The Stanford Nephrology Fellowship program aims to prepare trainees for careers as independent investigators in nephrology and related disciplines. As such, we strongly encourage trainees to spend a minimum of two, but preferably three or more years in research training. The extended period of research training provides fellows with ample time for didactic training either in focused areas of basic science, translational research or disciplines related to clinical investigation. It also affords fellows time to take advantage of mentoring experiences within and outside of the School of Medicine and Stanford University. Two or more years of research in a fertile laboratory or clinical research program also provides an opportunity to venture deeply into more challenging and in some instances, technically demanding areas within the fellow’s chosen area of study.
The core of research training for each trainee is the pursuit of one or more specific projects under the direct supervision of one or more members of the training faculty. Since the choice of research preceptors is so important to trainees, we encourage applicants to preview research opportunities at Stanford while applying to the program. We encourage prospective fellows to meet with members of the training faculty who are not nephrology-based. We are aiming to always keep the Division of Nephrology website current, which provides a description of each faculty member’s research interests with links to project websites and representative publications.
For any fellows who remain undecided on research preceptors, the first three months of the Division’s Research Conference are delivered by the training faculty, in the format of a “work-in-progress” seminar. Undecided fellows are encouraged to meet with the Program Director and the Fellowship Directors at or before the monthly Fellows’ meeting (held the first Tuesday morning of each month) to make sure that fellows have explored all potential training opportunities within nephrology, and among non-Division-based training faculty.
Fellows with established research interests who have identified mentors early in the first year (or before) will be encouraged to seek extramural funding (e.g., National Institutes of Health F32, American Kidney Fund, National Kidney Foundation, American Heart Association) as well as remaining eligible for support from our umbrella training grant from the National Institutes of Health (T32). The application for extramural funding during the first year of training affords the fellow several advantages: it may help to encourage further background reading on related topics, solidify the working relationship between fellow and mentors, and help focus the research question, while identifying obstacles to a project’s success.
We encourage our most promising senior fellows to apply for career development awards (e.g., K08 or K23 awards from the National Institutes of Health, American Heart Association fellow-to-faculty awards, and selected awards from the American Society of Nephrology and American Society of Transplantation) to support their initial years on faculty. The Department of Medicine has mechanisms to provide our most promising graduates opportunities to join the faculty through the Instructor series at the School of Medicine.
Didactic Training in Basic and Translational Research
The Division espouses a curriculum for research training based on well-defined and well-supported pathways in a variety of disciplines. For a nephrology fellow performing research in one of nine pathways offered, the fellow and his or her Oversight Committee members will devise a training plan consisting of research projects and graduate-level didactic coursework.
For example, a fellow performing research in the “Cell Biology” track would train 3-4 years under the supervision of a training faculty member (Clarke, Kraemer, Mochly-Rosen, Nelson, Rabinovitch) and be required to audit three or more courses most relevant to the chosen project. One such syllabus would include: Molecular and Cellular Physiology (MCP) 222 – Imaging: Biological Light Microscopy; MCP 256 – How Cells Work: Energetics, Compartments, and Coupling in Cell Biology, and Biosciences (BIOSCI) 214 – Cell Biology of Physiologic Processes. For a fellow performing research in the “Genomics/Proteomics/ Bioinformatics” track, he or she would train 3-4 years under the supervision of a training faculty member (Butte, Sarwal, Utz) and be required to audit three or more courses most relevant to the chosen project. One such syllabus would include: Biomedical Informatics (BIOMEDIN) 205 – Biomedical Informatics for Medicine, BIOMEDIN 212 – Introduction to Biomedical Informatics Research Methodology, and BIOMEDIN 303 – Statistics for Research. The Division also requires all fellows conducting research to complete Medicine (MED) 255 – The Responsible Conduct of Research in addition to other didactic training.
Laboratory Training in Basic and Translational Research
We recognize that an important component of basic science training for our trainees is the laboratory environment for postdoctoral research. The basic science research community includes the entire Stanford University School of Medicine and the natural sciences departments at Stanford University. As a whole, Stanford University is widely regarded as one of the premier research and teaching institutions in the world and should fulfill the research training needs of all of our nephrology fellows. Moreover, there are more than 30 specialized research institutes and core facilities in which adult and pediatric nephrology trainees might participate. The Institutes of Medicine at Stanford include the Center for Biomedical Ethics, the Comprehensive Cancer Center, the Cardiovascular Institute, the Neurosciences Institute, the Institute for Stem Cell Biology and Regenerative Medicine, and the Institute for Immunity, Transplantation and Infection. Established core research facilities include: Advanced Materials Facilities, Biofilm Laboratory, Carbohydrate Microarray Laboratory, Cell Sciences Imaging Facility, Center on Polymer Interfaces and Macromolecular Assemblies, Cognitive Neuroscience Facility, Data Coordinating Center, Department of Surgery FACScan Center, Developmental Biology Fly Facility, FACS Facility, Functional Genomics Facility, High Resolution Electron Microscope Facility for Biomedical Sciences, High-Throughput Bioscience Center, Human Immune Monitoring Center, Lucas Center for Magnetic Resonance Spectroscopy & Imaging, Magnetic Resonance Laboratory, Mass Spectrometry Laboratory, Microbiology and Immunology Electron Microscope Facility, Parallel Computer Cluster, Protein & Nucleic Acid, Proteomic & Integrative Research Facility, Stanford Center for Innovation and In Vivo Imaging, Stanford Nanofabrication Laboratory, Synchrotron Beamline, Tissue Bank (Pathology), Transgenic Mouse, Veterinary Service Center and Visual Art Services.
The Bio-X program is emblematic of Stanford’s efforts to facilitate collaborative scientific discourse across the University. Bio-X investigators include faculty from the School of Medicine, as well as Engineering, Computer Science, Physics and Chemistry. Many of the investigators and much of the shared space for the program are located at the James H. Clark Center on the campus adjacent to SHC. The interdisciplinary themes of Bio-X include: biocomputation, biodesign, biophysics, brain and behavior, chemical biology, genomics/proteomics, imaging, and regenerative medicine. Drs. Clarke, Mochly-Rosen and Nelson are members of Bio-X.
Didactic Training in Clinical Investigation
Within the School of Medicine, the foundation for training in clinical research is based in the Department of Health, Research and Policy, which has established Master’s programs in epidemiology and health services research. The Master’s degree programs are designed to compliment training in the medical and social sciences and to prepare trainees for research careers in epidemiology, health services research and health policy analysis. Based on our recent experience, we anticipate at least 2-3 fellows annually will wish to pursue Master’s level training. As an introduction to clinical and translational research methods, we encourage all fellows contemplating careers in clinical research to participate in Stanford’s “Intensive Course in Clinical Research (ICCR): Study Design and Performance,” co-directed by Drs. Steven Alexander and Philip Lavori. More than 60% of projects spawned in the ICCR over the last three years have led to proposals funded by NIH or national research foundations. Other Departmental resources are available to nephrology trainees interested in clinical investigation, including the Center for Clinical Investigation, the Stanford Prevention Research Center, the Stanford Center for Biomedical Informatics Research, the Center for Health Policy and the Center for Primary Care and Outcomes Research, and the Stanford-UCSF Evidence-based Practice Center.