Welcome

The Nephrology Genetics fellowship is aimed to establish competence in the management of patients with kidney disease that is attributable to heritable causes. While genetic diseases of the kidney were previously thought restricted to pediatric-onset conditions, it is now understood that 10% of adult patients who reach kidney failure have a genetic cause. Genetic forms of kidney disease affect men and women of all ages and ethnic backgrounds. Identification of patients early in their disease course has the potential to greatly reduce the morbidity of their disease. Cascade screening of family members can lead to the identification of additional affected family members early in the disease course. The impact of heritable kidney disease on patients and society is significant leading to profound personal and socioeconomic implications. Exposure to heritable disease in the Nephrology Genetics Fellowship will include autosomal dominant polycystic kidney disease, autosomal dominant tubulointerstitial kidney disease, Alport syndrome, Fabry disease, Tubular sclerosis complex, focal and segmental glomerulosclerosis, nephronophthisis and more. The Nephrology Genetics fellowship is designed to provide a focused experience in developing competence in the diagnosis and management of heritable kidney disease.

Entry requirements

The fellowship program is designed for current residents or recent graduates of Adult Nephrology Residency programs. Paediatric Nephrology Residency training will be considered. MD Medical Geneticists interested in kidney experience would also be considered.

If the fellow wants to pursue a Master’s in Population Genomics, they will need to meet the requirements of that program as well. View more details here: https://fhs.mcmaster.ca/pgp/index.html and: https://healthsci.mcmaster.ca/hei-hrm/education/degree-requirements/msc-degree-requirements

Recent graduates are required to submit an application form and comply with McMaster University Postgraduate Medical Education requirements for residents and fellows.

Application deadline

Annually on November 30.

Certification outcome

The successful completion of the fellowship will grant a McMaster Fellowship Certification.

Goals of Training

Main objectives of the Nephrology Genetics Fellowship Program:

The overall goal of the Nephrology Genetics fellowship is to develop competence in the management of a glomerular disease. The objectives include:

1. To provide trainees with focused clinical exposure in order to suspect and appropriately diagnose heritable kidney disease.
2. Experience ordering and arranging for diagnostic genetic testing.
3. To provide trainees with the clinical expertise to identify patients at high risk of disease progression and patients who may benefit from the use of targeted therapy.
4. To counsel patients regarding the pros and cons of genetic testing including ramifications on family members.
5. To familiarize trainees with safe prescription practices and monitoring requirements in patients with genetic diseases of the kidney.
6. To encourage trainees to pursue careers in academic or community medicine specializing in the treatment of patients with heritable kidney disease.

1. Medical Expert

1. Trainees will be able to identify patients with potentially heritable kidney disease and arrange for appropriate genetic testing.
2. Trainees will recognize when a patient is at risk for rapidly progressive presentations and institute an appropriate management plan.

2. Communicator

1. Trainees will consistently communicate clearly, empathically, and effectively with patients, families, and other care providers.
2. Trainees will develop skills in response to patients’ concerns and views in the course of care.
3. Trainees will provide patients with essential information related to diagnosis, prognosis and treatment in a clear and understandable manner that encourages patient autonomy and participation in decisions for care.
4. Trainees will clearly and accurately document patient encounters (including disclosure of side effects or risks of treatment), phone conversations and other communications with patients.
5. Trainees will clearly communicate the relevant issues of a patient when there is a need for advice.

3. Collaborator

1. Trainees will seek and incorporate the advice of other practitioners in the care of their patients.
2. Trainees will work closely with patients and families to promote cooperation and adherence to treatment recommendations.
3. Trainees will work with inter-professionals in the clinic in order to provide comprehensive care to patients with genetic kidney disease.

4. Leader

1. Trainees learn the skills of arranging care both within and outside the office setting to allow timely and efficient achievement of patient outcomes.
2. Trainees will be able to assess the priority and urgency of patient issues and be able to learn to triage referrals and follow-up appointments.
3. Trainees will work with Nephrology Genetics team members including medical genetics, genetic counsellors, and specialized nursing.

5. Scholar

1. Trainees will identify their learning needs and address them to develop a comprehensive understanding of the content area.
2. Trainees will develop a personal learning plan covering the core learning objectives of the rotation.
3. Trainees will be aware of resources that will allow them to maintain their knowledge of the field and learn to apply evidence-based management plans.
4. Trainees will participate in a genetic kidney disease-based research or quality improvement project.
5. Trainees will participate in providing nephrology grand rounds, journal clubs and academic half days.

6. Professional

1. Trainees will be punctual and reliable in attending the ambulatory experience.
2. Trainees will complete tasks they begin, including documentation, following up on tests and other aspects of patient care.
3. Trainees will interact with patients, families, office staff and other providers appropriately both in the office setting and in-between visits.

7. Health Advocate

1. Trainees will link patients consistently to needed programs and services.
2. Trainees will demonstrate an understanding of government funding of therapy, including ODB and individual clinical review mechanisms, and consistently act to ensure their patients’ access to therapies is optimized.
3. Trainees will consistently identify barriers (e.g. financial, social, psychological) to patients’ care and develop plans to help overcome them.
4. Trainees will promote cascade screening and disease prevention with patients.

Length of training

Duration: 1-2 years.