Non-ACGME Fellowship - Hypertension Fellowship Program
Purpose of the Program
The fellowship program in Hypertension started at the University of Chicago in 2006 and is a continuation of the program started by Dr. Bakris at another institution in 1993. It is designed to provide expertise in the area of Hypertension and clinical research to people who have completed their general medical training and are either contemplating or are in one of the following medical subspecialties: cardiology, nephrology, endocrinology or general internal medicine. Those who are already pursuing one of these subspecialties at the University of Chicago may have one year of their training dedicated to this fellowship. Individuals who choose this fellowship will also receive credit toward completion of their primary fellowship, pending approval by the respective division chair. The central disease process studied in this fellowship is Hypertension, a disease common to all of these subspecialties.
The broad objective of the fellowship is to teach physicians how to initiate, carry out and complete a meaningful clinical research studies. The focus of the research will be to understand the consequences of Hypertension as they relate to the genesis of cardiovascular, metabolic (diabetes) and renal disease. Moreover, the fellowship will focus on strategies that may prevent or delay the onset of these problems. To achieve this goal, we have formulated a curriculum that incorporates knowledge and skills from the areas of epidemiology. Statistics, Molecular Biology, Clinical Pharmacology and Internal Medicine.
Five primary units comprise the annual curriculum of the fellowship program:
- Fellow initiated and completed grant proposal
- Lectures and workshops
- Active participation in ongoing clinical trials
- Active participation in the journal club and seminars
- Consultation on the Hypertension Service
Each of these is discussed in detail below.
To provide fellows with an in-depth review of the spectrum of hypertensive disorders. To achieve this objective the following curriculum will be employed:
- Didactic lectures. These lectures take place at monthly at Hypertension Grand Rounds as well as at special seminars sponsored by the Section of Endocrinology, Diabetes and Metabolism. Both "in house" and visiting faculty participate. Topics center on various aspects of Hypertension and include the areas of molecular biology, pathophysiology, genetics, end organ injury and assessment of secondary causes (pheochromocytoma, primary aldosteronism, renal artery stenosis and other related diseases).
- Consultation service. Fellows are responsible for both inpatient and outpatient consultation of hypertensive patients throughout the year. Specifically, fellows assess and generate a diagnostic and therapeutic plan for each patient they evaluate. This plan is reviewed with a faculty member in the section. In this regard, fellows work with various faculty members in the Section of Endocrinology, Diabetes and Metabolism throughout the year.
- Journal Club.Each fellow presents four articles per month for the journal club. These articles are selected from a group of related journals on cardiovascular/renal diseases. In addition, fellows are given selected articles, submitted to various journals by outside authors, to review with a faculty member. They are also required to present a bimonthly talk (review) on a topic that deals directly with their research interest.
- Case conferences.A combined Hypertension case conference occurs each month. It involves fellows from endocrinology, nephrology and cardiology with an interest in Hypertension. Each fellow is responsible for organizing and presenting a case during this time.
Fellows are typically exposed to an average of 40-50 hypertensive patients per week during the yearlong fellowship. Fellows are responsible for all aspects of diagnostic and therapeutic evaluation in these patients and are required to discuss all related issues with the corresponding attending. Fellows are also required to be on-call for all problems in these patients with an attending backup to discuss these issues. Fellows are responsible for the following clinical activities:
- Initial assessment and development of a plan for management of Hypertension in all patients for whom we are consulted in both the inpatient and outpatient setting.
- Discussion of all patients seen with the corresponding attending physician, who evaluates the fellow's diagnostic and therapeutic plan.
- Spending a minimum of six hours each day on direct patient care in the outpatient or hospital consultation setting.
- Interacting with all primary care physicians involved in a case and discussing the final diagnosis and plan with them.
- Participating in weekly hospital teaching rounds, which involve bedside assessment of hypertensive patients, and discussing all attendant problems in the presence of an attending.
- Being first call for all clinic patients after clinic hours.
- Reading all ABPMs with the respective attending physician of the month.
- Coordinating all journal club and case conference activities.
- Participating in lectures and rounds to house staff.
- Attending the Hypertension clinic that meets Tuesday afternoons from 1-4:30 pm and Wednesdays from 8-4 p.m. During this time fellows are responsible for evaluating between seven and 10 patients.
- Learning and becoming proficient in developing CRC consent forms and all other aspects of drug trials. Fellows are responsible for handling specific protocols and assisting, when needed, in seeing afternoon study patients as they relate to various ongoing studies. This is limited, however, to a maximum of two days per week.
The time remaining after clinical responsibilities are fulfilled should be dedicated to research activities. Research time includes protocol development, journal reading and manuscript writing. In addition, fellows should use this time to prepare for journal club and case conferences.
The University of Chicago Hypertension Center sees patients, primarily in consultation, typically for a second or third opinion, when blood pressure control is poor or cardiovascular risk high. However, a few physicians also do a small amount of primary care. Physicians, working predominantly in the research areas of cardiovascular or renal disease are available to see patients for consultation by appointment in their given areas of expertise. Patients with secondary Hypertension (that is, due to a specific cause, like a blocked renal artery or a tumor) or those with diabetes and renal insufficiency are of special interest.
How to Apply
The University of Chicago is an equal opportunity, affirmative action employer and applications are encouraged from minority groups and physically disadvantaged individuals. Please note that applicants must have completed or are completing an Internal Medicine Residency in the United States prior to starting the fellowship. Foreign Medical Graduates need to have a J1 Visa or Green Card. To apply to this program, click here.
For more information contact:
Administrative Assistant to George Bakris, MD