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NephrologyEducationFellowship in Pediatric NephrologyOur fellowship in Pediatric Nephrology is designed to prepare talented individuals for investigative careers in academic medicine. To achieve this goal, we provide broad experience in the clinical discipline of nephrology in addition to intensive research training. Fellows enter the program after completing three years of residency in pediatrics and are expected to commit three or more years to our postdoctoral program in nephrology. Twelve months are devoted to training in clinical nephrology. Two or more years are then spent in research activities. One candidate is accepted into the program each year for combined clinical and research training. Research activities are supported, in large part, by a training grant from the National Institutes of Health. The educational experience in Pediatric Nephrology at Yale University School of Medicine and Yale-New Haven Children's Hospital is relatively unique. The entire focus of the three years is to provide for the subspecialty residents the opportunity to develop a high level of clinical expertise and acquire research skills that will allow them to pursue careers as academic pediatric nephrologists. To achieve this goal, the program is uniquely designed so that postdoctoral fellows experience a continuum of learning in both the clinical arena and research laboratory over three years. The continuity of patient care is absolutely essential for children who have chronic illnesses and require long term therapy. Similarly, the complexity of contemporary research, both clinical and basic, requires the progressive acquisition of research skills and sufficient time to become familiar with and expert in research technologies. Consequently, the Pediatric Nephrology Program allows intense clinical experience during all three years as well as an early introduction to either laboratory or patient oriented research in the first year of the program. 
Clinical ExperienceFellows participate in the diagnosis and management of patients on the pediatric inpatient service, pediatric ICU, neonatal ICU and pediatric specialty center. Patient problems encompass the full range of clinical disorders and include fluid and electrolyte disturbances, acute and chronic renal failure, various forms of glomerulonephritis and interstitial nephritis, nephrolithiasis, hypertension, intoxications, inherited renal diseases and related disorders. Fellows also gain extensive experience with percutaneous renal biopsy and acute/chronic dialysis. One of the full time faculty in pediatric nephrology serve as attending physician and conduct teaching rounds daily. These teaching sessions provide instruction in the basic scientific disciplines that underlie the clinical practice of nephrology as well as supervision and training in the practical aspects of patient management. Fellows receive extensive training in renal replacement therapies. They gain experience with the use of peritoneal dialysis, hemodialysis and continuous arterio-venous hemofiltration (CAVH). Experience in chronic dialysis is also provided, as fellows participate in the treatment of patients with chronic ambulatory peritoneal dialysis (CAPD) and in-center hemodialysis. Moreover, clinical renal fellows are involved in an active program for patients undergoing renal transplantation, which provides experience in managing the acute postoperative care and the long-term follow-up of these patients. Fellows participate in outpatient renal clinics under the supervision of the faculty. This component of clinical training provides experience in the work-up of common renal disorders not initially requiring hospitalization (e.g., proteinuria, hematuria, mild azotemia), the assessment and treatment of childhood hypertension and the long-term follow-up of patients after discharge from the inpatient and transplant service. Several teaching conferences are devoted to clinical nephrology. The most important of these is Renal Grand Rounds, which is held weekly and is attended by all trainees and faculty in both pediatric and adult nephrology. The clinical fellows select the patients and topics for discussion. The conference provides a forum to discuss interesting diagnostic and management problems, and to review the literature on timely and controversial issues. In addition, formal Pediatric Renal Rounds is held weekly and all fellows in pediatric nephrology participate in a series of activities which include review of diagnostic studies, current literature and didactic peer teaching. A conference including nephrologists throughout the state is held monthly to review renal biopsies with Dr. Michael Kashgarian, Yale's outstanding renal pathologist. A clinical or research journal club meets weekly. A didactic course on dialysis and renal transplantation is held throughout the year. A course on renal physiology and pathophysiology is presented each academic year by the Section of Nephrology faculty. In recent years, several other didactic series have been organized at the request of the fellows. Examples include a course on renal pathology given by Dr. Kashgarian and a course on renal imaging techniques given by members of the Department of Diagnostic Imaging. The pediatric renal fellows join all of the postdoctoral fellows in the Department of Pediatrics for a Research in Progress session on a weekly basis as part of the Department of Pediatrics Child Health Research Seminars. These include didactic teaching in biometrics and biostatistics.
Clinical Learning ObjectivesThese clinical experiences are designed to provide a progressive education and expertise in the care of children with renal disorders and related diseases:
Research ExperienceBecause our program is aimed at preparing trainees for careers as independent investigators in the area of nephrologic research, fellows spend a minimum of two years in research activities. In fact, during the last few years many fellows have extended the period of research training to three years. Extending the period of research experience provides fellows with additional time for course work, and, more importantly, allows them to become involved in more challenging and technically demanding research projects. It is our perspective that the acquisition of high quality research skills is fundamental to a viable long?term career in academic medicine. The application of such skills to issues of relevance to pediatric nephrology is easily accomplished. Therefore, we have assembled a group of preceptors for research training which is broad based and encompasses the highest level of contemporary techniques. The core of research experience for each trainee is the pursuit of a specific project under the direct supervision of one or more members of the faculty. The Yale University School of Medicine is unique in having a large group of outstanding investigators with expertise in a broad range of biomedical disciplines relevant to nephrologic research. The current program seeks to combine the "traditional" interest in renal physiology with an appropriate emphasis on cell and molecular biology. The overall emphasis of the program is clearly on basic science laboratory research, as the majority of the training faculty hold primary or secondary appointments in basic science departments. Specifically, the program includes faculty with expertise in molecular genetics, cell biology and experimental pathology, cellular and molecular physiology, and cellular biochemistry and metabolism. Additional faculty provide expertise in integrative aspects of renal tubular and epithelial physiology and pathophysiology. Thomas Kennedy, M.D., the Acting Chief of the Section of Pediatric Nephrology serves as the Program Director. He is assisted by a Advisory Committee consisting of Peter Aronson, M.D., Professor of Medicine and Cellular and Molecular Physiology and Michael Kashgarian, M.D., Professor of Pathology. The choice of a particular preceptor and project is the most important decision facing each fellow. Because it is the philosophy of the program that preceptors should be chosen by trainees rather than assigned, each fellow is provided with extensive help in the form of information, advice and time to make a careful and deliberate selection of preceptor and project. Applicants have the opportunity to discuss research alternatives with Drs. Aronsen and Kennedy and individual members of the Advisory Committee during the interview process. In addition, arrangements are made for each fellow to spend 7-10 days in specific laboratories in which they may have an interest prior to choosing a preceptor. During the first three months of fellowship, each trainee will have many opportunities to meet with the faculty whose research programs are of possible interest to them. Finally, with the advice and approval of the Program Director and Advisory Committee, each applicant will make a choice of preceptor after having had the chance to attend seminars in different fields, and having met the trainees already in these laboratories. Research experience begins during the first year of fellowship. Fellows are encouraged to take at least four one-semester courses during the period of research experience. Rather than require a common curriculum for all trainees, the Program Director and Advisory Committee will assist each trainee in selecting courses of greatest relevance to the trainee's chosen area(s) of research. Particularly recommended will be general courses emphasizing fundamental basic sciences and research methods. All trainees will participate in a Nephrology Research Journal Club and will give oral presentations at least yearly as part of a monthly Nephrology Research Conference. In addition, each fellow attends departmental Child Health Research Seminars weekly. Also, fellows will have a particularly rich spectrum of seminars from which to choose, as the Departments of Pediatrics, Internal Medicine, Cellular and Molecular Physiology, Cell Biology, Pathology, Molecular Immunology and Human Genetics, each sponsor research seminars.
Research Learning ObjectivesThe longitudinal design of our fellowship program allows each fellow to develop, progressively, more sophisticated skills in either bench or clinical research.
Affiliated FacultyYale University School of Medicine is unique in having a large group of distinguished faculty whose research interests include the study of normal or abnormal kidney structure and function. The training faculty for our program includes investigators outside the Department of Pediatrics or Medicine with expertise in a broad range of biomedical disciplines relevant to nephrological research. Many of these affiliated faculty have previously directly supervised the research experiences of nephrology fellows. This provides fellows with access to a broad range of research projects within the fields of biostatistics, clinical epidemiology, genetics, immunology, transplantation biology, physiology, and cell biology. Some of these faculty also participate in the didactic components of nephrological training.
Additional Information/Interview ScheduleWe hope that this information has provided you with an in depth perspective of our Fellowship Program in Pediatric Nephrology at Yale. If you feel that additional information would be helpful, please contact us via telephone or email. We are now accepting applications through the Electronic Residency Application Service (ERAS). Please visit the ERAS Website to access the on-line application. You should include:
After you have had a chance to review these materials, if you have any additional questions, please contact us. Salary support for our fellows is provided by a training grant from the National Institutes of Health. This grant only provides salary support for a U.S. citizen, naturalized citizen or a citizen holding permanent residency in the United States. Yale University School of Medicine is committed to increasing representation of women and members of minority groups among its students, residents, postdoctoral trainees and faculty, and we particularly encourage applications from such candidates. Once we review your application and letters of recommendation, we would be pleased to arrange an interview for you if you wish to pursue the fellowship possibilities in pediatric nephrology at Yale. If you have any questions, please contact Marie Campbell at (203) 785-4643 between 9:00 a.m. and 4:00 p.m. EST or e-mail her at: marie.campbell@yale.edu. We cordially invite you to visit our program and gain first-hand knowledge about living and learning Pediatric Nephrology at Yale. Thomas Kennedy, MD |
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