Nephrology Fellowship Training Program

Welcome to the Nephrology Fellowship Training Program!

The Nephrology Fellowship Training Program provides MD and/or PhD postdoctoral fellows with wide-ranging clinical and research training opportunities across the spectrum of molecules to populations, including, but not limited to, acute kidney injury (AKI), chronic kidney disease, end-stage kidney disease (ESKD), transplantation and pediatrics. 

Our program aims to provide excellent training that is tailored to the fellow's career path, including medical education, basic science, clinical science, private practice, health care administrative leadership or nephrology government service. Fellows will generally complete the program in two to three years depending on their chosen track. 

An educationally-enriched program comprised of inpatient and outpatient clinical experiences, as well as structured and mentored research opportunities, fellows receive protected time for daily noon didactics and funding to attend national conferences, including the American Society of Nephrology (ASN) and National Kidney Foundation, as well as other educational conferences such as Home Dialysis University. 

Program highlights include:

  • Diverse faculty expertise
  • Advanced degree opportunities
  • Training in all dialytic therapies
  • Huge home dialysis unit
  • Daily noon lectures with lunch
  • Extensive research opportunities
  • Diverse patient population
  • World renowned renal pathology program
  • Point-of Care ultrasound training

Diverse subspecialty clinical experiences

Our robust outpatient and inpatient clinical services see over 3,000 outpatient clinic visits per year, perform over 250 kidney transplants per year, and have more than 100 home dialysis and over 200 in-center hemodialysis patients.

Fellows rotate on four separate inpatient consultative services, including AKI, ESKD, Kidney Transplant and Veterans Affairs. During that time, they receive instruction in all inpatient dialytic procedures, including peritoneal dialysis, hemodialysis, sustained low efficiency dialysis, continuous renal replacement therapy, plasmapheresis and extracorporeal membrane oxygenation. We have dedicated faculty in the outpatient clinic who expertise in nephrolithiasis, kidney disease in pregnancy, glomerular disease, cystic disease and other rare disorders.

Fellows also have extensive elective rotations with exposure to subspecialty clinics, including hypertension, vascular access, nephrolithiasis, interventional radiology, pathology and palliative care. 

Fellows may select from one of four tracks – Clinical, Clinical Educator, Clinical Research or Basic Science Research – based on their desired career path. Track selection is chosen during the first six months of fellowship, and does not need to be declared at the time of application. 

Clinical Track timeline 

  • First year: Usual clinical responsibilities, including one to two half-days of clinic per week 
  • Second year: Six months research time (highly protected with opportunity for structured projects) plus six months of clinical responsibilities.  Also includes one to two half-days of clinic per week 

Research Track timeline (Clinical, Clinical Educator and Basic Science tracks) 

  • First year: Usual clinical responsibilities, including one half-day of clinic per week  
  • Second and third years: Protected research time, including the option to do a Master of Science in Clinical Investigation, Master of Public Health or Master of Education in the Health Professions program

The clinical portion of the fellowship is divided into serial two- to three-week rotations over six months. Fellows repeat the six months two to three times depending on their track. A sample of the six-month block is available below.  

  1. VUMC Renal Consults 
  2. Pathology
  3. VUMC Renal Consults
  4. VA
  5. VUMC ESRD
  6. Outpatient ESRD
  7. VUMC Afternoon Consult
  8. Transplant
  9. Outpatient Specialty Clinics
  10. VUMC AKI-ESKD Consults

Call

Call is divided up between the fellows as follows:

  • Night call (home call): Varies based upon the rotation. First-year fellows take home call once every seven to 12 days. Second-year fellows average one to two home calls per month.
  • Weekend morning coverage (6 a.m. to noon): Variable based upon the rotation, but typically two to three weekend days (Saturdays and/or Sundays) per month.


Continuity Clinic

Fellows have continuity clinic throughout their fellowship. Each fellow has one half-day per week of a general nephrology continuity clinic throughout the year. Each fellow is expected to attend, or find coverage for, their respective clinics during each of their rotations through the year.


Procedures

We train fellows in ultrasound-guided kidney biopsies, temporary dialysis catheter placement and point-of-care ultrasound.

At VUMC, both native and transplant kidney biopsies are performed by the Division of Nephrology and Hypertension. This allows fellows an excellent chance to become competent in performing the procedure, in addition to learning the indications, risks, and benefits of a kidney biopsy.

At VUMC, temporary dialysis catheters are placed by many services, including nephrology, so as not to overburden the already busy nephrology teams.

Dr. Natalie McCall runs the POCUS curriculum throughout the academic year. It includes lectures, hands-on practice in the simulation center, and experience utilizing POCUS in treating patients, as well as performing procedures.


Description of Clinical Rotations

Inpatient Nephrology Consults – VUMC  

  • Composed of two fellows and up to two medical students/residents, the general consult service evaluates and helps manage all care not otherwise covered by the ESKD service. This includes diagnosing and managing causes of AKI, electrolyte and acid/base disorders, initiation of dialysis, continuous kidney replacement therapies, and management of apheresis. The fellow is on service until 1 p.m. 

Inpatient ESKD Consults – VUMC  

  • This service is comprised of an attending, fellow, nurse practitioner and, at times, a medical student. The fellow is responsible for the management of care for ESKD patients on dialysis who have been admitted to the hospital. On this service, trainees learn how to tailor dialysis needs to coordinate ongoing inpatient care. This includes the continuation of dialysis in anticipation of a scheduled procedure, transition to alternative modalities, or adjustment of dialysis to meet the needs of patients with complex medical issues. Fellows are responsible for mastering the management of hemodialysis and peritoneal dialysis in the inpatient setting. The fellow is on service until 1 p.m. 

Inpatient Combined AKI/ESKD Consults – VUMC  

  • This service is comprised of an attending and fellow. The goal of this service to provide the fellow with a more real-world experience, taking both new AKI and ESRD consults from 8 a.m. to 2 p.m. The overall responsiblities are the same for the general and ESKD services. 

Afternoon Consults – VUMC  

  • The afternoon fellow's day starts with noon conference. After noon conference, they cover the general consult and ESKD services from 1 to 6 p.m., taking all new consults and covering the needs of those already on service. The overall responsibilities are the same for the general and ESKD services.  

Inpatient Renal Consults – Tennessee Valley Veterans Affairs Hospital (located across from VUMC) 

  • One fellow and one attending comprise the VA consult service and help with the management of both acute consults and the management of ESKD patients on dialysis. Additionally, the fellow is responsible for assisting in the management of the outpatient dialysis unit at the VA and helping to coordinate care plans for outpatient ESKD patients. The VA fellow is available to perform biopsies if needed. The fellow on service is responsible for taking call 7 a.m. to 6 p.m., and has every other weekend off.   

Inpatient Transplant Rogers service – VA and VUMC  

  • The Nephrology fellow works alongside the Transplant Nephrology fellow(s) at VUMC and the VA from 7 a.m. to 6 p.m. while on service. The shared responsibilities include evaluation of new transplant recipients admitted preoperatively and through the remainder of their hospital course. Additionally, the fellows are responsible for any consultations on previous transplant recipients admitted to other services. The fellows also share in the responsibility of performing transplant biopsies. The entire service is comprised of a transplant attending, transplant fellow, general nephrology fellow, intern, pharmacist and medical student.   

Outpatient Renal Pathology, Pediatrics, lnterventional Radiology Specifics (weekends off) 

  • Renal Pathology: Fellows have a dedicated rotation with our world-renowned Renal Pathology program, which evaluates over 2,000 specimens per year. Fellows on this rotation review cases from VUMC and the surrounding catchment area with Renal Pathology attendings and fellows, as well as daily teaching topics. This rotation is required in the fellow’s first year. 
  • Pediatrics: Round with and see patients with the Pediatric Nephrology consult service to obtain exposure to diseases that are less common in the adult population and help facilitate a greater understanding for adolescent kidney diseases.  
  • Interventional Radiology: Observe and participate in placement of tunneled dialysis catheters and access management, and attend monthly access conferences with IR, surgery and nephrology faculty.  

Ambulatory Rotation (weekends off) 

Fellows will have daily exposure to the following during their Ambulatory rotation: 

  • Outpatient dialysis clinic, including in-center, home hemodialysis and peritoneal dialysis 
  • Dialysis access clinic 
  • Vasculitis clinic
  • Hypertension clinic 
  • Chronic kidney disease clinic 
  • Nephrology-palliative care exposure as part of a conservative care curriculum  
  • Kidney stone clinic 
  • Renal transplant evaluation clinic 

Outpatient ESKD Rotation 

Fellows have the opportunity to rotate with different Nephrology attendings during their outpatient hemodialysis shifts at the two Vanderbilt dialysis units, as well as attend home dialysis clinic. We have a robust outpatient dialysis program with over 300 patients, 40% of which utilize home therapies, including continuous ambulatory peritoneal dialysis, continuous cycling peritoneal dialysis and home hemodialysis. During this rotation, fellows work with the clinic’s multidisciplinary team to learn about the management of a dialysis unit, dialysis access and the water room. Graduating fellows are well-prepared to become medical directors of dialysis units and care for patients on home dialysis therapies and/or in-center hemodialysis.

Research is an important part of our training tracks, and we provide extensive clinical and basic research opportunities in either six months of dedicated research time in the two-year clinical track, or two or more years of dedicated research time in the research tracks. Learn more about the research component of each track below.

For selected fellows, we have an NIH-funded T32 training grant that provides a structured and mentored training experience in basic and clinical and translational research. You can read more about this opportunity here.

To discover some of the research going on in the division, click here.

The division offers a wide variety of high-quality didactics for both fellows and faculty. A sample of weekly didactics:

Monday 

  • Board Review and Fellows Conference
  • Home Dialysis Journal Club 
  • Point-of-Care Ultrasound Conference 
  • Dialysis Access Conference 

Tuesday 

  • Renal Pathology Conference 
  • Morbidity and Mortality Conference 
  • Journal Club 
  • Case Conference 

Wednesday 

  • Physiology Conference 

Thursday 

  • Renal Grand Rounds 

Friday 

  • Clinical Conference 
  • Transplant Conference
  • Renal Research Conference 

Suggested textbooks:

  • Comprehensive Clinical Nephrology (Johnson)
  • National Kidney Foundation Primer on Kidney Disease
  • Clinical Physiology of Acid-Base Disorders (Rose)
  • Brenner and Rector's The Kidney (Skorecki)
  • Handbook of Dialysis (Daugirdas)
  • Oxford Handbook of Nephrology and Hypertension (Steddon)
  • Handbook of Kidney Transplantation (Danovitch)
  • Critical Care Nephrology (Ronco)

All fellows receive:

  • A laptop
  • $1,000 in textbook/conference money 
  • Free membership to the  ASN 
  • Free membership to the National Kidney Foundation 
  • Free airfare/hotel stay coverage to the ASN Kidney Week during the second year of fellowship 
  • Program support for any ASN poster or abstract, regardless of year 
  • ID card with funds to be used at on-campus food and cafeteria services 
  • 15 weekdays of vacation, not including weekends, to be taken during elective/ambulatory rotations  

Vanderbilt University Medical Center's Nephrology Fellowship Training Program considers all interested applicants without regard to race, color, religion, gender identity, sexual orientation, sex, or national origin. All applications must be made through the Electronic Residency Application Service (ERAS). We have endorsed the “all in” participation in the NRMP match.

Application Requirements

  • ERAS Application
  • Current CV  
  • Transcript of medical school grades  
  • One (1) letter of recommendation from Dean of your medical school (also known as the Medical Student Performance Evaluation)
  • Three (3) supporting letters of recommendation  
  • Recent photograph  

Interview Day Structure: 

  • Interview days start at 7 or 8 a.m. CT depending on faculty schedules  
  • Interviewee will meet with two to three faculty in the morning, attend noon conference, have lunch with the fellows, and end the day with two to three more faculty interviews 
  • Interview day concludes by 4 p.m. CT

Learn more about life as a fellow in Nashville

For questions about our program, please email nephclinicalfellowship@vumc.org.

Program Leadership

Anna Burgner, MD, MEHP

Associate Professor of Medicine
Director, Nephrology Fellowship Program 

Julia Lewis, MD

Professor of Medicine
Associate Director, Nephrology Fellowship Program