In 2014 the Vasculitis Foundation created the Vasculitis Clinical Research Consortium (VCRC) -Vasculitis Foundation (VF) Fellowship Program in Clinical Investigation. The VCRC is an integrated group of academic medical centers, patient support organizations, and clinical research resources dedicated to conducting clinical research in different forms of vasculitis. The VF has partnered with the VCRC since its creation in 2002 to recruit patients with vasculitis to participate in research and to connect researchers with patients.
Summary: The VCRC-VF Fellowship is a mentored training program of up to two years for physician-investigators who have a strong interest in vasculitis and wish to pursue a period of specialized training with an emphasis on clinical and/or translational patient-oriented clinical investigation. The trainee will undertake the Fellowship between 2014-2019 at a VCRC-affiliated site in North America that has an established distinct clinical and research program in vasculitis and availability of senior faculty mentors.
There are two principal goals of the VCRC-VF Fellowship:
1. For the Fellow to be involved in the care of enough patients with various forms of vasculitis to develop experience and expertise in the diagnosis and management of patients.
2. To familiarize trainees with the major unmet research needs in vasculitis, the investigative techniques used in clinical and translational research in vasculitis, and understand how to conduct high-quality clinical research in vasculitis.
The eligibility criteria for the VCRC-VF Fellowship are as follows:
1. The candidate must be an MD (or equivalent) committed to a career in clinical investigation.
2. The candidate must have finished a residency and (preferably) have some sub-specialty training relevant to vasculitis. Candidates from various subspecialty backgrounds are encouraged to apply.
3. The VCRC Fellowship training will take place after the applicant has completed a formal subspecialty fellowship.
4. The candidate must have a training license or full license to practice in the state/province where the Fellowship will take place from the START of the Fellowship/funding period.
5. The fellow must be a citizen of the host country or have a valid visa that is acceptable to the host site from the START of the Fellowship/funding period.
6. Preference is given to candidates who propose research related to ongoing VCRC projects, but new projects that capitalize upon VCRC resources or augment areas of VCRC emphasis are also acceptable.
Expectations of Awardees:
1. VCRC-VF Fellows will devote 100% of his/her professional time on Fellowship-related activities.
2. VCRC-VF Fellows will comply with all requirements and guidelines as outlined in this document as well as additional reasonable stipulations or requests from the VCRC Steering Committee.
3. VCRC-VF Fellows will provide updates on their careers to the VCRC, upon request, for at least 10 years following completion of the Fellowship and will ensure the VCRC has active and accurate contact information for the Fellows at all times.
There are two tracks available for VCRC-VF Fellows:
1. Research/clinical fellow for two years which includes a minimum of two half-days per week in a vasculitis clinic over two years, combined with a research project(s) under the guidance of mentor. Necessary didactic training is required; preference given to those willing to complete a Master’s degree or research certification program.
2. Clinical fellow for a one year which includes three to four half-days/week of clinical training in vasculitis and includes some didactic curriculum to assist in carrying out research. A research/academic project is expected to be completed in this time frame.
For more information on the VCRC-VF Fellowship Program, please contact Joyce Kullman, VF Executive Director.
Introducing our 2016-2017 VCRC-VF Fellow
Jennifer Rodrigues, MD
McMaster University, Hamilton, Ontario Canada
The Vasculitis Foundation welcomes Dr. Jennifer Rodrigues, as our 2016-2017 VCRC-VF Fellow. Dr. Rodrigues completed medical school at the University of Calgary in 2011, her Internal Medicine training at McGill University in 2014, and a Nephrology fellowship at the University of Toronto this past year. She will complete this fellowship under the direction of Dr. Michael Walsh, Associate Professor of Medicine and Clinical Epidemiology & Biostatistics at McMaster University, Hamilton, Ontario
Dr. Walsh said that he is particularly excited to be mentoring Dr. Rodrigues because she is bringing a stellar background in basic immunology and a longitudinal clinical experience to her new role.
“Dr. Rodrigues is highly regarded for her clinical skills, thoughtfulness with respect to her patient’s well-being and attention to detail. These qualities are complemented by her scientific curiosity and highly organized nature,” said Dr. Walsh. “Although I only recently started working with Dr. Rodrigues, her drive to develop the best evidence to guide the treatment of patients with vasculitis is obvious. With the help of the VCRC-Vasculitis Foundation award, Dr. Rodrigues is on the road to becoming a leader in vasculitis research and her contributions will undoubtedly improve the quality of care provided to patients.”
In the following interview with the Vasculitis Foundation, Dr. Rodrigues talked about why her particular focus on nephrology is such a critical area of research. She also shared why the VCRC-VF Fellowship is not only a professional opportunity for her, but believes it could yield valuable research insights that will help vasculitis patients in the future.
Briefly describe the focus of your work.
I am a Nephrologist interested in glomerulonephritis, diseases that affect the filters of the kidneys, the second most common cause of kidney failure requiring dialysis. The kidneys are frequently affected by vasculitis and while there are treatments, including immunosuppressive and anti-inflammatory steroid medications, to initially control the disease and prevent flare-ups, we don’t know how long patients should remain on these medications.
The duration of treatment has to be balanced with the risk of infection, bone fracture, and the impact on a patient’s quality of life. I will study whether long-term treatment with very low doses of medications prevents flare ups of vasculitis without significant side-effects. Opinions about whether low-dose medications, particularly prednisone, work in vasculitis vary dramatically around the world so the information from this study will change how vasculitis is treated no matter what it shows!
Why is this important to people with vasculitis?
Most patients with vasculitis will receive prednisone through the course of their treatment. At high doses, prednisone can control the damage vasculitis causes but, it also increases the risk of infections, bone fractures, and may play a role in cardiovascular disease and has very obvious effects on patient’s quality of life. While most of these side-effects disappear at low doses for most patients, it is not clear whether they continue to reduce the risk of vasculitis flare-ups. Avoiding long-term use may reduce the risk of harmful side effects but it may also increase the risk of disease flare-ups and the damage to organs like the kidney.
How did you decide on your specialty?
My interest in Nephrology began as a teaching assistant in physiology and was solidified during the early clinical rotations of Internal Medicine training where one of my first patients had kidney failure requiring dialysis. It is a diverse specialty combining various areas including electrolytes, dialysis, kidney transplant, glomerulonephritis, and immunology in daily practice. We look after a wide variety of patients, from the sickest patients in the intensive care unit to those in clinic who are living with kidney disease. Every day we are presented with new challenges and the opportunity for an important impact on patients’ lives.
What do you find most challenging about it?
I think the biggest challenge in Nephrology is the need for more studies to better understand the complex diseases that affect the kidneys such as vasculitis, in order to determine the best treatments for our patients.
As a nephrologist, you are focused specifically on studying the impact of vasculitis on the kidneys. Tell us more about the research you will be doing into this area.
With the support of the Vasculitis Foundation, I intend to conduct a pilot clinical trial examining whether long-term low dose prednisone is effective at preventing relapse of ANCA-associated vasculitis and its impact on kidney function with a particular focus on the side effects of prednisone and its impact on patients’ quality of life.
I will study whether long-term treatment with very low doses of medications prevents flare ups of vasculitis without significant side-effects. Opinions about whether low-dose medications, particularly prednisone, work in vasculitis vary dramatically around the world so the information from this study will change how vasculitis is treated no matter what it shows!
Talk about how your research could potentially impact the way that patients are treated with Prednisone in terms of risks vs. benefits to the patient.
Avoiding long-term use of prednisone may reduce the risk of harmful side effects but it may also increase the risk of disease flare-ups and the damage to organs like the kidney. My study will clarify the risks and benefits of low-dose prednisone which will ultimately change the way many patients around the world are treated. Importantly, this study will also help us understand the potential effects of low-dose prednisone in other inflammatory and kidney diseases.
You have said that Glomerulonephritis (GN) is the next big development in our area of study. Please explain Glomerulonephritis and why it needs greater research.
Glomerulonephritis (GN) is a complex and rare disease that is the second most common cause of kidney failure. Specialized clinics, as well as an increase in the amount of clinical research in this area will translate into improved outcomes. There are many types of GN in addition to vasculitis, and these patients frequently receive long-term immunosuppressive medications to control their disease.
Determining how long these patients should remain on immunosuppression once their disease is in remission in order to balance medication side effects and impact on patient’s quality of life with the risk of disease relapse is an important research question.
Personally, what does this VF Fellowship mean to you? How do the VF Fellowships advance our understanding of vasculitis?This fellowship will provide me with the opportunity to improve the care provided to patients with vasculitis. I am fortunate to have many excellent mentors within the field of vasculitis and glomerulonephritis and to be among the many previous successful recipients of this fellowship.
The Vasculitis Foundation has been critical to representing patient interests, raising awareness about these diseases, and helping to set research goals.
What is the most rewarding about your work?
It is a privilege to look after patients with kidney disease as we are often able to treat them when they are very ill in the hospital and then follow them over time in the clinic after they improve. We also look after a wide variety of patients of all ages and with a variety of conditions. We see patients with very aggressive types of vasculitis that can cause kidney failure and to be able to offer effective therapy is very rewarding.
Introducing our 2015-2016 VCRC-VF Fellow
Medha Soowamber, MD
Medicine/Rheumatology, Mount Sinai Hospital, Toronto, Canada
On the first day of her longitudinal clinic, I observed Medha during a full encounter with a new patient, and I was impressed with both her clinical and communication skills. She is kind and puts her patients very much at ease. Medha is an excellent listener and does not interrupt, and still directs the interview. She is very responsible and follows up on her lab work and imaging studies. Medha is curious, searches the literature without being asked and asks good questions. A number of patients have spontaneously commented to me on how impressed they were with her kindness and thoroughness. Medha is a bright young woman who is very motivated in orienting her career in the field of vasculitis.
~Simon Carette, MD, Director of the Vasculitis Clinic and Deputy Physician-in-Chief, Mount Sinai Hospital, Toronto
“My first peek into the field of rheumatology was when, as a fourth-year medical student, I did a rheumatology rotation. What initially struck me was the wide variety of diseases that this field entails,” recalls Medha Soowamber, the recipient of the 2015 Vasculitis Research Clinical Consortium – Vasculitis Foundation (VCRC-VF) clinical fellowship.
“My interest was further driven by its diagnostic and therapeutic challenges as well as its multi system approach. Someone told me that rheumatologists are the ‘Sherlock Holmes of medicine.’ This statement is indeed true!”
Dr. Soowamber completed medical school and internal medicine training at McGill University in Montréal, and two years of rheumatology training at the University of Toronto.
“During my rheumatology training, I was given the opportunity to do several oral presentations to physicians, medical students, and even patients,” she recalls. “I received positive feedback from these talks, especially the ones given to patients. They were impressed by the simplicity and clarity of my presentations.”
The Mauritius-born Soowamber will complete her VCRC-VF fellowship at Toronto’s Mount Sinai Hospital, under the guidance of mentor physicians Simon Carette and Christian Pagnoux.
“This one-year clinical fellowship will allow me develop the knowledge, expertise and experience required in diagnosing as well as managing patients with vasculitis,” Soowamber explains. In fact, she finds that one of the most rewarding aspects is the long-term doctor-patient relationship that invariably develops. “What keeps me motivated is the awareness that I can potentially make a positive impact on someone’s life.”
The fellowship also will give Soowamber the opportunity to better understand the current research in vasculitis. “As I deepen my knowledge and gain experience in vasculitis, I would like to incorporate the teaching of this rare disease to both professionals and patients as part of my future career,” she says.
Soowamber is excited by the opportunity the fellowship provides.
“There are still many unanswered questions in vasculitis; it is a growing field with extensive clinical research being undertaken to improve the care and quality of life of patients,” she notes. “With the knowledge gained from the fellowship, I’ll be able to devote my career to greater research in vasculitis and the development of educational and awareness programs for patients and health care providers.”