
 Internal Medicine

 Monique E. Cho, MD                            Metabolic and cardiac complications of CKD
 Assistant Professor

 Sarah Gilligan, MD, MS                        AKI and glomerular diseases
 Clinical Attending

 Martin C. Gregory, MD, PhD.                   Alport Syndrome
 Clinical Professor

 Isaac Hall, MD                                Kidney transplant predictors & outcomes
 Assistant Professor                           Acute kidney injury

 Yufeng Huang, MD, PhD.                        Pathogenesis of diabetic nephropathy
 Research Associate Professor                  and kidney fibrosis

 Bellamkonda Kishore, MD, PhD.                 Purinergic regulation of renal function,
 Research Professor                            pathology and experimental therapies

 Donald E. Kohan, MD, PhD.                     Hypertension, Renal physiology, Ion transport
 Professor                                     Polycystic kidney disease

                                           9
Marcus Pezzolesi, PhD, MPH          Diabetic nephropathy, genetics,
Assistant Professor                 kidney disease

Divya Raghavan, MD
Assistant Professor

Nirupama Ramkumar, MD, MPH          Renin angiotensin system, hypertension,
Assistant Professor                 Ion transport, renal physiology

Aylin Rodan, MD, PhD                Ion Transport, Renal Physiology,
Assistant Professor                 Potassium Homeostasis

Fuad Shihab, MD                     Chronic cyclosporine nephropathy
Clinical Professor                  Renal transplantation outcomes
                                    Biomarkers in kidney transplants

Yan-Ting Shiu, PhD.                 Biophysics of vascular access stenosis
Research Associate Professor        Ets-1 in vascular biology

Christof Westenfelder, MD           Stem cells in acute kidney injury
Professor                           Renal actions of erythropoietin

Tianxin Yang, MD, PhD.              PPAR gamma, obesity, clock genes
Professor                           Collecting duct signaling

Off-campus faculty

Marcellus Assiago, MD               Clinical care in Northern Utah
Clinical Assistant Professor

Terrence Bjordahl, MD               Clinical care in Salt Lake City
Clinical Assistant Professor

Yaw Boateng, MD, PhD                Clinical care in Southern Utah
Clinical Assistant Professor

Scott Eppich, MD                    Clinical care in Utah County
Staff Physician

                               10
Nasimul Ghani, MD                   Clinical care in Idaho
Staff Physician

Arsalan Habib, MD                   Clinical care in Salt Lake City
Clinical Assistant Professor

Bruce Horowitz, MD                  Clinical care in Northern Utah and VAMC
Clinical Professor

Siddhartha Kakani, MD, MHA          Clinical care in Utah County
Staff Physician

Andrea Nelson, MD                   Clinical care in Salt Lake City
Clinical Assistant Professor

Kishore Patcha, MD                  Clinical care in Northern Utah
Clinical Attending

Pace Romney, MD                     Clinical care in Utah County
Clinical Attending

Abinash Roy, MD                     Clinical care in St. George, UT
Clinical Associate Professor

Trevor Smith, MD                    Clinical care in Northern Utah
Clinical Attending

Robert Yenchek, MD                  Clinical care in Salt Lake City
Clinical Assistant Professor

Tahir Zaman, MD                     Clinical care in Salt Lake City
Clinical Assistant Professor

                               11
Nephrology Clinical Training Program Curriculum                       (RETURN TO TABLE OF CONTENTS)

Clinical Curriculum Introduction

The Nephrology Fellowship Clinical Training Program is designed to provide individuals with the
opportunity to achieve the fundamental knowledge, procedural skills, practical experience, and
professional and ethical behavior necessary for the subspecialty of Nephrology. Fellows care for patients
with the full spectrum of renal disorders at all stages of the disease process. Efforts are made at every point
to emphasize the integration of fundamental medical knowledge, disease prevention, social, psychological,
and economic issues.

This section describes the clinical curriculum. The first part presents an outline of the Clinical Program goals
and objectives. Subsequently, the full clinical curriculum is described, relating Clinical Program goals and
objectives to the manner in which they are achieved.

Overview of Clinical Program Goals and Objectives
The Nephrology Fellowship Clinical Training Program is structured around goals and objectives derived from
three major sources:
     • ACGME Core Competencies;
     • ACGME subspecialty requirements for Nephrology training programs
     • additional input derived from University of Utah Nephrology faculty
These various components are combined to achieve an integrated set of goals and objectives that cover
all aspects of the training program.

In this first section, an overview of the training program’s goals and objectives is presented, broken down
by the six core competencies and then the specific Nephrology areas. This should be reviewed so that
Fellows understand each of these components. The following section, devoted to the detailed
curriculum, then combines the core competencies and specific nephrology issues into an integrated and
comprehensive set of goals and objectives.

Core competencies                                                    (RETURN TO TABLE OF CONTENTS)

1. Patient care - Fellows must be able to provide patient care that is compassionate, appropriate, and
   effective for the treatment of health problems and the promotion of health. Fellows are expected to:
      a. communicate effectively and demonstrate caring and respectful behaviors when interacting with
         patients and their families
      b. gather essential and accurate information about their patients
      c. make informed decisions about diagnostic and therapeutic interventions based on patient
         information and preferences, up-to-date scientific evidence, and clinical judgment
      d. develop and carry out patient management plans
      e. counsel and educate patients and their families
      f. use information technology to support patient care decisions and patient education
      g. perform competently all medical and invasive procedures considered essential for the area of
         practice
      h. provide health care services aimed at preventing health problems or maintaining health
      i. work with health care professionals, including those from other disciplines, to provide patient-
         focused care
2. Medical knowledge - Fellows must demonstrate knowledge about established and evolving
   biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the
   application of this knowledge to patient care. Fellows are expected to:
      a. demonstrate an investigatory and analytic thinking approach to clinical situations know and apply the
         basic and clinically supportive sciences which are appropriate to their discipline
                                                       12
3. Practice-based learning and improvement – Fellows must be able to investigate and evaluate their
   patient care practices, appraise and assimilate scientific evidence, and improve their patient care
   practices. Fellows are expected to:
       a. analyze practice experience and perform practice-based improvement activities using a
          systematic methodology
       b. locate, appraise, and assimilate evidence from scientific studies related to their patients’ health
          problems
       c. obtain and use information about their own population of patients and the larger population from
          which their patients are drawn
       d. apply knowledge of study designs and statistical methods to the appraisal of clinical studies and
          other information on diagnostic and therapeutic effectiveness
       e. use information technology to manage information, access on-line medical information; and support
          their own education
       f. facilitate the learning of students and other health care professionals
4. Interpersonal and communication skills - Fellows must be able to demonstrate interpersonal and
   communication skills that result in effective information exchange and teaming with patients, their
   patients families, and professional associates. Fellows are expected to:
       a. create and sustain a therapeutic and ethically sound relationship with patients
       b. use effective listening skills and elicit and provide information using effective nonverbal,
          explanatory, questioning, and writing skills
       c. work effectively with others as a member or leader of a health care team or other professional
          group
5. Professionalism - Fellows must demonstrate a commitment to carrying out professional responsibilities,
   adherence to ethical principles, and sensitivity to a diverse patient population. Fellows are expected
   to:
       a. demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and
          society that supercedes self-interest; accountability to patients, society, and the profession; and
          a commitment to excellence and on-going professional development
       b. demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical
          care, confidentiality of patient information, informed consent, and business practices
       c. demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities
6. Systems-based practice - Fellows must demonstrate an awareness of and responsiveness to the
   larger context and system of health care and the ability to effectively call on system resources to
   provide care that is of optimal value. Fellows are expected to:
     a. understand how their patient care and other professional practices affect other health care
          professionals, the health care organization, and the larger society and how these elements of the
          system affect their own practice
     b. know how types of medical practice and delivery systems differ from one another, including
          methods of controlling health care costs and allocating resources
     c. practice cost-effective health care and resource allocation that does not compromise quality of care
     d. advocate for quality patient care and assist patients in dealing with system complexities
     e. know how to partner with health care managers and health care providers to assess,
          coordinate, and improve health care and know how these activities can affect system
          performance

Specific renal competencies - Fellows will acquire expertise in:

1. An understanding of normal renal biology including:
    a. Renal anatomy and histology
    b. Renal physiology, including in the elderly
    c. Fluid, electrolyte and acid-base regulation
    d. Mineral metabolism
    e. Blood pressure regulation - normal and abnormal
                                                    13
f.  Renal drug metabolism and pharmacokinetics, including drug effects on renal function and
         including in the elderly
    g. Renal function in pregnancy
    h. Basic immunologic principles, including mechanisms of disease and diagnostic laboratory testing
         relevant to renal diseases
    i. Medical genetics
2. Prevention, evaluation, and management of general nephrologic disorders including:
    a. Acute renal failure
    b. Chronic renal failure
    c. End-stage renal disease
    d. Fluid, electrolyte, and acid-base disorders
    e. Disorders of mineral metabolism including nephrolithiasis and renal osteodystrophy (including use
         of lithotripsy)
    f. Urinary tract infections
    g. Hypertensive disorders
    h. Renal disorders related to pregnancy
    i. Primary and secondary glomerulopathies including infection-related glomerulopathies. This also
         entails a basic understanding of immunologic mechanisms of renal disease and the laboratory
         tests necessary for their diagnosis.
    j. Diabetic nephropathy
    k. Tubulointerstitial nephritis including papillary necrosis
    l. Genetic and developmental renal diseases including renal cystic diseases, hereditary
         glomerulopathies and interstitial nephritis, phakomatoses, systemic diseases with renal
         involvement, congenital malformations of the urinary tract, maternally inherited mitochondrial
         diseases, and renal cell carcinoma.
    m. Vascular diseases including atheroembolic disease
    n. Disorders of drug metabolism and renal drug toxicity
    o. Renal disorders associated with the elderly including altered drug metabolism
    p. Renal cystic diseases without a recognized genetic basis
    q. Nutritional management of general nephrologic disorders
3. Pre- and post-renal transplant care including:
    a. Pre-transplant selection, evaluation and preparation of transplant recipients and donors
    b. Immunosuppressant drug effects and toxicity
    c. Immediate postoperative management of transplant recipients
    d. Immunologic principals of types and mechanisms of renal allograft rejection
    e. Clinical diagnosis of all forms of rejection including laboratory, histopathologic and imaging
         techniques
    f. Prophylaxis and treatment of allograft rejection
    g. Recognition and medical management of nonrejection causes of allograft dysfunction including
         urinary tract infections, acute renal failure, and others
    h. Understanding major causes of post-transplant morbidity and mortality
    i. Fluid, electrolyte, mineral and acid-base regulation in post-transplant patients
    j. Long-term follow-up of transplant recipients in the ambulatory setting including economic and
         psychosocial issues
    k. Principles of organ harvesting, preservation and sharing
    l. Renal disease in liver, heart and bone marrow transplant recipients
4. Dialysis and extracorporeal therapy including:
    a. Evaluation and selection of patients for acute hemodialysis or continuous renal replacement
         therapies
    b. Evaluation of end-stage renal disease patients for various forms of therapy and their instruction
         regarding treatment options
    c. Drug dosage modification during dialysis and other extra-corporeal therapies
    d. valuation and management of medical complications in patients during and between dialyses and
         other extra-corporeal therapies, and an understanding of their pathogenesis and prevention
    e. Long-term follow-up of patients undergoing chronic dialysis including their dialysis prescription
                                                         14
modification and assessment of adequacy of dialysis
     f. An understanding of the principles and practice of peritoneal dialysis including the establishment
        of peritoneal access, the principles of dialysis catheters, and how to choose appropriate catheters.
    g. An understanding of the technology of peritoneal dialysis including the use of cyclers
    h. Assessment of peritoneal dialysis efficiency using peritoneal equilibration testing and the
        principles of peritoneal biopsy
    i. An understanding of how to write a peritoneal dialysis prescription and how to assess peritoneal
        dialysis adequacy
    j. The pharmacology of commonly used medications and their kinetic and dosage alteration with
        peritoneal dialysis
    k. An understanding of the complications of peritoneal dialysis including peritonitis and its treatment,
        exit site and tunnel infections and their management, hernias, plural effusions and other less
        common complications and their management
    l. An understanding of the special nutritional requirements of the hemodialysis and peritoneal dialysis
        patient
    m. An understanding of the psychosocial, economic and ethical issues of dialysis
    n. An understanding of dialysis water treatment, delivery systems and dialyzer reuse
    o. An understanding of end-of-life care and pain management in the care of patients undergoing chronic
        dialysis.
    p. Evaluation, selection and management of patients for therapeutic plasma exchange
5. Personally conducting the following procedures:
    a. Urinalysis
    b. Percutaneous biopsy of native and transplanted kidneys
    c. Peritoneal dialysis
    d. Placement of temporary vascular access for hemodialysis and related procedures including use
        of vascular ultrasound guidance
    e. Acute and chronic hemodialysis
    f. Continuous renal replacement therapies
    g. Therapeutic plasma exchange
6. Understanding indications, complications (if relevant), and interpretation of the following procedures:
    a. Placement of peritoneal catheters
    b. Renal imaging - ultrasound, CT, IVP, MRI, angiography, and nuclear medicine studies
    c. Therapeutic plasmapheresis
    d. Radiology, angioplasty and declotting of vascular access
7. Special areas in the management of patients of renal diseases including:
    a. Psychosocial and economic issues confronting patients with renal disease
    b. Ethical issues relevant to care of patients with renal disease
    c. Optimizing the relationship of the nephrologist with other health care providers
    d. Optimizing mechanisms towards achieving life-long learning as a nephrologist
    e. Quality assessment and improvement, patient safety, risk management, preventative medicine, and
        physician impairment as it relates to the nephrologist

Progressive objectives                                                (RETURN TO TABLE OF CONTENTS)

The objectives of the nephrology fellowship program are designed to reflect a progressive increase in
learning. The learning principles are based on Bloom's taxonomy, describing progression through the six
learning domains: knowledge, comprehension, application, analysis, synthesis and evaluation. In
practice, the program's objectives change every 6 months of the 2-year training period. These four 6-
month periods' progressively changing objectives are summarized in the sections addressing the three
major rotations - general nephrology, dialysis and transplantation. These progressive objectives are
reviewed with the fellows by the Program Director at the beginning of each 6-month rotation, i.e., each
time the objectives change. A detailed description of these objectives is described in the fellowship curriculum.

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Nephrology Research Training Program                               (RETURN TO TABLE OF CONTENTS)

Clinical research curriculum as part of 2-year clinical fellowship

   1. Research Sites – Clinical research is conducted primarily when the Fellows are on the OP
      rotation. The OP service, which comprises three months each year, allows a substantial amount
      of time for research, without having inpatient responsibilities. Additionally, several opportunities
      exist for Fellows to become involved in ongoing multicenter collaborations.
   2. Research Schedule - Within the first month of Fellowship, Fellows meet with all clinical research
      faculty to discuss possible clinical research projects and mentorship. Basic research projects are
      not realistic during the two years of Fellowship. Fellows are expected to become involved in projects
      already in progress and not to be responsible for designing a new project. Fellows are not expected
      to obtain independent funding to support their salary or research activities. After identifying a mentor
      and project, Fellows are actively involved in the faculty-directed clinical research project while on
      each OP rotation.

Goals and Objectives of Research Program
  1. Understand fundamentals of clinical research including basics of research design, data analysis
      (biostatistics), public policy, economics, health education, designing trials, recruiting subjects,
      responsible use of informed consent, standards of ethical conduct of research, clinical
      epidemiology, and outcomes analysis.
  2. Gain hands-on experience with conducting a clinical research project including research design
      (where feasible), data analysis, subject recruitment, data collection, and manuscript preparation.
  3. Understand principles of grant writing.
  4. Provide sufficient exposure to clinical research to allow Fellows to make an informed decision about
      pursuing a career involving clinical research.
  5. Provide sufficient exposure to clinical research to allow Fellows to critically assess clinical research
      literature and to be competent in using available medical informatics systems. Bibliographic
      retrieval and critical appraisal skills are of paramount importance.
  6. Become a co-author on a published manuscript or abstract, or present research at a national meeting.

Nature of Supervision - Fellows should select a project and mentor by September 1 of the first year of
Fellowship and inform the Nephrology Fellowship Program Director of their selection. For the next 22
months, the Fellow’s clinical research activities will be guided by the Mentor. This involves frequent
meetings (at least every two weeks during the OP rotation and every two months during other rotations)
between the Fellow and mentor during which all aspects of conducting the clinical research projects are
addressed.

Means of Fellow Evaluation – The mentor provides the Fellow with ongoing informal feedback. In addition,
the mentor meets with the Nephrology Training Program Director semi-annually to report on the Fellow’s
progress. The Training Program Director also discusses the research progress with the Fellow during
their semi-annual meetings. Evidence of successful completion of the Fellow research requirement includes
presenting an abstract at a national or regional meeting, publishing an abstract or manuscript, and/or
presentation of the research to the Division of Nephrology for the one-hour research conference.

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Research fellowship curriculum for fellows on 3-year research fellowship
(RETURN TO TABLE OF CONTENTS)

   1. Research Sites – Basic or clinical research are conducted at the VA or at University Hospital,
      depending upon the location of the mentor.
   2. Research Schedule - Research fellows identify a mentor within the first month of their fellowship.
      Depending upon the fellow's preference and the number of clinical fellows, the research fellow will
      do their clinical year either at the beginning or the end of their fellowship. Once the fellow starts in
      the laboratory, they will do this exclusively for two years with the exception that they will maintain a
      ½-day general nephrology continuity clinic throughout their entire fellowship.

Goals and Objectives of Research Program
  1. Understand fundamentals of basic or clinical research. For both clinical and basic research, this
      includes research design and data analysis (biostatistics). For clinical research, this also includes
      public policy, economics, health education, designing trials, recruiting subjects and other
      epidemiology issues, and outcomes analysis.
  2. Gain hands-on experience with conducting a basic or clinical research project including research
      design (where feasible), conducting the study, data analysis, and manuscript preparation. It is
      expected that the fellow will generate at least one peer-reviewed original research publication from
      this work, although this is not a requirement for graduation from the program.
  3. Understand principles of grant writing.
  4. Provide sufficient experience in basic or clinical research to allow Fellows to make an informed
      decision about their academic career choices.
  5. Provide sufficient exposure to basic or clinical research to allow Fellows to interpret basic and
      clinical research literature.

Educational Training

Didactic courses
   1. Clinical Research Training Track for Physician-Scientists. All fellows engaging in clinical research
      are given the option to enroll in the Masters of Science in Clinical Investigation (MSCI) at the
      University of Utah. The MSCI is a two-year post-graduate experience that emphasizes epidemiology,
      clinical outcomes, clinical trials and health services research. The MSCI is funded by a Clinical
      and Translational Scientist Award (CTSA) of the NIH. Additional funding to support the program is
      provided by the Vice President for Health Sciences. The program is composed of formal didactic
      coursework, a longitudinal seminar series, and a mentored clinical research project. Fellows who
      successfully complete the program are eligible for a Master’s Degree awarded by the School of
      Medicine. Fellows successfully completing the program are awarded a Master’s Degree in Clinical
      Investigation. This degree is offered by the General Clinical Research Center, which has been
      designated as a degree-granting academic department within the SOM. The academic year for the
      TPCI program begins the second week of July and runs through the last week in May.
   2. The curriculum during Year 1 of the MSCI program begins with a six-week intensive block of didactic
      course work and workshops (Schedule A). Fellows take a set of core courses in epidemiology, data
      management, bioethics, biostatistics and the research seminar series. Workshops in grant writing
      and the preparation of clinical research protocols are also offered. The curriculum focuses on
      community intervention studies, an epidemiology seminar and a computer practicum. During the six-
      week intensive block, the renal fellow will design and initiate their research project in conjunction
      with their preceptor.
   3. Advanced, didactic coursework is continued through the fall and spring semesters (Schedule A).
      Courses are given two afternoons each week or in brief blocks over Thursday, Friday and Saturday
      morning. The mentor-based clinical research project continues. During the second year, effort is
      focused on the clinical research project. However, during the fall semester of the second year,
      all fellows are required to take a weekly one-hour course entitled "Scientific Integrity & Ethics of
      Scientific Research". This course meets federal requirements for training grants and is described
                                                      17
below.
   4. During the late fall semester or early spring semester of the second year of the MSCI program,
      fellows will prepare (with the aid of his/her mentor) an application for a career development award
      through the NIH, the Department of Veterans Affairs, or an appropriate professional society. At the
      conclusion of the second year, a master’s thesis is submitted which can also serve as a research
      paper of publishable quality. Throughout the two-year program, fellows are required to attend a
      longitudinal research seminar series, given on two Friday afternoons per month. This series covers
      a wide variety of subjects of interest to students and also provides an opportunity for camaraderie
      amongst all MSCI participants, not just those in the Nephrology Training Program. All enrollees to
      date have ample time during the two years to complete their clinical research projects and to be highly
      competitive for NIH funding.
   5. Fellows will be expected to participate by presenting their research at these research conferences as
      described above. Fellows will attend the annual American Society of Nephrology meeting each of
      these two years and will be expected to present their research at this meeting during the third
      year. Fellows also will be encouraged to present their research at the annual National Kidney
      Foundation meeting as well as any relevant regional conferences.

Schedule A. Training program in clinical research curriculum (RETURN TO TABLE OF CONTENTS)

  INITIAL                  MDCRC 6010 Introduction to Epidemiology. Covers the basics of
  BLOCK (6         epidemiology including: measures of disease frequency, measures of effect, basic
  weeks)           study designs, confounding bias, stratification, and causal reasoning. This course is
                   presented in two-hour sessions, two days a week for the first three weeks of the block.
                            MDCRC 6020 Data Management. Covers managing databases for research,
                   including problems and solutions for data management, database design, table
                   linkage, confidentiality issues and data security. The course is presented in six two-
                   hour sessions.
                            MDCRC 6430 Bioethical Issues in Clinical Research. Ethical issues and
                   standards for scientific investigation are covered in depth. Course- work emphasizes
                   the history and evolution of research norms and practices, institutional expectations
                   and standards, and the process of review and oversight for experimental protocols.
                   Additional material covers ethical issues and public policy linked to genetic
                   research. Case-based problem solving is used to cover interactions with the
                   Institutional Review Board. This course is presented in two hour blocks, once weekly.
                            MDCRC 6000 Introduction to Biostatistics. Basic statistics with emphasis
                   on medical and epidemiologic research problems, including description of data,
                   theoretical distribution, experimental design, hypothesis testing, comparison of
                   groups, correlation, confidence intervals and sample size estimation. This course
                   is presented in two-hour blocks, once weekly.
                            MDCRC 6410 Research Seminar Series. This course is presented during
                   the intensive introductory course and throughout the fall and spring. The course is
                   presented for two hours on every Friday afternoon throughout the intensive
                   introductory course and on the second and fourth Fridays of the fall and spring
                   semester. Each seminar begins with the presentation of a clinical issue related to
                   health care delivery or epidemiology. Discussions follow based on the methods used
                   for defining epidemiologic and other health care issues. The seminars are designed
                   to illustrate the process of scientific discovery in clinical investigation, provide
                   examples of how innovative approaches and methods were applied and to discuss
                   obstacles that impede progress. Visiting faculty from other universities participate in
                   the seminar series.
                            MDCRC 6100 Epidemiology               Seminar. Key       papers describing
                   epidemiological methods are discussed followed by critical reviews of representative
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studies illustrating the application of these methods. This course is presented in two
            two-hour blocks each week for the first three weeks.
                   MDCRC 6030 Computer Practicum. This course is designed to afford
            hands-on practice with statistical software (e.g. Stata). Students learn to merge
            databases, analyze data, scientific graphing, Monte Carlo simulation, and sensitivity
            analysis. This course is offered in two-hour blocks twice weekly during the last three
            weeks.

FALL                MDCRC 6040 Design and Implementation of Clinical Trials. This course
SEMESTER   defines clinical trials and reviews drug registration trials, phase I, II and III trials, clinical
YEAR ONE   endpoints, surrogate endpoints, pharmacokinetics, drug-drug interactions, data and
           safety monitoring, criteria for closure and single versus multi-institutional trials. Case-
           based sessions covering clinical trials in occlusive heart disease, arthritis, asthma and
           oncology provide informative examples of trial design and potential pitfalls. This course
           is presented in a weekly two- hour block.
                    MDCRC 6240 Community Intervention Studies. Strategies are presented for
           designing and implementing field intervention trials. Methods of analysis are covered,
           including cluster randomization and time series analysis. This course is presented as
           a one day intensive experience totaling 8 hours of lectures and tutorials.
                    MDCRC 6230 Health Services Research. This course focuses on measurement
           of clinical outcomes and includes scale development, reliability and validity, study design,
           misclassification bias, co-morbidity, severity of illness scores, organizational structure
           and quality of life measurements. The course is taught as 3 intensive 1- day blocks every
           2 months.
                    MDCRC 6130 Introduction to Decision Analysis. This course serves as an
           introduction to the subject of decision analysis related to health care and includes
           concepts, creation and evaluation of decision trees, Markov chains, sensitivity analysis
           and incorporation of patient preferences with utility analysis. This course is presented as
           a two and one-half day intensive experience totaling sixteen hours of lectures and
           tutorials.
                    MDCRC 6120 Cost Effectiveness Analysis. The material presented covers
           concepts used in the economic evaluation of health care programs, foundations of cost
           effectiveness analysis, interpreting and critiquing the literature of cost-effective analysis,
           and constructing these analyses. This course is presented as a two and one-half day
           intensive experience totaling sixteen hours of lectures and tutorials. OPTIONAL
                     MDCRC 6110 Intermediate Epidemiology. Students enrolling in this course
             must have completed MDCRC 6010, Introduction to Epidemiology. Intermediate
             Epidemiology covers research design and conduct of epidemiologic studies,
             including assessing effect modification, stratification, matching, sampling and
             reasoning with causal diagrams. This course is presented in a weekly two- hour
             block during the second six weeks. OPTIONAL
SPRING         MDCRC 6140 Intermediate Decision Analysis. Students enrolling in this class are
SEMESTER   required to have completed MDCRC 6130, Introduction to Decision Analysis. The
YEAR ONE   intermediate decision analysis course is a practicum in designing and constructing
           a decision analysis model to solve an actual health care problem. A problem is
           provided and students are instructed in methods to solve the problem utilizing decision
           analysis. This course meets in two one-day blocks, each eight hours in duration. In the
           first block the problem is presented; in the second block students present their
           solution to the problem.
                    MDCRC 6200 Meta Analysis. This focuses on the meta-analysis approach
           combining quantitative data. Subjects covered include statistical methods, eligibility
           criteria of studies, tests of homogeneity, summary measures, sources of variation and
           sensitivity analysis. This course is presented in a weekly two-hour block throughout the
           last six weeks. OPTIONAL

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MDCRC 6210 Regression Models. Students enrolling in this course must have
                   completed MDCRC 6000, Introduction to Biostatistics and MDCRC 6010, Introduction
                   to Epidemiology. The course in regression models covers linear regression, logistic
                   regression, Poisson regression, Cox regression, and includes methods for correlated
                   data (generalized estimating equations and mixed models), testing model assumptions,
                   and assessment of model fit. This course is presented in a weekly two-hour block.
                            MDCRC 6220 Survey Methods. Students must have completed MDCRC 6210.
                   The course on survey methods covers the design and analysis of surveys, including
                   questionnaire development, sample designs, stratification, clustering, multi-stage
                   sampling, and the analysis of data generated from these complex designs. This course
                   is presented as a two and one-half day experience totaling sixteen hours of lectures and
                   tutorials. OPTIONAL
   FALL                     INT MD 7570 Scientific Integrity & Ethics of Scientific Research. The
   SEMESTER          course meets federal ethics requirements for training grants. The series covers topics
   YEAR TWO          of general interest in ethics and science. Topics include the norms of scientific
                     inquiry and the nature of scientific misconduct; conflicts of interest (including the
                     university policy); intellectual property and technology transfer; responsible
                     authorship and editorial policies; and protection of research subjects and research
                     with animals. Sessions are panel discussions featuring responsible administrators,
                     scientists and physicians from a wide range of disciplines, and faculty in philosophy
                     and law. The course meets 12 times during the fall semester and each meeting lasts
                     for 1 hour. Course coordinator is Leslie Francis, Professor of Philosophy and Law.

1. Division of Nephrology Statistics course – Fellows attend 10 two-hour sessions held on Thursdays
   from 4:30-6:30 PM dedicates to understanding medical statistics. The course is taught by members of
   the nephrology division as well as University of Utah statisticians.
2. Division of Nephrology Clinical Research course – Fellows interested in clinical research, but not
   enrolled in the CTSA program, attend a one-hour session each month devoted to understanding basics
   of research design, data analysis (biostatistics), public policy, economics, health education, designing
   trials, recruiting subjects and other epidemiology issues, and outcomes analysis. The course is run by
   Dr. Beddhu and is largely based on the JAMA publications devoted to these areas.
3. Fellows engaging in basic research will be required to take the Basic Research in Nephrology
   Curriculum. This curriculum involves required core and elective courses. Core courses are taken during
   the first year and involve training in biostatistics (MDCRC 6000) (Schedule A), scientific integrity and
   ethics of scientific research (INT MD 7570) (Schedule A), and basic research techniques. Since every
   basic research laboratory utilizes some degree of physiologic, cell biologic, and molecular biologic
   techniques, fellows will be given the option to take core courses in these areas (Schedule B). In
   addition, they may take a course on scientific lecturing and writing (Schedule B). Depending upon the
   nature of the basic research project, fellows will be offered courses on an elective basis. While multiple
   courses exist, given the Nephrology Training Program research activities, it is anticipated that they
   will most likely take one or more of the courses described in Schedule C. These courses are intended
   to supplement learning that occurs in the laboratory due to interactions with the preceptor, collaborators,
   and laboratory members.
4. During the fall and spring semesters of year 2 of research training (depending on the application due
   date), trainees will apply for mentored research grants, such as an NIH K08, an American Heart
   Association Scientist Development Grant, or similar funding.

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Schedule B. Basic research core courses.                          (RETURN TO TABLE OF CONTENTS)

 FALL        BLCHM 6400 Genetic Engineering. This course covers essential techniques used in
 SEMESTER genetic engineering. Topics include the use of restriction endonucelases, amplification of
 YEAR ONE DNA sequences using PCR, Southern and Northern blotting, properties of cloning vectors
          and their use in constructing genomic and cDNA libraries, DNA sequencing and sequence
          analysis, creating and detecting mutations in DNA and introducing these mutations into a
          genome (transgenic and knockout models ), and expression of proteins. Held in 2-hour
          weekly sessions.
 FALL AND    PHYS 7910 Practicum in Physiology. A laboratory-oriented practicum emphasizing
 SPRING   the practice of physiological technique as it pertains to specific research problems. Course
 SEMESTER covers membrane models, ion selectivity, intracellular pH and Ca2+ regulation. Recording
 YEAR ONE surface potentials, ionic currents, nerve discharge and documentation of nervous activity
          with antibody markers are taught. The second half of the practicum emphasizes assays
          involving antibodies including receptor binding, and                   radio immunoassays.
          Microfluorometric analysis, confocal microscopy, in-vivo drug assay and genetic markers
          in disease are given practical consideration. Held in three hour sessions once a month.
             ANAT 7790 Fluorescence Microscopy and Digital Imaging. Laboratory and lecture
          course of basic and advanced microscopic techniques. Phase contrast, fluorescence, and
          confocal microscopy. Digital image-processing, quantitative analysis, and production of
          publication-quality images. Held in 1-hour sessions once a month.

 FALL             ANAT 7690 Scientific Lecturing and Writing. Course teaches guidelines for writing
 SEMESTER      clear scientific papers and delivering good lectures. Lectures, discussion, homework
 YEAR          assignments and submission of a new original scientific paper in an area chosen by each
 TWO           student. Held in hourly sessions once a month.

 Schedule C. Selected highly relevant basic research courses

 Physiology   PHYS 6010 Systemic Physiology II. Must have had basic physiology. Emphasizes
              physiological principles of major organ systems. Three hours weekly in fall semester.
 Molecular    MBIOL 6420 Genetics and Genome. The Genetics and Genomes course covers the
 Biology      basic principles of genetics in both prokaryotes and eukaryotes, and the basic
              mechanisms of genome structure and replication. Mechanisms governing the transmission
              of genetic information are covered in bacteria, fungi, flies, worms, and vertebrates, including
              mutagenesis, transposons, suppression, epistasis, recombination, mosaics, gene
              knockouts, and two hybrid analysis. The genomes section of the course covers the
              organization of genes on chromosomes, chromatin structure, DNA replication and repair,
              gene silencing, chromosome inactivation, imprinting, and genome evolution. Three hours
              weekly in fall semester.
              MBIOL 6440 Gene Expression. This course covers transcriptional and post- transcriptional
              mechanisms of gene regulation. Lectures cover recent advances in these fields with
              material based on the primary literature. The transcriptional regulation section of the course
              covers, basic mechanisms of gene activation and repression, chromatin remodeling
              machines, regulation of transcription activation by signal transduction cascades. The
              post-transcriptional section covers mechanisms regulating RNA processing (splicing,
              editing, and transport), translation and mRNA stability. Three hours weekly in spring
              semester.

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Cell          MBIOL 6480-2 Cell Biology II. Must have had basic cell biology. The course covers: 1.
  Biology       cell structure/function and intracellular trafficking. 2. Signal transduction, cell cycle and
                apoptosis. 3. Cell-cell communication, differentiation and tissue maintenance. Each
                section consists of a series of lectures that explore the basic concepts associated with the
                various topics. Each section has an in class exam and a writing assignment in the form of
                a mini grant proposal that encourages the identification of important scientific problems
                and the formation of a testable hypothesis, the creation of a research plan to test the
                hypothesis and the presentation of this material in an acceptable and persuasive format. 3
                hr weekly in fall semester.
The research mentor-Fellow relationship is the primary means by which Fellows will achieve training in
basic or clinical research.
Nature of Supervision - Fellows should select a project and mentor by September 1 of the first year of
Fellowship and inform the Nephrology Fellowship Program Director of their selection. For the next 23
months, the Fellow’s research activities will be guided by the Mentor. This involves frequent meetings
(at least bi-weekly during the two years of research).
Means of Fellow Evaluation – The mentor provides the Fellow with ongoing informal feedback. In
addition, the mentor meets with the Nephrology Training Program Director semiannually to report on the
Fellow’s progress. The Training Program Director also discusses the research progress with the Fellow
during quarterly meetings between the Research Fellow and the Training Program Director. Fellows
are expected to be a first author on at least one publication in a peer-reviewed journal. In addition, they
are expected to present their research at least once annually at national meetings.

Guidelines for Promotion and Graduation                               (RETURN TO TABLE OF CONTENTS)

  1. Clinical Track – 2-year clinical fellowship - Promotion from 1st to 2nd year – The criteria for
     promotion are listed in the General Nephrology, Dialysis, and Transplant tables. All of these criteria
     must be met in order to be promoted. They must have been met within the last month of the 1st year
     of fellowship. Failure to meet all criteria will result in review by all Clinical Faculty with whom the Fellow
     has had contact in the past year, and placement on probation. The Fellows must demonstrate
     satisfactory performance over the next 1 month of clinical activities, as determined by the criteria for
     performance during year 1, in order to be allowed to continue in their training. Any exceptions will be
     determined on an individual basis by the entire Clinical Faculty, and will be based on all circumstances
     surrounding the Fellow’s activities.
  2. Graduation – The criteria for graduation are listed in the General Nephrology, Dialysis, and
     Transplant tables (labeled as 2nd year performance). All of these criteria must have been met over the
     last 3 months of fellowship in order to graduate. Failure to meet all criteria will result in review by all
     Clinical Faculty with whom the Fellow has had contact in the past year, and a decision made on a
     necessary course of action. Such action may include, but is not limited to, requirement for additional
     clinical activities, counseling, or other actions.

  3. Research Track – 1-year clinical fellowship. The criteria for graduation are listed in the General
     Nephrology, Dialysis, and Transplant tables (labeled as 2nd year performance). Note that these
     criteria are labeled 2nd year since they pertain to the 2nd year clinical fellows, but they apply to fellows
     doing only 1 year of clinical fellowship. These criteria must have been met over the last 3 months of
     fellowship. All of these criteria must be met in order to graduate. Failure to meet all criteria will result
     in review by all Clinical Faculty with whom the Fellow has had contact in the past year, and a decision
     made on a necessary course of action. Such action may include, but is not limited to, requirement for
     additional clinical activities, counseling, or other actions.

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