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Education

Transplant Nephrology Fellowship

Sami Alasfar, M.D.
Assistant Professor of Medicine
Transplant Nephrology fellowship program director
443-287-4936
e-mail:  salasfa1@jhmi.edu

Linda Thompson-Berky
Administrative Coordinator
443-287-4936
email:  lthomp30@jhmi.edu
 

Thank you for your interest in our transplant nephrology fellowship program. If you are interested in applying, please email Dr. Sami Alasfar and Mrs. Thompson-Berky and attach your CV, a one page personal statement, a letter of good standing from your current Program Director, and two letters of recommendations.
 

Introduction:

History:  The program is accredited by the American Society of Nephrology and American Society of Transplantation (ASN/AST) since 2003 and complementary to the ACGME-accredited general nephrology fellowship.

Duration:  The Transplant Nephrology Fellowship is of one year duration.  Interested and qualified individuals may seek additional training in Transplant Nephrology-related research beyond the one-year clinical fellowship.

Prerequisite Training/Selection Criteria:  Interested individuals should have a strong commitment to training in Transplant Nephrology.  Interested individual should be board-certified or able to be board-certified in Internal Medicine by the American Board of Internal Medicine (ABIM) or an equivalent body if the individual is an international scholar.  Individuals should have completed or be completing an American College of Graduate Medical Education (ACGME) fellowship in general nephrology or its equivalent if the individual is an international scholar.

Goals and Objectives:  The goals and objectives of the Transplant Nephrology Fellowship are to train the individual in all aspects of Transplant Nephrology and satisfy the requirements to be able to be certified as a Transplant Nephrologist by the United Network of Organ Sharing (UNOS).

Program Certification:  The Kidney, Pancreas, Heart, Liver, and Lung transplant programs are all UNOS-certified.

Teaching Staff:

Daniel Brennan, MD — Professor of Medicine, Director of Comprehensive Transplant Center

Hamid Rabb, MD — Professor of Medicine, Medical Director of Kidney Transplant Program

Edward Kraus, MD —Professor of Medicine

Nada Alachkar, MD — Associate Professor of Medicine, Transplant Nephrologist

Fawaz Al Ammary, MD, PhD —Assistant Professor of Medicine, Medical Director Live Donor Transplantation

Fizza Naqvi, MD — Assistant Professor of Medicine

Sami Alasfar, MD — Assistant Professor of Medicine, Transplant Nephrology Fellowship Program Director

Facilities:
The Johns Hopkins Kidney transplant program performs an average of 220 kidney transplants yearly and 5-10 kidney-pancreas transplants yearly.  We follow over 3000 kidney and kidney-pancreas transplant patients in the outpatient center. Transplant Nephrology is the primary renal consultant for solid organ transplant recipients.   The average yearly number of these other solid organ transplants performed is:  Liver (100), Lung (25), and Heart (20).

Educational Program (Basic Curriculum)

Expectations for Transplant Nephrology Fellows

Our Transplant Nephrology Fellowship is accredited by the American Society of Nephrology/American Society of Transplantation (ASN/AST).  Completion of the fellowship and its requirements should allow most fellows to satisfy requirements to be a United Network of Organ Sharing (UNOS) Medical Director of Renal and Pancreas Transplantation.  A transplant nephrology fellow should be committed to learning all aspects of transplant nephrology. This will require knowledge of past, contemporary, and insight into the future of transplant nephrology.  This will require clinical, academic and professional competence.  We expect fellows to be exceptional internists and nephrologists, desire to become exceptional transplant nephrologists.

Objectives:

Patient Care

  • The fellow will rate as valuable the importance of being a transplant nephrologist to a medically and socially diverse group of patients
  • The fellow will be able to obtain and document a complete history and physical, formulate a thorough assessment and plan, and communicate this assessment to the transplant surgery or medical primary care team
  • The fellow will demonstrate the ability to make daily assessments of their patients and convey that information to the team through a variety of methods, including daily written progress notes
     
  • Specific educational goals are to provide clinical expertise and opportunities to gain experience in:

a. Immediate post-operative management of transplant recipients, including administration of immunosuppressive medications and transplant induction protocols
b. Diagnosis and management of delayed graft function
    1)     Clinical diagnosis of all forms of delayed graft function including laboratory, histopathologic, and imaging techniques
    2)     Post-transplant dialytic management
    3)     Medical management of rejection, including use of immunosuppressive medications (pharmacology and risks) and other modalities (i.e. plasmapheresis)
c.  Recognition and medical management of the surgical and non-surgical complications of transplantation including the differential diagnosis of acute and chronic graft dysfunction
d.  Diagnosis and management of acute and long-term infectious complications of solid organ transplantation
e.  Management of long-term non-infectious complications (hematologic, cardiovascular, metabolic) of kidney/kidney-pancreas transplant recipients in the inpatient setting
f.   Evaluation and selection of transplant candidates.
g.  Preoperative evaluation and preparation of transplant recipients and donors.
h.  Reading transplant biopsies with the transplant attending and the pathologist

  •   You will complete the clinical requirements for a transplant nephrologist:
  1. 6 months of inpatient transplant nephrology from the time of transplant
  2. 6 months of outpatient transplant nephrology
    a.  Pre transplant evaluation
    b.  Post-transplant evaluation
  3. Observe 3 multiple organ transplant recoveries at least one of which is from a deceased donor and one from a living donor.
  4. Observe 3 kidney transplant operations at least one of which is a living donor transplant and one a deceased donor transplant
  5. Perform at least 10 transplant kidney biopsies
  6. Be primarily responsible for 30 inpatient renal transplant recipients and 30 outpatient recipients
  7. Evaluate 25 potential kidney transplant recipients, and 10 potential living donors
  • Attend  histocompatibility/tissue typing laboratory rotation
  • Attend mandatory transplant committees meetings. Meetings schedule is accessed here.
  • Learn the technique of ultrasound guided kidney transplant biopsies including pre biopsy assessment and post biopsy monitoring

Education:

  • A schedule of didactics is accessed here.
  • Attend the weekly combined Transplant Nephrology and Surgery weekly curriculum lectures conducted September through June. The curriculum is accessed here.
  • Attend transplant pathology conference (monthly)
  • Attend the Kidney Transplant Morbidity and Mortality conferences (Quarterly)
  • Attend Department of Medicine and Renal Division Grand Rounds (both weekly)
  • Encouraged to attend general nephrology fellows noon-conference (Monday, Wednesday, and Friday)
  • Present at general nephrology fellows noon conference at least once
  • Present at Renal division Grand Rounds
  • Teach and educate general nephrology fellows, residents, and students rotating on transplant floor

Research:

  • You are expected to produce at least one abstract to American Transplant Congress, one review article, and submit one original research manuscript
  • Learn how to plan, design, and conduct high quality scientific research
  • Learn how to present and document your scientific findings
  • Be engaged within the research group
  • Take advantage of professional development opportunities
  • Participate in clinical or basic research
    • Obtain consent for ongoing research
    • Contribute to ongoing research
    • Develop independent project
    • Apply for independent funding
  • Attend the weekly research meeting and provide weekly progress reports.
  • Read relevant scientific journal articles
  • Present at Renal Research Conference

Professional Development

  • There are many resources through the Bloomberg School of Public Health
  • Review funding and training opportunities announced routinely from the renal division
  • Apply for AST membership
  • Attend Transplant Fellows National Symposium meeting
  • Attend American Transplant Congress
  • Look on the AST website for job opportunities

Communication Skills

  • The transplant fellow will demonstrate effective communication skills with the attending physician by discussing each consultation or admission in a timely fashion
  • The transplant fellow will discuss the ongoing care of each patient with the appropriate attending daily
  • The transplant fellow will demonstrate effective teaching and feedback skills with the renal fellow, interns, residents, and medical students.
  • The transplant fellow will model effective interpersonal communication skills with patients, families, transplant surgery team, consulting teams, and allied health professionals

 Professionalism

  • The transplant fellow will demonstrate compassion and understanding to a group of socially, economically and racially diverse group of patients
  • The transplant fellow will rate as comfortable his/her ability to assume the leadership role on the healthcare team
  • The transplant fellow will model appropriate team function by including allied health professionals in management discussions

Practice-Based Learning and Improvement

  • The transplant fellow will incorporate basic knowledge of evidence-based medicine in evaluation and management of patient medical problems
  • The transplant fellow will continue the process of acquiring skills and documenting the procedures required by the ABIM, as listed in the procedure summary
  • The transplant fellow will model practice based learning and effective information seeking in the daily care of patients

Systems-Based Practice

  • The transplant fellow will demonstrate competence in the integration of inpatient and outpatient care, and a systems approach to care, by demonstrating appropriate follow-up/discharge plans for all patients he/she has admitted
  • The transplant fellow will demonstrate an awareness of issues cost-effective medicine in patient care, by discussing the cost implications of a case/month with the attending physician
  • The transplant fellow will rate as valuable the contributions of other members of the health care team into management plans for patients
  • The transplant fellow will routinely evaluate the socioeconomic needs of his/her patients, including health insurance, access to care and copayments necessary to provide care

 Supervision and Evaluation

1. Mentoring and Supervision:  At the start of the Transplant Nephrology Fellowship, all fellows meet with the Director to go over expectations and objectives.  Fellows meet with their Transplant Nephrology Faculty Mentor or director at least monthly.  Trainees are mentored and supervised one on one with the attending Transplant Nephrologist on the inpatient and outpatient services.  All Fellows are directly supervised during all admissions, consults and biopsies.  Biopsies are reviewed with Pathology in most cases the afternoon after the biopsy is performed.  Combined rounds with Transplant Surgery occur daily at 8:00 pm Monday to Friday.  Fellows attend the weekly research meeting.

2.  Evaluation process:  All fellows meet with the inpatient attending after the inpatient service to complete a formal evaluation and provide feedback.  Transplant Nephrology Fellows also complete an evaluation for the American Society of Transplantation (AST) at 6-months and just prior to completion of the fellowship at 12-months.

Vacation and Benefits

  1. 15 business days per year are allowed for vacation.
  2. Additional benefits can be found here https://www.hopkinsmedicine.org/som/offices/registrars/_fellows_docs/HouseStaffSummaryOfAllBenefits.pdf .

Alumni

2019:
Anshul Bhalla, MD – Transplant Nephrologist, University of Tennessee – Memphis, TN
Sudhir Thaduri, MD – Transplant Nephrologist, University of Alabama – Birmingham, AL

2018:
Amtul Alaa, MD – Transplant Nephrologist, Beth Israel Deaconess Medical Center – Boston, MA

2017:
John Manllo Dieck, MD – General Nephrologist and Transplant, South Texas Kidney Specialists – McAllen, TX

2016:
Sami Alasfar, MD – Transplant Nephrologist, Johns Hopkins University – Baltimore, MD

2015:
Shadi Nijim, MD - Transplant Nephrologist, Johns Hopkins University – Baltimore, MD

2014:
Fahad Alotaibi – Transplant Nephrologist – Saudi Arabia
Nadear Elmahi, MD – Transplant Nephrologist – Dallas, TX

2013:
Fizza Naqvi, MD - Transplant Nephrologist, Johns Hopkins University – Baltimore, MD

2012:
Gaurav Gupta - Transplant Nephrologist, Virginia Commonwealth University - Richmond, VA

2011:
Bassam Abu Jawdeh, MD – Transplant Nephrologist, University of Cincinnati – Cincinnati, OH

 

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