Renal Transplant Fellowship Program
One Renal Transplant Fellowship Position is offered each academic year to an individual interested in a more extensive exposure to solid organ transplantation. The successful completion of at least two years of an ACGME-approved general nephrology fellowship training program is required.
The Renal Transplant Fellowship Position is designed to meet all United Network of Organ Sharing (ONOS) as well as American Society of Transplantation/American Society of Nephrology criteria for certification as a transplant physician.
The following outlines how the patients are assigned to the nephrology fellow in the in-patient and out-patient setting and how the patients are assigned to the renal transplant fellow. These are the transplant nephrology related services that the fellows rotate through which explain the work load distribution and the patient assignments:
Transplant Nephrology Ward Service
- This busy inpatient service deals with diagnosis and management of any medical problem requiring hospitalization of patients who underwent a kidney transplant and are on immunosuppression
- This is an excellent opportunity for fellows to learn about the diagnosis and management of hospital medicine in a renal and pancreas transplant population, management of a newly transplanted patient and performing diagnostic renal transplant biopsies
- Transplant nephrology fellow spends 3 -4 months/year and sees between 10-20 patients per day. General nephrology fellows spend 1 month/year. The general and transplant nephrology fellows do not overlap so each have their own unique experience during the month that they are on service
- 5-10 renal transplant biopsies/month
- 10-20 newly transplant renal and pancreas transplant patients
- The fellow works with the attending in the supervision of two to four nurse practitioners on the service
Transplant Nephrology Consult Service
- This service is for the management of renal and pancreas transplant recipients admitted to the non-transplant nephrology ward services
- This also includes Transplant nephrology consults for the affiliate UAB Hospital at Highlands
- Transplant nephrology fellow spends 1-2months/year, seeing between 5-10 patients per day. General nephrology fellows spend 1 month/year. Again they do not overlap
- Important teaching points include peri-operative management of immunosuppression in a renal transplant patient undergoing non kidney transplant related surgery, in a patient in a critical care unit, or on other medicine services
- Acute inpatient evaluation for simultaneous liver kidney or heart kidney transplant
University of Alabama Kidney Pancreas Recipient Evaluation Clinic
- 1-2 half days/week
- Transplant nephrology fellow spends 2-3 months/year General nephrology fellows spend 1 month/year. Again there is no overlap between the general and transplant nephrology fellows so that each of them have their own unique experience
- 4-10 patients/day
- All patients with chronic kidney disease or ESRD who wish to be active candidates for renal transplantation, and individuals desiring to be living renal donors, are scheduled in transplant evaluation clinic daily, which is supervised by the Transplant Attending.
- These patients are then evaluated by the fellow under supervision of a Transplant Attending from 1pm – 5 pm.
- At the end of the day, the Nephrology fellow is responsible for formulating a plan and determining need of any further investigations and discussing it with his Attending and coordinators. He or she then dictates a complete consultation note reflecting their findings and recommendations.
- The Fellow will present each patient for formal discussion at the Transplant Evaluation conference the next week
- The fellows also provide supervision to the nurse coordinators with any acute issues that arise during the course of the patients day while they undergo their evaluation
University of Alabama Living Kidney Donor Evaluation Clinic
- Every Tuesday/Thursday from 1-5
- 2-4 potential living donors/clinic day
- Either a general or a transplant nephrology fellow per clinic day
- This is an excellent venue to get one-on-one instruction in evaluation of a potential donor for live kidney donation. It teaches the fellow to interpret the various tests to determine normal kidney function and over all patient health in the context of undergoing a unilateral nephrectomy and the long term consequences related to this
University of Alabama Kidney Pancreas Continuity Clinic
- This clinic is held daily in the morning starting at 8:00 am
- 25-35 patients are assigned per clinic half day
- There are up to two fellows in clinic on any given day
- Transplant nephrology fellow comes to clinic 2 times a week on the non-ward months and 2-3 times a week on their research month
- General nephrology fellows are assigned half day of clinic every week throughout their second year of their general nephrology fellowship
- Fellows are expected to see between 3-5 patients during this time. In addition to the data gathering, generating an evaluation and plan of care, discussing this with the supervising attending, the fellow is also responsible for the dictation for this encounter which is then reviewed and cosigned by the attending of record.
The trainee is expected to participate in clinical research activities, and may elect to become involved in basic research activities of the transplant center.
In-Patient Medical/Surgical Renal Transplant Ward and Consult Services
The Transplant Service is a combined medical and surgical service which provides kidney transplants to approximately 250-300 patients per year.
The Transplant Ward is a 52-bed unit served by a separate transplant dialysis unit with 6 stations and 1 mobile machine. Each transplant nephrology fellow rotates on the in-patient service for 4 months. On this rotation the transplant fellow will perform allograft biopsies on in-patients.
The Transplant Nephrology Consult Service provides support to transplant recipients who are on other in-patient services. The transplant fellow is exposed to the management of immunosuppressive therapy in various clinical situations while on this service. The transplant fellow will perform all outpatient allograft biopsies on this rotation.
Full tissue typing laboratories are located at UAB supporting solid organ and bone marrow transplantation.
Renal Transplant Outpatient Services
All patients approaching or at end-stage renal disease who wish to be active candidates for renal transplantation, as well as individuals desiring to be living related or unrelated kidney donors, are seen in the Renal Transplant Evaluation Outpatient Clinic. The fellow on the Transplant Evaluation rotation completes a full consult note for all patients and discusses the findings and recommendations with the Transplant Nephrology attending physician on the Transplant Evaluation Service.
Ample exposure to outpatient management of transplant patients is obtained at the Renal Transplant Clinic which the fellow attends twice weekly.
Special conferences for Transplantation Service include weekly Transplant Journal Club, ESRD Conference and Transplant Teaching Rounds.
TRANSPLANT FELLOWSHIP APPLICATION PROCESS
Applications are accepted from graduates of U.S. and foreign medical schools that have successfully completed or are currently in post-graduate training in Nephrology in an ACGME-approved training program in the United States. Applications will be accepted as early as January, with interviews starting in May of the current year for the following year's program. However, applications will not be accepted at this time if the applicant is a holder of a J1 visa.
We require a personal interview of all applicants. To streamline the interview process, we extend invitations for personal interviews only to select applicants. You will be notified if you are chosen for a personal interview after your written application is complete.
Transplant Nephrology Faculty
- John J. Curtis, M.D.
- Robert S. Gaston, M.D.
- Bruce A. Julian, M.D.
- Roslyn Mannon, M.D.
- Shikha Mehta, M.D.
- Samy Riad, M.D.
- Graham Towns, M.D.