The MedStar Health - Georgetown University Hospital Fellowship Program in Nephrology
Thank you for your interest in the MedStar Georgetown University Hospital Division of Nephrology and Hypertension within the Department of Medicine. This website contains information directed towards those interested in considering a fellowship in our Division. Our goal for the fellowship is to train the next generation of leaders and successful clinicians in nephrology.
For over 50 years, Georgetown has stood at the forefront of nephrology training programs with the aim of producing the very best nephrologists. Trainees undergo a rigorous clinical and investigative program specializing in all major aspects of adult nephrology including:
- Chronic kidney disease
- Acute kidney injury
- Hypertension (Home of the Georgetown University Hypertension Research Center)
- Acid-base disorders
- Electrolyte disorders
- Pregnancy related renal disease (Home of the Georgetown University Center for the Study of Sex Differences in Health and Disease)
- Onco-nephrology (in close collaboration with the Georgetown Lombardi Comprehensive Cancer Center)
- Kidney transplantation (MedStar houses the only Renal Transplant Institute in Washington, DC)
Our fellowship training program is approved by the ACGME (Accreditation Council of Graduate Medical Education). We typically accept 3 fellows per year into the training program depending on available ACGME slots and candidate qualifications. Georgetown has a diverse class of fellows who enjoy great camaraderie and a friendly environment in a superb multicultural capital city with outstanding sporting and recreational activities. Georgetown has a prominent research program with a strong focus on both basic science and clinical projects. The hard work and dedication of the clinical and basic science faculty as well as a strong partnership with the Washington DC Veteran Affairs Hospital makes Georgetown one of the pre-eminent nephrology research divisions in the United States.
Why train here
At the Division of Nephrology and Hypertension at MedStar Georgetown University Hospital, our goal is to train outstanding clinical nephrologists and investigators for positions in either academic or private practice. Our faculty are dedicated to our fellows and are always working with our fellows to optimize their learning experience. The second year of fellowship provides an opportunity to tailor the experience to each fellow’s interests through clinic, research and scholarly activities. We host the Mid-Atlantic Nephrology Fellows research forum annually.
We invite you to explore our Nephrology Fellowship Program web page to learn more about our Fellowship Training Program. Please feel free to contact us anytime.
Distinguishing Features of the Division of Nephrology and Hypertension
- Founding of the Division by George E. Schreiner, M.D. (Chair of International Society of Nephrology and president of the National Kidney Foundation);
- A strong nephrology training program founded more than 50 years ago;
- Dedication to a strong clinical and research training program for faculty and fellows;
- Nephrology and hypertension research fellowship training program with DC VAMC;
- Largest NIH funded research program in the Department of Medicine with a Program Project Grant that has been renewed three times;
- A strongly NIH funded science program supporting eight research faculty with five R01 grants from the NIH;
- Human Hypertension Research Center funded by philanthropy and equipped to study endothelial function, cardiac output, exercise physiology and more;
- National and international recognition of faculty, evidenced by one faculty elected to the American Association of Professors, three faculty who together have delivered twenty named lectures at universities or at national and internal meetings including the Harriet Duston Award of the American Heart Association; the Dahl Lecture of the AHA; the Starling lecture of the American Physiology Society, the Lifetime Achievement Award of the AHA and the Excellence in Hypertension Research Award of the AHA;
- Three faculty who are, or have been, permanent members of NIH peer review groups and one who has chaired four groups;
- Two faculty who hold directorship of Georgetown University Centers: The Hypertension Research Center, and the Center for Sex Difference in Disease;
- Five faculty who hold medical directorships at the MedStar Georgetown University Hospital inpatient hemodialysis, continuous ambulatory peritoneal dialysis, and continuous renal replacement treatment programs and at regional dialysis units in the Washington DC/Metropolitan Area;
- The first to open a “Home Only” dialysis program in D.C.
- Inpatient nephrology services for MedStar Georgetown University Hospital encompassing:
- Three intensive care units (medical, surgical, and neurosurgical)
- Several intermediate care units
- A solid organ transplantation ward (kidney, pancreas, liver, and multi-visceral/small bowel transplants)
- An oncology ward
- Many general medical and surgical ward floors
- Partners in a limited liability joint venture company with DaVita Inc. to operate three dialysis units in the DC region;
- Success in raising more than $3,000,000 in philanthropic support;
- A strong history of placing graduating fellows in their choice academic or private practice setting;
- A clinical program that has been profitable for more than 25 years.
Georgetown nephrology fellows receive training as they rotate through the inpatient and outpatient services, and through a series of lectures delivered by faculty and fellows. Fellows should expect to accomplish the following:
- Become confident in all aspects of nephrology practice and a wide range of problems encountered by patients with kidney disease, renal transplant or hypertension. Fellows receive instruction in taking an appropriate history, performing a complete physical examination and generating an appropriate differential diagnosis.
- Understand the pathophysiologic basis of kidney disease and hypertension.
- Develop a full understanding of the laboratory and imaging methods used to evaluate patients with kidney disease.
- Understand the principles of hemodialysis, peritoneal dialysis, home hemodialysis, plasmapheresis, continuous renal replacement therapy and how to write both acute and chronic dialysis prescriptions.
- Learn to diagnose and treat a variety of primary and secondary kidney diseases.
- Understand the principles of immunosuppression and how to evaluate the potential renal transplant donor and recipient.
- Acquire a thorough understanding of the management of the renal transplant recipient.
- Learn to critically evaluate a scientific publication
The first year of fellowship focuses heavily on clinical training. MedStar Georgetown University Hospital encompasses three ICUs (medical, surgical, and neurosurgical), several IMC units, a solid organ transplantation ward (where kidney, pancreas, liver, and multi-visceral/small bowel transplants recipients receive their care), an oncology ward, and many other general medical and surgical ward floors. This creates a well balanced environment providing a wide variety of clinical cases for inpatient training. The goal is to provide first class clinical training but also to respect fellows time and to provide a good opportunity for reading. In order to limit the patient load of each individual fellow and allow adequate time for didactics on rounds, the services are divided into three teams, each with its own fellow and attending:
- Acute Inpatient Service – this service manages episodes of acute kidney injury, acid base disorders, electrolyte disturbances, hypertensive disorders, onco-nephrology, and pregnancy related disorders in non-dialysis and non-transplant patients
- Chronic/Dialysis Inpatient Service – This service focuses on the care of established dialysis patients (both hemodialysis and peritoneal dialysis) and plasmapheresis patients in the inpatient hospital setting
- Transplant Service – This service cares for all renal transplant patients and for renal disease in many other solid organ transplant patients including liver transplants, small bowel/multi-visceral transplants, pancreas transplants, and lung transplants.
Each team is composed of one fellow, one attending, and rotating Georgetown or visiting internal medicine residents, and medical students. MedStar Georgetown has five certified transplant nephrologists who run the Transplant service. Chanigan Nilubol, MD, is a full time faculty member in the Division of Nephrology and Hypertension and a trained and experienced transplant nephrologist. There is also a surgical transplant team with its own transplant surgery attending to provide a multi-disciplinary environment for these complex patients. There is a strong focus on clinical teaching while rounding. The aim is to provide an environment that is thought provoking with an open forum for questions and opinions. The inpatient teams provide consultative services since medical patients at Georgetown are admitted by Department of Internal Medicine hospitalists. This permits the fellows to concentrate on the nephrology problems of the patient. Fellows receive training in many clinical services and procedures including: inpatient hemodialysis, inpatient peritoneal dialysis, continuous renal replacement therapy modalities in the ICU, slow continuous ultrafiltration, urine sediment microscopy, temporary hemodialysis catheter insertion (with real time ultrasound guidance), kidney biopsies (native and transplant), and plasmapheresis.
Each fellow participates in a rotating continuity outpatient clinic at Georgetown University Hospital throughout their training. The clinic is typically one half day a week. The fellow rotates every 6 months to interact with different faculty and specialty clinics. A few clinics focus on some selected nephrology topics including chronic kidney disease, resistant and secondary hypertension, onco-nephrology, and kidney transplantation. Other clinics see general nephrology with a mix of different pathologies.
The second year of fellowship focuses on outpatient dialysis, outpatient clinics, and on research. Fellows typically will rotate through the DC Department of Veterans Affairs Hospital for one of their outpatient clinics. Outpatient dialysis training is undertaken at the Georgetown University DaVita Dialysis units at Union Plaza and the “Home Only” unit on Wisconsin Avenue and at the Department of Veteran Affairs Hospital. Georgetown has the first “Home only” dialysis unit in Washington DC specializing in peritoneal dialysis, home hemodialysis and nocturnal home hemodialysis training. Fellows receive training in these rapidly expanding modalities.
Didactics are complemented by:
- Dahlgren Library Access
- Provides access to a multitude of Nephrology references such as Brenner and Rector’s The Kidney / KDIGO Guidelines / Pathology Atlas / ECT
- Access to PubMed
- Access to UpToDate
- Full reimbursement to attend the NKF conference (first years)
- Full reimbursement to attend the ASN conference (second years)
- A personal copy of the Handbook in Nephrology and Hypertension by Christopher Wilcox, M.D., Ph.D. and the Primer on Kidney Diseases by Arthur Greenberg, M.D.
Transplant Nephrology Lecture Series
The clinical transplant nephrologists lead a didactic series focused on all aspects of renal transplantation.
The transplant lecture series is designed to give additional background and to provide a literature review on selected topics. The structure of the series is designed to transition from more passive learning (primarily directed lectures on selected topics) early in the year to more active participation (in the form of case conferences) and ultimately to get the nephrology fellow to lead the teaching by the end of the year (through case conferences and their own presentations). Lectures are attended by the transplant nephrology fellow, the surgical transplant fellows and the general nephrology fellows allowing each discipline to add their own experience and viewpoint to the discussion.
In addition to providing information on a variety of topics, the series is also designed to highlight the strengths and weaknesses in the transplant literature and provide examples of common features and problems found in the design of transplant studies. It is hoped that the literature reviews enable better critical thinking by the fellow in reviewing research and in designing their own research protocols.
Transplant Lecture topics include:
- Introduction and Overview of Transplantation
- Transplant Immunology
- Tissue Typing
- Pathology- Banff Classification
- Clinical Aspects of Rejection
- Kidney Allocation Policy
- Recipient Evaluation
- Donor Evaluation
- Calcineurin Inhibitors
- mTORs and celecept
- Steroids and Steroid Sparing Agents
- Induction Agents
- Pancreas Transplantation
- Delayed Graft Function
- Marginal Organs
- Polyomavirus Associated Nephropathy
- Surgical Issues
- Simultaneous Liver/Kidney Allocation
- Allograft Failure
Journal ClubA clinical scientific research article is selected. New articles alternate with classic articles that have shaped modern Nephrology. There is a fellow presentation and attending-led critique to help fellows learn how to evaluate modern statistics and clinical methods. All attendings are present.
Fellows Clinical Lecture Series
This conference is given by clinical faculty at the Georgetown Division of Nephrology. It provides a two-year comprehensive review of the key clinical and scientific topics in Nephrology and Hypertension.
General nephrology lecture topics include:
- The Glomerulus
- Potassium/Magnesium Physiology
- Introduction to Renal Function, Renal Circulation, Renal Transport, GFR
- Genetic Tubular Disorders
- Proximal Tubule, Loop, and Countercurrent Mechanism
- Normal Blood Pressure, Renal Sodium Handling, Salt Sensitivity, Edema
- Diuretic Action and Resistance
- Hyponatremia and hypernatremia
- Vascular Access
- Renal Imaging/Contrast Nephropathy
- CKD Management
- Lupus Nephritis
- Hypertension Trials
- FSGS and Minimal Change
- IgA Nephropathy
- TMA in Renal Diseases/TTP/HUS/AHUS
- Secondary Hypertension
- ANCA Vasculitis and Anti-GBM
- Membranous Nephropathy
- Amyloidosis/Light and Heavy Chain Deposition
- Dialysis In Depth
- Nephrolithiasis – Nephrologist Prospective
Renal PathologyThis conference is coordinated by the Georgetown University Department of Pathology. Cases are selected from both adult nephrology and kidney transplant patients. Attendings and fellows from MedStar Georgetown and Washington Hospital Center attend this shared conference.
Clinical Case ConferenceThis conference is a fellow driven morning report style of conference focusing on interesting cases from the three inpatient consultation services alternating with selected patients from the outpatient clinics. All attendings are present and help to provide an environment for general discussion and learning.
- Candidates should have the MD, DO or MD / PhD degrees
- Candidates should have completed clinical training in an ACGME accredited Internal Medicine program and be ABIM board eligible for Internal Medicine
- Candidates will be interviewed and ranked by the faculty based upon stated career goals in nephrology, interviews, letters of recommendation, and past performance.
- Candidates must apply through ERAS.
Visa Policy: Only J1 visas are sponsored through MedStar Georgetown University Hospital. We currently do not have the ability to sponsor H1B visas.
How to Apply through ERAS
You should apply for the Nephrology Fellowship Program at Georgetown University Hospital through the Electronic Residency Application Service (ERAS). ERAS is an internet-based applications process developed by the Association of American Medical Colleges to transmit fellowship applications, letters of recommendation, Program Director letters, medical transcripts and other supporting credentials from applicants, residency programs and medical schools to fellowship program directors using the Internet. Visit ERAS on the web for information about the process or to register.
Upon receiving the applications through ERAS, Georgetown will contact candidates about the possibility of an interview. Interviews will be scheduled in the early fall.
Once you have applied to our Nephrology Fellowship Program and accepted our invitation to interview with our faculty, fellows and staff, we hope you will choose to rank Georgetown at the top of your list of desirable training programs in Nephrology Medicine.
Georgetown participates in the National Resident Matching Program’s Medical Specialties Matching Program (MSMP) in Nephrology. This is a computerized venue for matching an applicant’s preferences for fellowship positions with program directors’ preferences for applicants. Visit NRMP on the web for more information or to register to participate.
July – ERAS website opens for applications
July – October – Applicants may submit applications to Nephrology programs
September – October – Interviews conducted
Late November/early December – Match results available
Keiko Greenberg, MD, MHS
Fellowship Program Director
Assistant Professor of Medicine
MedStar Georgetown University Hospital
3800 Reservoir Road NW – Pasquerilla Health Center, 6th Floor
Washington, DC 20007
Fellowship Program Administrator
MedStar Georgetown University Hospital
3800 Reservoir Road NW – Pasquerilla Health Center, 5th Floor
Washington, DC 20007