Training & Curriculum




Amyloid with aligned subepithelial fibrils A) causing silver positive spikes on the Jones stain and B) in the subepithelial area with overlying foot process effacement by electron microscopy.


The Renal Pathology Fellowship encompasses education in all techniques and skills needed for excellence in the practice of native and transplant renal pathology, including light microscopy, immunofluorescence, immunohistochemistry, electron microscopy, clinical-pathologic correlation and laboratory management administration, which are accomplished in a coordinated fashion.

The division accessions approximately 3,500 specimens annually, of which 20 percent are transplants. The fellow rotates with each of the five renal pathologists on a biweekly basis, to gain a breadth of experience.

The faculty and fellows perform electron microscopy on all renal biopsy specimens, providing hands-on experience. Fellows also review non-neoplastic kidney sections from tumor nephrectomies, non-neoplastic nephrectomies (native and transplant) and autopsy kidneys in consultation.

Responsibilities are graduated, with fellows progressing to working up and dictating cases independently and discussing cases with referring nephrologists. In the latter part of the year, the fellow rotates with attendings on weekend renal pathology call. Up to eight weeks of protected time off is provided for work on research projects.


Endocapillary hypercellularity in postinfectious glomerulonephritis
(Jones silver stain)

Renal pathology responsibilities:

  • Selected native and transplant kidney cases, including light microscopy, immunofluorescence and electron microscopy, and report preparation
  • Communication with nephrologists
  • Review of non-neoplastic tumor nephrectomies, nontumor nephrectomies and autopsy kidneys
  • Weekend call in the latter part of fellowship
  • Resident education in renal pathology (see Teaching Responsibilities below)
  • Conference presentation and participation (see Conferences below)
  • Administrative functions (see Administrative Responsibilities below)

Research time:

  • At least one clinical or translational research project is expected.
  • State-of-the-art research techniques and departmental support available.

Opportunities for graduated responsibility:

  • Working up and dictating cases independently after three to six months of fellowship
  • Discussing cases with referring nephrologists
  • Independent consultations on autopsy kidneys
  • Teaching pathology residents and nephrology fellows
  • Weekend renal pathology call after six to eight months of fellowship


Mandatory Conferences

The fellow is expected to prepare and present at:

  • Working Renal Transplant Conference, weekly
  • Cedars-Sinai Renal Pathology Conference, monthly
  • Harbor-UCLA Renal Pathology Conference, monthly
  • Consensus conference of interesting or difficult renal pathology cases, monthly

Attendance is expected at:

  • Pathology Grand Rounds, monthly
  • Autopsy Conference, when relevant to renal pathology
  • Cedars-Sinai Clinical Pathological Conference, quarterly

Optional Conferences

The following conferences and educational endeavors are optional, but the fellow may want to participate to enhance knowledge of nephrology and maintain competence in general pathology:

  • Nephrology Grand Rounds, weekly
  • Renal Transplant Noon Conference, weekly
  • Consensus surgical pathology case review conference, daily

Administrative Responsibilities

The fellow has administrative responsibilities, affording an opportunity to learn skills required for academic and private practice. Administrative quality assurance activities in which the fellow participates include:

  • Evaluation of new immunostains
  • Review of oncologic reports to ensure compliance with College of American Pathologists elements for surgical pathology cases
  • Review of amended reports
  • Frozen section — permanent section correlation
  • Quarterly interinstitutional review of cases sent to other institutions

Teaching Responsibilities

The fellow is expected to hone teaching skills by taking an active role in resident education. The fellow teaching activities include:

  • Reviewing renal pathology cases with residents on the renal pathology rotation
  • Supervising residents as needed for non-neoplastic nephrectomies in the Gross Room
  • Reviewing cases with nephrology fellows
  • Presenting one unknown and one known slide conferences for residents during the academic year

Research Responsibilities

Research is an important aspect of education and has strong departmental and institutional support, including a large, well-organized biobank. State-of-the-art research techniques are available.

  • Up to eight weeks of protected research time is provided.
  • At least one clinical or translational research project is expected.
  • Research may be in the Pathology Department or in collaboration with the Transplant Division or other renal-related specialties.

Evaluations and Mentorship

The program director of the Renal Pathology Fellowship meets with the fellow at the beginning of the academic year to identify the fellow's goals and career aspirations, create an individualized development and learning plan and tailor training as needed.

The program director also meets with the fellow at least twice a year to review the fellow's evaluations, ensuring that the fellow is on track to meet all appropriate milestones, make considered career choices and engage with local and national pathology organizations. In addition, the fellow has open access to the program director to discuss any issues that may arise throughout training.

Evaluations are based on Accreditation Council for Graduate Medical Education milestones incorporating the six competencies into the curriculum:

  • Medical knowledge
  • Patient care
  • Interpersonal and communication skills
  • Professionalism
  • Practice-based learning
  • Improvement and systems-based practice

Assessment tools include direct observation, faculty evaluations, 360 evaluations, educational and research activities, quality assurance and patient-safety activities and conference presentations. The fellow will also become a member of the fellowship Program Evaluation Committee, reviewing the fellowship program and offering insight regarding areas in need of improvement.