Transplant Nephrology Fellowship Program | DC | MedStar Health

The MedStar Health—Georgetown University Hospital Fellowship in Transplant Nephrology

The MedStar Georgetown Transplant Institute, centered at the MedStar Georgetown University Hospital, is a multidisciplinary program dedicated to providing solid organ transplants to the greater Washington, D.C., community. The transplant nephrology fellowship is part of the transplant institute’s overall academic mission. The center is not only one of the largest in the country, but also one of the few to perform all four abdominal transplants (kidney, liver, pancreas, small bowel). Transplant fellows will gain exposure to all of these types of transplants.

The transplant nephrology fellowship is a one-year clinically oriented fellowship program. It includes three components:

  • A clinical component in which the fellow is involved in primary management of both inpatient and outpatient care of transplant patients

  • A didactic component with weekly one-hour sessions on a variety of topics

  • A year-long project component designed to expand knowledge in a specific area of transplant and to prepare the fellow for future academic work

Why train here

With over 300 kidney transplants, 100 liver transplants, 30 pancreas transplants, and 15 small bowel transplants performed annually, we can offer experience in all facets of solid organ transplantation.

Beyond the size of the program, our strength is rooted in our collaborative approach, with all aspects of the transplant team working as part of an integrated transplant institute. In addition to transplant surgeons and transplant nephrologists, the institute has a strong infrastructure including pathology, an on-site histocompatibility lab, a dedicated transplant floor, and specialized transplant nursing to form one of the most comprehensive transplant centers in the country.

Fellows are exposed to all types of kidney transplants, including crossmatch positive transplants, ABO incompatible transplants, HIV- and HCV-positive transplants (including HCV into non-HCV recipients), paired kidney exchange and transplants from non-directed donors, and PHS increased risk transplants. They will have firsthand experience in seeing the recipient operation as well as procurement of a donor organ. They will do biopsies of transplanted kidneys as well as plasmapheresis and dialysis. They’ll also learn about a variety of research protocols used in transplantation including combined kidney/bone marrow transplantation.

During the year, fellows have opportunities to take part in ongoing clinical research protocols and pursue their own topic in either clinical or basic science research. They are also part of the educational program at the institute, helping to teach and mentor general nephrology fellows as well as residents and students doing their transplant rotations.

Curriculum

The overall structure of the fellowship will be 12 one-month rotations. While the rotations are designed to focus on a particular area in transplant education, all aspects of transplant will be part of the fellowship throughout the year. Fellows work on their research/project throughout the year, but will have one dedicated month towards the end of the year to focus on and finish that work.

The rotation includes:

  • 8 Clinical rotations

  • 1 Rotation in the histocompatibility lab

  • 1 Rotation in pathology

  • 1 Rotation in pediatric transplantation

  • 1 Rotation in research

Fellows are provided four weeks of vacation during their fellowship year. Although they’re granted wide latitude in when they can take vacation, it is expected to occur only during one of their clinical rotations rather than during HLA, pathology, pediatric, or research blocks. Fellows are not expected to take overnight or weekend call during their fellowship.


  • Post Transplant Management Conference

    Transplant hepatology fellows are expected to attend the weekly Monday post transplant management conference over the course of the 12-month program. The purpose of the conference is to make medical and surgical treatment decisions on newly transplanted inpatients and outpatients as well as complicated long-term liver transplant recipients. Trainees will interact with transplant hepatologists, transplant surgeons, post transplant nurse practitioners, and transplant pharmacists.

  • Core Curriculum Conference

    Transplant hepatology fellows are expected to attend the weekly Tuesday core curriculum conference over the course of the 12-month program. The purpose of the conference is to discuss the physiology, pathophysiology, evaluation, and management of acute and chronic hepatobiliary diseases. Topics to be discussed include but are not limited to viral hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease, acute liver failure, drug-induced liver injury, vascular diseases of the liver, primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis, hemochromatosis, Wilson disease, hepatobiliary diseases related to pregnancy, alpha-1-antitrypsin deficiency, and benign and malignant hepatobiliary tumors. Additionally, trainees will gain an understanding of complications of portal hypertension including prevention and treatment of variceal bleeding and re-bleeding, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. Transplant hepatology fellows will also gain an appreciation of the importance of nutrition, medical imaging, and pathology when assessing patients with acute and chronic liver diseases in the pre-transplant and post-transplant settings. Fellows will understand the indications, contraindications, and side effects of immunosuppressive medications and other agents applicable to the post-transplant setting. Other topics to be discussed include the variety of medical and surgical complications that can arise after transplantation.

    The core curriculum conference will consist of didactic lectures, case presentations, and journal club. Fellows will be expected to periodically lead select conferences over the course of the 12-month program. We anticipate that key clinical faculty will mentor fellows in preparation for their presentations. All presentations at core curriculum conferences will be uploaded on the Georgetown Transplant institute share drive for later reference.

  • Research Conference

    Transplant hepatology fellows are expected to attend research conferences over the course of the 12-month program. The MedStar Georgetown transplant institute has a variety of protocols pertaining to non-transplant and transplant hepatobiliary programs. Trainees are expected to present their work at these conferences.

  • Transplant Surgery Academic Conference

    Trainees are expected to attend the weekly Friday transplant surgery academic conference over the course of the 12-month program. A variety of topics are discussed including but not limited to journal club, morbidity and mortality conference, and didactics pertaining to hepatobiliary and transplant surgery. Guest speakers in addition to Georgetown faculty are frequently invited to present at these conferences.

  • Pathology Conference

    Transplant hepatology fellows are expected to attend the weekly Wednesday pathology conference. As per ACGME, fellows are expected to review over 200 native and allograft biopsies over the course of the 12-month program. Trainees will interact closely with pathologists, transplant hepatologists, transplant surgeons, and post transplant nurse practitioners. Fellows are expected to present inpatients and outpatients whom they have seen during their mandatory rotations.

  • Transplant Selection Committee Conference

    Transplant hepatology fellows are expected to attend the weekly Tuesday transplant selection committee conference. As per ACGME requirements, fellows will present a minimum of 10 patients undergoing liver transplant evaluations over the course of the year. Given the volume of the transplant program, fellows will typically present many more patients than the minimum required by ACGME. Fellows will interact closely with transplant hepatologists, transplant surgeons, pre liver transplant coordinators, nutritionists, social workers, psychiatrists, financial counselors and other staff as appropriate.

  • Hepatobiliary Tumor Conference

    Transplant hepatology fellows are expected to attend the weekly Tuesday multidisciplinary hepatobiliary tumor conference over the course of the 12-month program. The purpose of the conference is to review imaging and make treatment decisions on patients with benign and malignant hepatobiliary tumors. Trainees will present cases and interact with transplant hepatologists, hepatobiliary surgeons, oncologists, radiation oncologists, diagnostic radiologists, and interventional radiologists.

Conferences

Fellows receive time off and support to attend the AST Transplant Fellows Symposium offered each September. Fellows are encouraged to submit their research for presentation at the American Transplant Congress held each spring. They are allotted time off to attend, and if their work is accepted for presentation, their travel expenses will be covered by MGTI.

How we evaluate fellows

Formal review and evaluation by the program director will occur midway through (at six months) and at the end of the fellowship. Additional interim reviews will be scheduled on an as-needed basis as deemed necessary.

Fellows must keep a log of the following procedures and experiences:

  • Primary patients managed (their ‘panel’): minimum 30 patients inpatient and outpatient

  • Primary pancreas transplant patients: minimum five patients (may also count for kidney primary)

  • Transplant recipient evaluations: minimum 25 patients

  • Pancreas evaluations: minimum five patients (may also count as kidney evaluations)

  • Living donor evaluations: minimum 10 patients

  • Renal transplant surgery observation: minimum three operations (including at least one living and one deceased donor)

  • Organ recovery observation: minimum three operations

  • Transplant kidney biopsies: minimum 10 procedures

Upon completing the program, fellows meet criteria set forth by UNOS for designation as a renal transplant physician and a pancreas transplant physician as well as being eligible to be the primary transplant physician at a CMS-certified program.

Training locations

MedStar Georgetown University Hospital

A nonprofit, acute care teaching and research hospital with 609 located in Northwest Washington, D.C., Read more about their mission to service our patients.

3800 Reservoir Rd. NW
Washington, D.C., 20007

MedStar Washington Hospital Center

A 912-bed, major teaching and research hospital. MedStar Washington is the largest private, not-for-profit hospital in the nation’s capital and among the 100 largest hospitals in the country. It is a major referral center for treating complex cases of illness.

110 Irving St. NW
Washington, D.C., 20010

Application information

Interested in applying?

Contact us

For more information about our program, please contact:

Leslie McDonald

202-444-1106 

Leslie.M.McDonald@medstar.net