Medical College of Wisconsin Pediatric Nephrology Fellowship

Clinical
Outpatient rotation

Minimum of 10 hours per week, averaging 15–25 hours of direct patient contact

Designed to provide exposure to and develop expertise in the diagnosis and management of the full spectrum of kidney diseases.

Clinical experience includes:

• continuity clinic
• acute and chronic dialysis
• renal transplantation
• kidney biopsies
• specialty clinics in metabolic bone disease and polycystic kidney disease
• emergency room and telephone consultations

Inpatient rotation
Estimated 32 weeks over the 3 years of training on the inpatient consult service taking at-home call every other night during each week

Responsibilities include:

• Fellows will be first call with increased responsibilities each year for making initial assessments and treatment plans on nephrology inpatients and consults. Fellows will round each day with resident teams and a nephrology attending who act as second call physician both day and night.
• Second and third year fellows will conduct teaching sessions with residents and medical students.
• Fellows are given many opportunities to gain expertise in kidney biopsy procedures and acute dialysis procedures.

Patient base

• 7-10 new kidney transplants performed each year; 65 total transplant patients followed.
• Average of 20-30 patients with end-stage kidney disease in the Dialysis Center and hundreds of patients with other kidney diseases, including acute and chronic glomerulonephritis, chronic kidney disease, hypertension, nephrotic syndrome, congenital urinary tract anomalies, inherited kidney disorders, and fluid and electrolyte abnormalities are seen and followed.
• The Division averages over 210 inpatient consultations/admissions per year and >2700 ambulatory visits per year.
• Nephrology averages 7-12 patients on the inpatient service.

Research

• 23 months protected research time beginning in the first year of training.
• Fellows will learn how to select a research project and mentor.
• Meet biannually with Scholarship Oversight Committee responsible to provide feedback and review progress of their project proposal.
• Mentorship provided for the writing and submission of at least one first-authored manuscript. Grant writing opportunities are available.
• Mentorship and guidance to prepare abstracts and manuscripts for publication and poster and oral presentations for regional and national meetings provided.

Our Division has a large clinical research portfolio, serving a variety of research interests.

Alexandra Connelly (left) is a Clinical Research Coordinator

Our clinicians lead Investigator-initiated studies and we have a designated clinical research coordinator who is responsible for operational elements of research projects, including feasibility, budget and contract development, regulatory, enrollment, database management, and sample processing. Active internal studies include:

• Native Nephrectomy and Transplant Nephropathy in Kidney Transplant Patients

We participate in multi-center clinical research studies funded by the NIH/NIDDK.

• Chronic Kidney Disease in Children Study (CKiD) The CKiD study is recognized nationally as a model for conducting a collaborative, multi-center study and has generated a wealth of data which has greatly impacted our understanding of pediatric CKD.
• Cure GN 2 - Cure Glomerulonephropathy Network CureGN is a large multi-center, long-term observational study of patients with Nephrotic Syndrome and other glomerular diseases, which aims to improve the diagnosis, treatment and outcomes of patients affected by these diseases.
• APOL1 Long-term Kidney Transplantation Outcomes Network (APOLLO) is a national observational study. The purpose of this study is to test kidney donors and kidney transplant recipients for variants of the apolipoprotein L1 gene (APOL1) to determine whether they impact outcomes. This study is being done to improve outcomes after kidney donation and kidney transplantation.

Our center has contributed decades of longitudinal data to North American Pediatric Renal Transplant Cooperative Study (NAPTRCS), a research effort organized in 1987 by a group of physicians and surgeons committed to the success of pediatric renal transplants

We are members of the Pediatric Nephrology Research Consortium (PNRC) and are frequent contributors to a variety of PNRC research studies, medical record abstraction and genetic, genomic, and biomarker studies. Some active studies include:

• GIGA Kids: Genetic, genomic, and biomarker studies of Henoch-Schönlein purpura and IgA nephropathy in kids
• Genetics of the DevelOpmeNt of the Urinary Tract (DONUT)
• MASTER FSGS: Medical and Surgical Treatment of End - stage Renal disease FSGS
• Safety and Efficacy of the COVID-19 Vaccine in Pediatric Kidney Transplant Recipients

Along with our colleagues in MCW Bioinformatics, we are participating in Preserving Kidney Function in Children with Chronic Kidney Disease (PRESERVE). This study will leverage the PCORnet® infrastructure to conduct large-scale observational studies that will address BP management knowledge gaps for pediatric CKD, focusing on outcomes that are meaningful to patients and clinicians.

We participate in industry-sponsored drug trials that may be of interest to our patients and their families. Although we do not have any open trials at this time, we are currently working to launch some in summer/fall 2023.

Dr. Allison Kriegel (left) is an associate professor of Physiology and Pediatric Nephrology. Her research is broadly centered on understanding how alterations in microRNAs and protein coding genes influence pathology and organ function in cardiovascular disease, renal disease, and cardiorenal syndromes. Her laboratory takes an integrative physiology approach to research, recognizing the interconnectedness of molecular pathways and organ systems in physiology and pathophysiology.

Major areas of research:

• Chronic Kidney Disease (CKD) and Metabolic Changes in CKD
• Cardiorenal Syndrome, Hypertension, and Cardiovascular Disease
• Polycystic Kidney Disease
• Sex Differences in (Patho)Physiology
• Cardio-Oncology

Per Dr. Kriegel, “We combine in vivo approaches for studying cardiac and renal function with advanced molecular techniques to comprehensively study the factors that influence left ventricular pathology. Frequently utilized techniques in our laboratory include: echocardiography, left ventricle pressure-volume relationship analysis, chronic and acute blood pressure recordings, sodium handling/GFR assessment, cell culture models (siRNA, miRNA), in vitro and in vivo miRNA/mRNA suppression, immunohistochemistry, in situ hybridization, immuno/affinity purification, western blot analysis, ELISA, proteomic/metabolomic analysis, miRNA and mRNA next generation sequencing and qRT-PCR.” Some active studies at Kriegel Lab include:

• Targeting Tolvaptan-Resistant Mechanisms of Fibrosis in ADPKD

The goal of this work is to identify and target fibrosis that persists despite a reduction in cyst size with tolvaptan treatment in a mouse model of ADPKD.

• Ellsworth Polycystic Kidney Disease Research This philanthropic funding supports research polycystic kidney disease (PKD) at the Children’s Research Institute.
• Studies to understand mechanisms regulating multi-organ complications in pediatric CKD.

Please see the lab webpage for additional information about Dr Kriegel’s team and research: www.kriegellab.org

Weekly
CRI Research Conference
Faculty and guest speakers present basic or clinical research to openly share their work and encourage the exchange of ideas between scientist and clinicians.

Pediatric Professor Rounds
Attended by students, pediatric residents, fellows and all faculty, a senior resident presents an interesting pediatric case. The diagnosis is not initially revealed and faculty are called upon to provide a lively discussion on their approach to develop a differential diagnosis and diagnostic work-up.

Internal Medicine – Nephrology Clinical Conference
Pediatric nephrology faculty and fellows are welcome to attend monthly case presentation by adult nephrology fellows. Fostering interaction between the adult and pediatric nephrology divisions.

Internal Medicine – Nephrology Academic Conference
Adult faculty, fellows and prominent guest speakers give presentations on current state-of-the art topics in clinical care and Nephrology research.

Department of Physiology – Renal Physiology Sessions
Pediatric fellows are given the opportunity to "sit in" on the graduate level classes on renal physiology presented by faculty in Physiology in the graduate department.

Pediatric Grand Rounds
Weekly lecture by faculty or local/national guest speaker presented on a topic of interest to the entire Department of Pediatrics.

Clinical Case Conference
Interactive review of interesting cases presented by nephrology faculty and fellows.

Monthly
Multidisciplinary Transplant Conference
A case-based discussion and evaluation of current and potential transplant recipients. The conference is attended by nephrology and surgery faculty, fellows and support staff.

Dialysis Quality Improvement Conference
Multidisciplinary discussion of patient medical and psychosocial information. Fellows participate in monthly review of patient outcomes and associated quality improvement initiatives.

Fellows Didactic Learning Sessions
Interactive lecture and discussion led by Nephrology faculty to enhance learning of specific nephrology topics outlined in the curriculum.

Renal Pathology Conference
In a small group setting using a 10 multi-head microscope, pathology faculty provide a review of recently performed kidney biopsies specimens with an interactive discussion of the patients' presenting symptoms, diagnostic evaluation, and management along with Nephrology faculty and fellows.

Fellow's Journal Club
Led by Fellows', a discussion of current literature on a clinical or research topic with critical evaluation of the article and recommendations for clinical application and improvement of quality patient care.

Biannual
Joint Fellowship Curriculum
All specialty fellows meet monthly to learn about topics common to all specialties including teaching skills, career development, quality improvement, etc.

Fellows
In addition to self evaluations, performance is evaluated after each learning experience by the Program Director as well as other members of the nephrology section. Twice annually a summary evaluation is conducted based upon compiled data received from faculty and staff evaluations.

Program
Fellows meet annually and participate in a confidential group interview where strengths of program as well as areas for improvement are gathered and disseminated to the Program Director.

The broad educational goals of the program are to develop the knowledge, skills, and professional attributes that will lead the pediatric nephrology fellow to becoming an excellent clinician caring for children with kidney disease. This will be accomplished by providing a rich environment with opportunities for direct inpatient, outpatient, and consultative patient care under the direct supervision of full-time faculty.

In addition, the trainees will gain knowledge and skills to become productive academic physicians. They will have the opportunity to pursue clinical and/or laboratory-based research as well as learn quality improvement science. Instruction regarding study design, epidemiology, and biostatistics will be available through the research mentor, pediatric nephrology faculty, and the Joint Fellowship Curriculum. Multiple scholarly opportunities exist in the department and at MCW. Under the supervision of a research mentor and Scholastic Oversight Committee, the training program will aim to develop the academic potential of the nephrology fellow. A summary of the goals of the training program will be distributed to each fellow and faculty member within the section, as well as to each research mentor on an annual basis. A brief summary of the goals and objectives include:

• Develop the clinical competencies to manage a wide spectrum of kidney disease, hypertension and urinary abnormalities in infants, children and adolescents.
• Be able to manage patients requiring all modalities of renal replacement therapies including kidney transplantation.
• Understand the role of the pediatric nephrologist in assisting primary care providers in the care and management of children with kidney disease and hypertension.
• Become knowledgeable about research methods and its application to the field of pediatric nephrology.
• Become proficient in the design, execution and dissemination of clinical or basic science research.
• Develop teaching skills and take a significant role in the educational activities of the division.

Learn More

At MCW and within the Department of Pediatrics, we have several programs and resources focused on fostering a diverse and inclusive environment. Our departmental and institutional focus is confronting negative perceptions and welcoming our community. Below is just a sampling of the efforts across our institutions to embed the principles of diversity and inclusion into our culture.

• DOP Diversity, Equity and Inclusion Council | Our Diversity Council, led by Dr. Mike Levas, the DOP Vice Chair for Diversity and Inclusion, and comprised of faculty, staff, administration, and trainees, is focused on connecting with partners across our system and within the community to ensure the DOP is a diverse, equitable and inclusive employer.
• DOP Fellowship and Residency Diversity and Inclusion Committees | In a city filled with its own diversity and rich cultural history, our fellows and residents recognize the importance of addressing diversity, health equity, and inclusion within our programs. As such, the program is proud to recognize the presence and work of its Committee for Diversity, Equity, and Inclusion.
• DOP Unconscious Bias Training | The AAMC has partnered with Cook Ross, Inc., a leading consulting firm, to create training focused on the science behind unconscious bias to help academic medical staff and faculty mitigate disparities. Seven members of our team have earned a certification as unconscious bias trainers through Cook Ross. These trainers have translated what they’ve learned into a two-hour training for our faculty and staff. By learning how to identify and confront unconscious bias, it is possible to mitigate the impact and promote respect for all groups.
• Trauma-Informed Workplace Training | This committee has undertaken actions including a department-wide survey and the creation of four online training modules sharing the principles of trauma-informed approach and how to recognize signs and symptoms of trauma in ourselves and others. This group started as part of Fostering Futures, a state-wide initiative aimed at infusing a trauma-informed approach into all the systems and organizations that touch the lives of Wisconsin citizens with the goal of expanding across the state to make Wisconsin the first trauma-informed state in the nation.
• Office of Diversity and Inclusion | Established in March 2016, the MCW Office of Diversity and Inclusion (ODI) partners within MCW and with community partners to foster and drive inclusion excellence as an effective, empowering enabler of MCW mission and strategic goals.
• Spring Festival of Cultures | The annual Spring Festival of Cultures encourages an increased awareness and celebration of the visible and non-visible identities among our MCW community. This three-day event is an opportunity to promote the fostering of diversity, inclusion and unity at MCW.
• President’s Diversity and Inclusion Award | MCW’s President's Diversity and Inclusion Award recognizes the accomplishments of faculty, staff, students, residents, trainees, and community members in contributing to diversity and inclusion through exemplary leadership.
• Institute of Health and Equity | The Institute for Health & Equity is focused on researching the root causes of health disparities in our communities, and advancing the best ideas to foster health equity throughout the world. We target populations with abnormally high rates of disease and injury – urban and rural alike – and then we find out why. Partnering with community health collaborators who live and work closest to the most vulnerable populations, we are making an impact on reducing those disparities, one community at a time.
• GMF-MCW Partnership | Through their overall partnership, MCW and GMF will bring complementary expertise on a range of strategies to invest in the health, equity and economic well-being of people across Milwaukee, beginning with the neighborhoods adjacent to the new development. Guided by community priorities and data, the GMF-MCW Partnership will be a catalyst for additional investment and community impact. Together, the partners will:
  • Engage resident and community partnerships
  • Improve social determinants of health
  • Catalyze change that leverages resources and investment

Learn More

Meet Our Faculty

About the Medical College of Wisconsin

With a history dating back to 1893, the Medical College of Wisconsin is dedicated to leadership and excellence in education, patient care, research and community engagement. More than 1,400 students are enrolled in MCW’s medical school and graduate school programs in Milwaukee, Green Bay and Central Wisconsin. MCW’s School of Pharmacy opened in 2017. A major national research center, MCW is the largest research institution in the Milwaukee metro area and second largest in Wisconsin. In the last ten years, faculty received more than $1.5 billion in external support for research, teaching, training and related purposes. This total includes highly competitive research and training awards from the National Institutes of Health (NIH). Annually, MCW faculty direct or collaborate on more than 3,100 research studies, including clinical trials. Additionally, more than 1,600 physicians provide care in virtually every specialty of medicine for more than 4.0 million patients annually.

About Children’s Wisconsin

Children’s Wisconsin is the region’s only independent health care system dedicated solely to the health and well-being of children. The hospital, with locations in Milwaukee and Neenah, Wisconsin, is recognized as one of the leading pediatric health care centers in the United States. It is ranked in nine specialty areas in U.S. News & World Report’s 2019-20 Best Children’s Hospitals report. Children’s provides primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. In 2019, Children’s invested more than $130 million in the community to improve the health status of children through medical care, advocacy, education and pediatric medical research. Children’s achieves its mission in part through donations from individuals, corporations and foundations and is proud to be a member of Children’s Miracle Network Hospitals.

I was geographically limited to Chicago due to my husband’s job. I came to MCW because of the proximity to Chicago. I did not expect much as I knew this was a new program and I was the first fellow. I was blown away by the individual attention from everyone. From faculty to staff members including research coordinator, nurses and administration. I was invited to participate in all the procedures like biopsies and acute dialysis. Not only did it offer a fulfilling clinical and educational experience, it was also an incredible research experience. I was equipped with both clinical and basic science research tools. I was very fortunate to have opportunities to learn from mentors in physiology and internal medicine/nephrology.  Graduating from the pediatric nephrology program I was a very confident, well equipped clinician. Milwaukee was also great place to live and start a new family. It offered great food, outdoor activities and we made lifelong friendships.

-Shireen Hashmat, MD

MCW combines excellent clinical training with vast research opportunities. Having a strong CICU, PICU, neonatology and urology program along with diverse patient population gives nephrology fellows the opportunity to see the length and breadth of the renal disease spectrum. MCW also has a strong liver and renal transplant program and fellows are involved in every stage of decision making and care of their patients. Along with multidisciplinary didactics and conferences, fellows are given the opportunity to choose their own research mentors and projects. There is a good mix of both basic, clinical and translational science research to choose from. Besides, Milwaukee is a great family friendly city. From food to arts, music to sports, there is something here for everyone!

-Vaishali Singh, MBBS

Shireen Hashmat, MD (2012-2015)
Position after graduation: Assistant Professor, University of Chicago, Comer Children's Hospital

Ameya Patil, MD, MS (2013-2016)
Position after graduation: Internal Medicine/Pediatrics, Nephrology and Pathologist, Mayo Clinic, Rochester, Minnesota

Vaishali Singh, MD (2015 – 2018)
Position after Graduation: Assistant Professor and Associate Program Director for Fellowship Program, Medical College of Wisconsin, Children’s Wisconsin

Find out why MCW students, faculty and employees take pride in calling Milwaukee home. You will find that there are many great things to do in Milwaukee.

Milwaukee is one of the Midwest’s best-kept secrets and a prime location for the Medical College of Wisconsin’s main campus. A one-of-a-kind city with a vibrant and diverse culture, this charming, yet metropolitan must-see is just 90 minutes north of Chicago and nestled on the coast of Lake Michigan. Whether you’re catching a show at Summerfest, the world’s largest music festival, immersing yourself in the old world charm of the Historic Third Ward or taking in the sights and sounds of one of the many cafés, beer gardens or restaurants that line the city’s riverbank and shoreline, Milwaukee never disappoints.

Learn more about housing and rental options.

More About Milwaukee

Our 3-year fellowship program is ACGME accredited and begins on July 1 each year. We accept one fellow each year through the National Resident Matching Program (NRMP). Applicants must have completed a US-accredited residency program. Applications from prospective applicants are accepted from July through October via the Electronic Residency Application Service (ERAS). We will access your application and contact you to make interview arrangements.

Complete applications should include the following:

• ERAS application form
• At least 3 letters of reference including Program Director letter
• Medical Student Performance Evaluation/Dean's Letter
• Curriculum Vitae
• Personal statement
• MD Applicants: USMLE scores - Steps 1, 2, and 3 or
• DO Applicants: COMLEX scores – Levels 1, 2 and 3
• ECFMG certificate for foreign medical school graduates (see visa information below)

Our program currently accepts the following visas:

• Permanent Resident Visa
• Visitor Exchange Visa sponsored by ECFMG (J-1)
• Temporary Professional Workers (H-1B)

For additional visa information please visit MCW’s office of Graduate Medical Education.

Apply on ERAS

Fellows are employed by the Medical College of Wisconsin Affiliated Hospitals (MCWAH).

See MCWAH Benefits, Conditions & Terms of Employment for information regarding vacations, leaves, insurance, stipends and professional liability.