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The Nephrology and Hospice & Palliative Medicine fellowship training programs of the University of Pennsylvania, Yale University, and the University of North Carolina have collaborated to create a combined 2-year training program through the ACGME’s Advancing Innovation in Residency Education (AIRE) program. The combined fellowship will lead to ABIM board eligibility in both disciplines. Each participating institution anticipates recruiting one carefully selected applicant into this program to start training in July 2021. Candidates will submit materials through ERAS, and a special track in the NRMP match will be used for application to the program. This new training program will integrate academic and clinical experiences in nephrology and hospice and palliative medicine to produce skillful nephrologists who can address the enormous need for palliative care in the practice of nephrology, and hospice and palliative medicine specialists who possess expertise in kidney supportive care.

The primary innovative goals of this program are:

  1. Addressing a currently unmet need for physicians who are experts in providing kidney supportive care for patients with advanced stages of chronic kidney disease, including those not on dialysis as well as those who are.
  2. Condensing the time commitment required for consecutive training in currently accredited training programs from 3 years (minimum) to 2 years.
  3. Embracing a competency-based approach to curriculum design and assessment in the combined training program.
  4. Enhancing the educational value of combined training by integrating the two disciplines, allowing for “crosstalk” and increased collaboration between departments at each institution

Candidates must be highly qualified third-year (PGY-3) internal medicine residents in an ACGME-accredited residency program (PGY-4 if doing a Chief Resident year), or be board certified by the American Board of Internal Medicine within three years of graduation from ACGME-accredited Internal Medicine residency program.

Fellows accepted to the program will spend most of their first year on nephrology services with experiences similar to those of traditional clinical track fellows at each institution, including inpatient consultation, transplant services, and outpatient continuity nephrology clinics. Up to six weeks during the first year will be spent on clinical rotations in Hospice & Palliative Medicine. During the second year, the majority of clinical time will be spent on inpatient palliative care consultation services, home and inpatient hospice rotations, and palliative long-term care experiences. In the second year of the program fellows will spend one half-day per week in a palliative medicine or conservative kidney care clinic for six months, and one half-day per week (or equivalent block time) in an ambulatory experience tailored to the trainee’s desired clinical practice focus. Up to 6 weeks may be designated for in-patient Nephrology rotations. Fellows will participate in teaching conferences of both the Nephrology and Hospice & Palliative Medicine programs over the two-year training period.

Fellows will be supervised and assessed by faculty who are experienced in both disciplines. Mentors will be assigned and assist in developing an educational plan tailored to each fellow’s particular needs and ambitions. Fellows will be evaluated using consensus EPAs and milestones in a competency-based paradigm. A capstone project focusing on the intersection of Nephrology and Hospice & Palliative Medicine will be completed during the second year.

This two-year fellowship is intended to provide training that allows each fellow the opportunity to achieve a high level of competence in all areas required for board certification in both Nephrology and Hospice and Palliative Medicine. We are excited to be offering this innovative opportunity and welcome interested candidates to contact any one of the programs directors for additional information.