Below is a typical 3-year Pediatric Nephrology Fellowship schedule. In addition to the rotations listed below, fellows participate in an outpatient continuity clinic, where they follow their own patients longitudinally. All attending nephrologists participate in staffing the continuity clinic.

Year 1

Inpatient Services*: 16 weeks
Dialysis Outpatient Unit: 8 weeks
Outpatient General Nephrology: 8 weeks
Pathology: 4 weeks
Urology: 4 weeks
Research: 4 weeks

Year 2

Research: 28 weeks (7, 4-week blocks)
Dialysis Outpatient: 4 weeks
Pheresis/Blood Bank: 4 weeks
Inpatient: 8 weeks

Year 3

Research: 28 weeks (7, 4-week blocks)
Transplant (adult/surgical rotation): 4 weeks
Inpatient: 8 weeks
Dialysis Outpatient: 4 weeks

*Inpatient service time is typically divided into month-long blocks

The Division of Pediatric Nephrology divides its rotational service into month-long blocks. 

Our inpatient Pediatric Nephrology Service, which is staffed by pediatric residents, is quite active with over 170 admissions per year.  In addition, we see over 130 consults from various other inpatient services including the neonatal and pediatric intensive care units.  We conduct over 2,000 outpatient clinic visits annually.  We have an extensive referral base not only within the State of Iowa, but also from southern Minnesota, southwestern Wisconsin, western Illinois, eastern Nebraska, and northern Missouri.  Patients come from across the USA and internationally to receive care in our Rare Renal Disease Clinic (Carla Nester, M.D.), which specializes in the care of patients with atypical hemolytic uremic syndrome and C3 glomerulopathy.

We have an independent pediatric dialysis unit which provides peritoneal dialysis and hemodialysis to pediatric patients.  The unit is fully staffed with dietician and social work support to meet the complex needs of our pediatric patients.  Our pediatric dialysis nurses are skilled at fistula development and access. Fellows are expected to co-manage dialysis patients with staff and rotate in the dialysis unit during fellowship training.

Our division is fully accredited as a pediatric kidney transplant center.  Fellows are expected to actively participate in the management of kidney transplant recipients and can rotate with the adult and surgical transplant teams during their second/third years of fellowships.  We also enjoy an excellent, friendly relationship with our transplant surgery division.

Fellows perform or are directly involved in a diverse number of procedures.  All procedures are supervised by faculty.  These include:

• Percutaneous kidney biopsy (native and transplant)
  • The assistance of pediatric anesthesia is available for kidney biopsies.  In high risk or critically ill patients, general anesthesia is utilized.  We perform more than 30 kidney biopsies per year on pediatric patients.
• Acute and chronic dialysis therapies (hemodialysis and peritoneal dialysis)
• Continuous renal replacement therapy (CRRT) as standalone therapy and in line with extracorporeal membrane oxygenation (ECMO)

Pediatric Nephrology Fellows Lecture Series

This twice-monthly lecture series is designed to cover the full content specifications of the Pediatric Nephrology sub-board of the American Board of Pediatrics every 2 years in a rotating schedule. The lectures are mostly given by the attending pediatric nephrologists, but the series also includes guest lectures from pharmacy, urology, dialysis nurse management, hospital administration, and dialysis water management. Fellows present selected topics 3-4 times per year.  Lectures are designed to be interactive, and the small group format encourages fellows to ask clarifying questions to maximize their learning. 

Pediatric Nephrology Division Meetings

These weekly meetings include case discussions and division updates.  The current inpatient cases are discussed as well as outpatient cases as needed. 

Pediatric Fellows Core Curriculum Seminars

Weekly departmental fellow seminars provide opportunities to enhance professional development, explore research options, and advance teaching skills.  Our fellows interact with other pediatric faculty and fellows during these conferences.  They have a chance to present their research to the pediatric department, get feedback, and learn how to evaluate their peers' research projects.

Pediatric Dialysis Patient Care Conference and Quality Assurance/Performance Improvement (QAPI)

These meetings involve discussions on dialysis outpatient care.  We review each dialysis patient with discussion of laboratory results as well as concerns that the primary physician may have regarding growth/nutrition, social well-being, or ability to refer to transplant.  This session includes teaching about pathophysiology, management of dialysis problems, and discussion with specialized team members including dialysis nurses, dietician, and social work.

Pediatric Transplant Surgery Conference

This monthly conference gives the fellows the opportunity to interact with the pediatric transplant team.  Pediatric patients who are pending kidney transplant are discussed during these meetings.

Pathology Meetings

Ad-hoc meetings with the renal pathologist are set via videoconference to review slides remotely, allowing fellows and faculty to see the slides with the helpful guidance of the pathologist.

Combined Adult and Pediatric Nephrology Fellows Seminars

Dialysis "Practicals"

These review sessions allow fellows to see the equipment, learn the technical aspects, and evaluate actual patient studies.  Clinical cases conferences are chosen from pertinent patient scenarios with interesting or difficult diagnoses or a diagnostic and therapeutic dilemma.

Journal Club

Topics are chosen to discuss state of the art or cutting-edge articles.  Case based discussion sessions are run by faculty and are aimed at assessing the fellows' knowledge base and thought process in article interpretation and review.

Fellows' Pathology Conference 

Staff renal pathologists provide teaching seminars for adult/pediatric fellows to review cases and pertinent pathology.  Fellows can practice use of the microscope and discuss basic to advanced pathology in a conversational setting.

Adult/Pediatric Pathology Conference

Staff renal pathologists chose interesting cases to be presented at a joint adult/pediatric pathology conference and discuss the clinical and pathological correlates of the case.  The referring physician (staff or fellow) is asked to present the case.

Board Review

These seminars include a variety of teaching sessions on a rotating basis.  Fellows discuss core curriculum based on KSAP (American Society of Nephrology).

Our division actively publishes in both the basic science and clinical research realms. All fellows in our program are required to complete a basic science or clinical research project. There are a numerous opportunities for research in any field of interest across all subspecialties both within and outside of our own division. Research within our division includes the work of Dr. Carla Nester, Dr. Lyndsay Harshman, Dr. Jason Misurac, Dr. Kathy Lee-Son,vand Mary Lee Neuberger, APN

Fellows also have the opportunity to find research mentors outside the division. For example, previous fellows had mentors in Internal Medicine Endocrinology and Adult Psychiatry/Neurology.

You can find a list of our publications here.Nephrology_Division_Publications_2016-2018.pdf

Our faculty and staff participate in numerous national pediatric nephrology collaboratives, which also provide opportunities for fellow engagement, involvement, and research:

Improving Renal Outcomes Collaborative (IROC): IROC is a national collaborative including 32 pediatric kidney transplant centers. IROC’s mission is “to partner with patients with kidney disease and their caregivers to achieve health, longevity and quality of life equivalent to the general population, by harnessing the inherent motivation and expertise of all stake holders to improve care, spawn innovation and conduct research that improves health and outcomes.”

• Lyndsay Harshman 
  • Local IROC PI
  • IROC Research committee member
• Jason Misurac 
  • Local IROC co-PI
  • IROC Quality Improvement/Information Technology committee leader
  • IROC Research committee member

Nephrotoxic Injury Negated by Just-in-Time Action (NINJA): NINJA is a multi-center collaborative of 15 children’s hospitals. Their mission is to “eliminate all preventable cases of nephrotoxic medication associated AKI in hospitalized children.” Their vision is that “children should only get the nephrotoxic medications they need for the duration they need them.” 

• Jason Misurac 
  • Local NINJA PI
  • NINJA Nephrotoxic Medication Subcommittee Leader

Neonatal Kidney Collaborative: The mission of the NKC is to improve the health of newborns with or at risk for kidney disease through multidisciplinary collaborative research, advocacy, and education.  www.babykidney.org

• Jennifer Jetton
  • Steering committee member
  • Education committee co-chair

CKiD: Chronic Kidney Disease in Children Study: The CKiD Study is a NIH-funded, multicenter, prospective cohort study of children aged 6 months to 16 years with mild to moderate kidney function impairment.

• Lyndsay Harshman
  • Local PI

Cure Glomerulonephropathy: (CureGN) is a multicenter five-year+ cohort study of glomerular disease patients funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes for Health (NIH).

• Carla Nester
  • Local PI

SCOPE: The Standardized Care to Improve Outcomes in Pediatric End-stage Renal Disease (SCOPE) collaborative prevents infections in pediatric peritoneal dialysis and hemodialysis patients using large-scale collaboration to identify and spread effective interventions across pediatric care settings.

• Kathy Lee-Son
  • Local PI

Pediatric Nephrology Research Consortium (PNRC): The PNRC started in 2004 as the Midwest Pediatric Nephrology Consortium with a mission to develop and execute multi-center clinical and translational studies related to pediatric kidney diseases. With over 200 members, it continues to be an active continent-wide platform for collaborative research by investigators dedicated to developing the evidence for the best standards of care for children with kidney disorders. 

• Jason Misurac
  • Member
  • Website Committee Leader 

Will I receive excellent clinical training at the University of Iowa?

Yes! Our active inpatient service, dialysis unit, and transplant program allow fellows to learn through experience and personalized one-on-one teaching. The fellows’ continuity clinic teaches fellows to manage their own patients. And our didactic lecture series ensures that all American Board of Pediatrics Pediatric Nephrology content specifications are covered on a 2-year rotating schedule. Fellows find that there is excellent balance between service expectations, protected research time, and learning. Our fellows graduate confident in their ability to care for patients across the full spectrum of pediatric nephrology.

What is the general outcome of your fellows?

All graduated fellows have passed the pediatric nephrology subspecialty board examination on their first attempt. All have obtained positions in pediatric nephrology at academic medical centers.  

How will I identify a research mentor and project?

The University of Iowa is a very strong research institution with basic, translational, and clinical research. Research mentors may be found within the division of pediatric nephrology but may come from another department depending on the fellow’s research interests. During the first few months of fellowship, fellows are encouraged to meet with several clinical and basic science investigators who have ongoing projects that match their own interests. The fellowship program director and associate program director will help facilitate these meetings. Should a fellow enter the program with a strong background in research or an identified project, a mentor with similar interests may be identified before the fellowship starts. A strong mentor-fellow relationship is imperative to success in research.

Will I have protected time to perform a research project and meet board eligibility requirements?

Yes. Research blocks are protected time. It is requested that fellows attend their outpatient continuity clinic and educational conferences. All other activities during research blocks should be dedicated to research, which allows our fellows to complete their research projects, meeting board eligibility requirements.

What is the call schedule?

Call is dependent on the rotations - during all three years fellows are expected to cover 2 weekends per month. During the inpatient rotations, nephrology fellows share call with the attending physicians every other night. 

Is a Masters Degree available to interested fellows?

Yes. A Masters in Medical Education is offered by the University of Iowa Carver College of Medicine. 

The University of Iowa Masters of Science in Clinical Investigation is designed for clinicians interested in pursuing careers in clinical research and is offered by the University of Iowa Department of Epidemiology in cooperation with the Institute for Clinical and Translational Science. 

Tuition discounts and tuition assistance are available. Schedule accommodations will be made to allow interested fellows to pursue a Masters Degree.  

Where is Iowa City?

Iowa City is 220 miles (3-4 hours) directly west of Chicago on Interstate 80. It's also within a 4-5 hour drive to Minneapolis, Omaha, Kansas City and St. Louis. It has the cultural, educational, social, and political opportunities of a bigger city with the ambiance of a Midwestern town. It’s clean, safe, it has a great city bus system (with bike racks!), wonderful parks, sports, schools and even sailing. Nothing is farther than a 15 min drive, and there are many affordable and safe housing options near the hospital. Those who have lived here and left, frequently return because what they were looking for was in their own back yard. 

How ethnically diverse are the patients?

Like a lot of university towns, Iowa City has a large international community. Growing cultural diversity is another reason Iowa City is an interesting and exciting place to live. Diversity is embraced and celebrated with city and university events, festivals, clubs and programs. The University works hard to recruit and retain minorities with its affirmative action policies. About 13% of Iowa citizens are non-white as are almost 13% of the patients seen in our clinic.

What is it like to live in Iowa City?

Iowa City and the surrounding areas of North Liberty and Coralville are great places to live! Who doesn't love a commute time of less than 20 minutes? Explore what Iowa City has to offer through our Discover Iowa page.

Are there any job opportunities for my spouse/significant other?

The Iowa City area boasts many employment options with businesses large and small, including the University of Iowa, one of the state’s largest employers.  

Do you have a freestanding children's hospital?

Yes. The University of Iowa Stead Family Children’s Hospital is a freestanding state-of-the-art pediatric hospital opened in 2017.

University of Iowa Stead Family Children’s Hospital is the only children’s hospital in Iowa nationally ranked for pediatric care by U.S. News and World Report. Read June 15, 2021 press release.

• 25 in Neonatology
• 35 in Pediatric Orthopedics
• 41 in Pediatric Diabetes and Endocrinology
• 42 in Pediatric Nephrology
• 50 in Pediatric Neurology and Neurosurgery

The 13th annual Best Children’s Hospitals rankings recognize the top 50 pediatric facilities across the U.S. in 10 pediatric specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and gastrointestinal surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and lung surgery, and urology. 

UI Stead Family Children’s Hospital and the UI Stead Family Department of Pediatrics are recognized nationally for a number of achievements.

Pediatric researchers at the University of Iowa have a long history of breakthrough discoveries in both the clinical and laboratory setting. Meet members of our research team:

• Faculty Research Profiles
• Researchers in the News

Applications deadline to be determined.

Medical specialty certification in the United States is a voluntary process which serves multiple purposes for the trainee and the public.

Certification is

• One mission of the training program to produce trainees who meet board eligibility criteria
• Distinguishes a physician as someone with a distinct level of expertise
• Provides more opportunities when applying for employment
• Presents resources and tools by the American Board of Medical Specialties (ABMS)
• A commitment to life-long improvement for providing the best patient care
• Elevates physicians into the ranks of doctors committed to the highest standards of healthcare

For more information visit the American Board of Pediatrics for specifics on board certification requirements.

Our fellowship coordinator will contact the fellowship candidate by email with an interview offer. After an interview date is made, the applicant will have an itinerary arranged. Generally, interviews are arranged with all the members of the Division of Pediatric Nephrology, as well as current fellows, support staff, and selected faculty members from outside the Division. If the fellow candidate has a specific research interest, we will arrange an interview with a faculty member in that area.

Due to the COVID-19 pandemic, we are planning to hold virtual interviews for the 2020 match. This will give the applicants the opportunity to meet us and ask questions while still complying with social distancing guidelines and with any travel restrictions that may be in place. Details about the interview day will be provided when an interview is offered.

Please check back for updates on our current fellows.

Eva Tsalikian, MD

Chair and Department Executive Officer

Welcome to the University of Iowa's Stead Family Children's Hospital. We are proud to showcase our extraordinary clinical care, dedication to the education of students and young physicians, and our world-class research programs.

Our comprehensive medical, surgical, and nursing services span the full spectrum of pediatric care. The consistently high rankings we receive on national and international benchmarks attest to the exceptional quality of care we provide. With more than 127,000 annual outpatient visits and more than 10,000 admissions to the 165 beds at University of Iowa's Stead Family Children's Hospital, we draw patients regionally, nationally, and internationally. Our commitment to family-centered care and our outstanding facilities have been praised for their innovative and patient-friendly design.

We are dedicated to excellence in the education of medical students, residents, and fellows, as reflected by a competency-based curriculum that is designed to provide practitioners with comprehensive knowledge and outstanding skills. The clinical and research efforts of trainees are closely mentored and nurtured. Our graduates move on to successful careers in clinical practice and academic pediatrics.

From genomics to cancer biology, from clinical trials to outcomes research, the department consistently ranks among the top National Institutes of Health (NIH) funded Pediatric Departments nationally. Our faculty and staff are engaged in cutting edge basic science and patient-oriented research in our unwavering quest to improve the health and well-being of all children.

We have a diverse faculty with wide-ranging clinical and research interests. Many are internationally known and have been in the department for many years. We also have bright young faculty who bring new interests and enthusiasm to the practice and teaching of nephrology. All clinical faculty participate in resident training, clinical practice, and research.

• Division Faculty
• Research Faculty
• Division Head
• Department Directory A-Z

Division Director, Fellowship Director

Carla Nester, MD, MSA, FASN
Associate Professor of Pediatrics - Nephrology, Dialysis and Transplantation
Associate Professor of Internal Medicine
Director, Pediatric Glomerular Disease Clinic
Dr. Nester completed a combined pediatric/internal medicine nephrology fellowship at the University of North Carolina Hospitals. She has been a faculty member at the University of Iowa since 2007 and has been the division director in pediatric nephrology since 2019. Her rare renal disease clinic is internationally renowned for the expert care she provides to patients with atypical HUS and C3 glomerulopathy. She is also active in basic science research with active R01 grants. 

Associate Fellowship Director

Jason Misurac, MD, MS
Clinical Associate Professor of Pediatrics - Nephrology, Dialysis and Transplantation
Dr. Misurac completed his pediatric nephrology fellowship at Riley Hospital for Children at Indiana University Health. He has been a faculty member at the University of Iowa since 2015 and was recently appointed as the associate fellowship director. His research interests include nephrotoxic acute kidney injury and clinical quality improvement. He is the associate medical director of the pediatric specialty clinic, and serves as the associate chief medical informatics officer (ACMIO) for pediatrics. His clinical areas of interest include acute kidney injury, glomerular disease, and hypertension.  

Faculty 

Issa Alhamoud, MD
Clinical Assistant Professor of Pediatrics – Nephrology, Dialysis and Transplantation
Dr. Alhamoud completed his pediatric nephrology fellowship in 2018 at The University of Texas Southwestern Medical Center, Dallas Texas. He joined the pediatric nephrology division in 2020. He is the Pediatric Dialysis Co-Medical Director. Areas of interest are acute kidney injury, continuous renal replacement therapy (CRRT), and intra-renal renin angiotensin system.
 

Lyndsay Harshman, MD, MS
Assistant Professor of Pediatrics - Nephrology, Dialysis and Transplantation
Lyndsay Harshman completed her pediatric nephrology fellowship at the University of Iowa in 2016 and continued her research in the long-term neurocognitive effects of chronic kidney disease. Specifically, her current work includes an NIDDK funded K23 utilizing magnetic resonance imaging (MRI) to quantitatively characterize the structure of the brain (e.g., volumes of regions and tissues) in mild to moderate pediatric CKD. In conjunction with standardized neurocognitive testing, specialized neuroimaging measures are used to evaluate brain structure, function, and metabolism in this population in order to better understand the relationship to underlying renal disease. Dr. Harshman’s clinical interests focus on aligning the above research concepts of brain growth and development in a chronic kidney disease life-course – specifically in the pediatric renal transplantation population. Her other clinical interests include tuberous sclerosis complex (TSC) patients, for whom she co-founded a multidisciplinary clinic. She is the local PI for the Chronic Kidney Disease in Childhood multicenter prospective cohort study and for the Improving Renal Outcomes Collaborative (IROC), a multicenter quality improvement collaborative focused on improving health, longevity, and quality of life in pediatric kidney transplant recipients.  Dr. Harshman is also the medical director of pediatric kidney transplant at the University of Iowa. 

Jennifer Jetton, MD
Clinical Associate Professor of Pediatrics - Nephrology, Dialysis and Transplantation
Dr. Jetton completed medical school, residency, and fellowship training at Baylor College of Medicine / Texas Children’s Hospital. She joined the rapidly growing pediatric nephrology division at the University of Iowa in 2010. Her clinical and research interests include acute and chronic dialysis and acute kidney injury. She is actively involved in medical education for trainees of all levels and has served as the Director of Pediatric Medical Student Education since 2015. Her primary clinical research interest is neonatal acute kidney injury. She is a founding member of the Neonatal Kidney Collaborative and currently serves as both a steering committee member and Co-Chair of the Education Committee. She also serves on the National Medical Advisory Committee for Make-A-Wish America and is a medical advisor for Make-A-Wish Iowa chapter.
 

Kang Yu Lee Son, MD, MHSc, FRCPC
Clinical Associate Professor of Pediatrics - Nephrology, Dialysis and Transplantation
Dr. Lee Son completed her pediatric nephrology fellowship in 2013 at University of British Columbia, Vancouver, Canada. She joined the division of pediatric nephrology in 2013. Dr. Lee Son is the medical director of the Pediatric Infusion and Dialysis center at the University of Iowa Stead Family Children’s Hospital. She is also the Physician Value Officer for the Department of Pediatrics. Her research interests include CKD in non-kidney organ transplant recipients and acute dialysis.   

Hua Sun, MD, PhD
Assistant Professor of Pediatrics - Nephrology, Dialysis and Transplantation
Dr. Sun completed her pediatric nephrology fellowship in 2020 at Boston Children’s Hospital at Harvard Medical School. She also completed her research fellowship in 2014 also at Harvard Medical School. Dr. Sun joined the growing pediatric nephrology division in 2020.

She has a clinical interest in rare genetic kidney disease in children, and she is dedicated to connecting patients and families with national resources. Dr. Sun is a physician scientist with a special research interest in podocyte disease. She uses transgenic cell and animal models to study the molecular mechanism of various podocyte diseases including minimal change disease, focal and segmental glomerulosclerosis and diabetic nephropathy, with a goal of finding innovative treatment for patients with these diseases.

Jean Robillard, MD
Professor of Pediatrics - Nephrology, Dialysis and Transplantation
Secondary Appointment(s): Molecular Physiology and Biophysics
Dr. Robillard is the former Vice President for Medical Affairs and Carver College of Medicine Dean. He is a longstanding member of the division of pediatric nephrology. Dr. Robillard is semi-retired, though he continues his research activities and mentors faculty through the promotion and tenure process. The Division is deeply indebted to his many contributions through the years.  

Other Division Providers

Brynna Van Wyk, ARNP, MSN
Nurse Practitioner
Brynna completed her Masters in Nursing from the University of Iowa. She became a Certified Pediatric Nurse Practitioner in 2011 and joined the Pediatric Nephrology team shortly after. With a background in pediatric critical care nursing, she spends her clinical time on the inpatient units providing consistency for pediatric nephrology patients in the PICU, NICU, as well as general inpatient units. Her areas of interest are acute kidney injury and biomarkers, as well as acute dialysis of all forms.
 

Christina JL Michels, DNP, ARNP, CPNP-PC
Nurse Practitioner
Christina Michels completed her undergraduate BSN studies at Goshen College in 2008 and graduate studies as a Pediatric Nurse Practitioner at the University of Iowa College of Nursing in 2016. She serves the Pediatric Nephrology population on an outpatient basis in the Stead Family Children’s Hospital infusion area and the Pediatric Specialty Clinic. Christina specializes in hypertension, prenatal consults, and all aspects of the Pediatric Kidney Transplant clinic with additional interest in transitioning care of adolescents to adult care after kidney transplant. Additionally, she participates in IROC (Improving Renal Outcomes Collaborative) and the C4K (Comfort4Kidney) support group. Christina is Sub-I with Dr. Nester in a couple clinical trials at the University of Iowa. She loves spending time outside and traveling with her husband. Bring on the adventure!