Virginia Commonwealth University Health System Program

The Nephrology Fellowship Program at Virginia Commonwealth University Health System is a distinguished two-year fellowship designed for physicians seeking advanced training in clinical nephrology, hypertension, and transplantation medicine, along with research opportunities. The program is structured to foster clinical excellence, intellectual curiosity, scientific discovery, innovation, collegiality, diversity, equity, integrity, and teamwork among its fellows, ensuring they are well-prepared for careers in either academic medicine or private practice.

Fundamentally, the fellowship integrates six core competencies: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. This comprehensive approach helps fellows develop a lifelong commitment to learning and professional growth in nephrology 1.

Program Curriculum and Rotations

The curriculum provides an extensive, well-rounded training experience in all aspects of nephrology including acute kidney injury, chronic kidney disease, glomerular diseases, diabetic nephropathy, hypertension, fluid and electrolyte disorders, management of end-stage renal disease (ESRD), renal transplantation, and nephrolithiasis. Rotations are organized primarily in facilities associated with VCU and the Richmond VA Health Care System, where fellows gain hands-on experience 1.

The typical rotational structure includes:

• In-Patient Consult Service: Involves sub-divisions for ICU and floor consultations, where fellows assess and manage hospitalized patients referred for nephrology consultations. This rotation allows for exposure to a variety of complex medical conditions requiring nephrology input.
• VCU Transplant Service: Focuses on caring for patients immediately post-renal transplant and managing both pre- and post-transplant care in outpatient settings.
• Richmond VA Medical Center Consult Service: This service usually consists of a significant patient case load that includes those admitted with ESRD, providing fellows opportunities to manage and round with attending faculty.
• Continuity Clinic: Occurs weekly, allowing fellows to maintain a panel of their own patients while also collaborating with pharmacists in managing cases 1.

Unique Learning Opportunities

The fellowship offers unique experiences in specialized clinics such as hypertension clinics focusing on resistant hypertension, glomerulonephritis specialty clinics, and opportunities for immersion in pediatric nephrology and various palliative care settings. This breadth of exposure enables fellows to develop niche expertise within nephrology 1.

Conferences and Scholarly Activities

A robust conference schedule underpins the educational structure, including:

• Nephrology Grand Rounds: Held weekly with presentations by internal and visiting faculty, where fellows also present on topics of their choice.
• Case Conferences: Interactive sessions every Friday to discuss interesting clinical cases.
• Board Review and Didactic Lectures: Weekly reviews featuring nephrology-related topics with contributions from faculty across the division.
• Research Participation: Second-year fellows are encouraged to attend and present at major conferences, such as the American Society of Nephrology Annual Conference 1.

Work-Life Balance and Well-Being

The fellowship allows for three weeks of vacation per year, along with five additional days off during the December holiday season. A comprehensive graduate medical education (GME) well-being program underscores VCU's commitment to the resilience and health of its fellows 1.

Visa Support and Competitiveness

The program is highly competitive, aiming to attract a diverse group of fellows. It maintains a commitment to supporting a wide array of applicants, including those from international backgrounds. Notably, the program only sponsors J-1 visas, ensuring compliance with immigration requirements for foreign medical graduates 1.

Application Requirements

To apply for the Nephrology Fellowship, candidates should have completed three or more years of internal medicine residency training in an ACGME-accredited program. A USMLE Step 3 passing score is required. Required application documents include a curriculum vitae, USMLE score reports, medical school transcripts, a personal statement, and four letters of recommendation, with one from the program director 1.