AST Renal Transplant/AFC Solid Organ Transplant

Fellowship Program at McMaster

Mission Statement

Our mission is to teach, role model, continually self-evaluate, innovate and inspire our learners to provide holistic patient-centred care in leading to a competent, compassionate, dedicated and well-rounded transplant nephrologist.

Our Vision

Our vision is to be leaders in Transplant Nephrology Education by empowering our learners to strive for excellence and innovation in all CanMEDS domains leading to a responsible, professional and competent nephrologist with a strong commitment to patient-centred care, research and commitment to society, to lead, represent and protect patients with renal disease.

Dr. Azim Gangji, Program Director
Dr. Azim Gangji, Program Director


The McMaster University AFC Solid Organ Transplant /AST Renal Transplant Fellowship Program is a learner-centred program with a strong emphasis on competency-based education.  The program is unique in that it is accredited by both the Royal College of Physicians and Surgeons of Canada and the American Society of Transplantation.   

The McMaster University Renal Transplant Fellowship Program is a competency-based training program that has a strong emphasis on providing a comprehensive learning experience in order to achieve skills in all CanMEDS domains.  The program is designed to be a one-year training program. 

The curriculum is unique and aimed to provide exposure to all aspects of transplantation yet allowing for flexibility and self-directed learning.  The program is tailored to learner needs and therefore a variety of assessment methods are utilized in order to provide trainees feedback and guidance. 

There is a dedicated and protected transplant academic half-day led by faculty and presented in both lecture and case-based formats. The faculty are extremely motivated and oversee all aspects of education. 

The Renal Transplant Program at McMaster University and St. Joseph’s Healthcare Hamilton is one of the largest clinical programs in Canada and therefore fellows are exposed to a highly complex pool of patients. The program performs living donor, paired exchange, deceased donor, extended criteria donor and high-risk transplantation and has associated with it a large renal transplant outpatient clinic. The program emphasizes full patient care including an emphasis on performing transplant biopsies.

The academic program also has a strong clinical, basic science and medical education research component. There are numerous renowned faculty within the Division of Nephrology who lead major research projects and are leaders in their field. A strong research infrastructure to support trainees in pursuing either clinical, basic science or medical education research is provided. In addition, residents are provided training in completing a quality improvement and patient safety project.

Certification Outcome

The successful completion of the AFC/AST fellowship will grant the following certifications:

  • Royal College of Physicians and Surgeon of Canada Area of Focused Competence in Solid Organ Transplant
  • American Society of Transplantation certification
  • McMaster University certificate in Renal Transplantation

Entry Requirement

The fellowship program is designed for individuals who have graduated or will be graduating in the upcoming academic year from an Adult Nephrology residency program.  For graduates from Canadian and foreign nephrology training programs, please provide the following: 

  • Curriculum Vitae (CV/Resume)
  • Source of funding
  • Letter of interest indicating reasons for wishing to train at McMaster in Nephrology and how this fellowship training will meet your career goals

Application Deadline

For graduates from foreign Internal Medicine training programs, the deadline is December 1 prior to entry into the upcoming academic year which starts on July 1st.

Goals of Training

The McMaster University Renal Transplant Training program has as its core objective to graduate trainees who are practical and competent transplant specialists. There is a strong emphasis on acquiring knowledge in a contextual manner to help integrate and consolidate knowledge in developing competencies in renal transplant-related problems and diagnostic procedures.

The McMaster University Renal Transplant Fellowship program is accredited by the Royal College of Physicians and Surgeons of Canada’s AFC Solid Organ Transplantation program and American Society of Transplantation. The goals and objectives are designed to achieve comprehensive competencies as outlined by these accreditation bodies.  

An outline of our milestone map and phases of training are identified below:

Transition to Discipline:  Block 1 

  • 3.2 Allocation of donated organs to recipients

Foundations of Discipline:  Blocks 2-5

  • 1.2 Lead patient discussion in interprofessional team meetings regarding suitability for renal transplantation
  • 2.1 Evaluate potential donors (deceased and living) with regard to suitability for renal transplantation
  • 3.3 Advocate for organ donation and renal transplantation

Core of Discipline: Blocks 6-11

  • 1.1 Assess individuals with ESRD for suitability for organ transplantation
  • 1.3 Discuss uncertainty and address challenging communication issues such as removal from the waiting list or lack of suitability for organ transplantation
  • 3.1 Participation in the allocation of donated organs to recipients
  • 4.2 Demonstrate knowledge of organ procurement and transplantation procedures
  • 4.3 Describe techniques to preserve the kidney transplants and strategies to optimize organ function
  • 5.1 Manage the early peri-operative care of the renal transplant patient
  • 6.1a Select/advise/adjust/monitor immunosuppressive regimen to optimize renal transplant function and minimize adverse effects
  • 6.1b Select/advise/adjust/monitor immunosuppressive regimen to optimize renal transplant function and minimize adverse effects
  • 6.2 Prevent, identify, diagnose and manage complications related to immunosuppression
  • 7.2 Diagnose and manage renal transplant dysfunction
  • 8.1 Evaluate renal transplant recipient with failing allograft function for the appropriate management

Transition to Practice:  Block 12-13

  • 7.1 Apply appropriate strategies for the surveillance of allograft function
  • 9.1 Completion of a scholarly activity in the field of renal transplantation
Phase Map
Phase map transplant fellowship

Curriculum Highlights

  • Academic Curriculum

    • Protected academic half days for renal transplant fellows provided by faculty to trainees.Format is either lecture based and/or case-based learning.
    • Histocompatibility case-based teaching
    • Evidence based Thursday noon rounds (weekly)
    • Nephrology Grand Rounds (weekly)
    • Renal and Transplant Clinical Pathology Rounds (monthly)
    • Research Rounds (every 2 weeks)
    • Nephrology Journal Club (every 2 months)
    • Transplant Journal Club (every 6 months)
    • Visiting professor rounds (4 times/year)
    • Quality Improvement and Patient Safety Rounds (every 3 months)
    • Combined Medicine Subspecialty Rounds (every 3 months)
    • Simulation based learning (every six months)

  • Procedure-Based Curriculum

    • Renal transplant biopsies
    • Ultrasound evaluation of Renal Transplant
    • Plasmapheresis

  • Clinical and Contextual Learning Curriculum

    • Longitudinal clinics
    • Pre transplant recipient assessment clinics
    • Post renal transplant clinics
    • Living donor clinics
    • Transplant infectious disease clinics
    • Histocompatibility case review
    • Donor call
    • Inpatient transplant ward rotations
    • Virtual care clinics
    • Renal transplant patient care and policy meetings
    • Renal transplant surgical issues meetings
    • Renal transplant cardiac meetings
    • Elective rotations

  • Research Curriculum

    The Renal Transplant Fellowship program has a strong research infrastructure to support trainees in pursuing either clinical, basic science or medical education research.  Numerous faculty members of the division have an interest in various aspects of transplantation. 

    Additional information regarding the Division of Nephrology’s research productivity can be found at the Hamilton Centre for Kidney Research website

  • Assessment

    The McMaster Renal Transplant Fellowship Training program utilizes a variety of assessment tools to enhance our learners' education in building competency.  Some of the tools utilized for evaluation include:

    • AFC milestones
    • ITARs
    • Procedures evaluations
    • Assessment of teaching by junior learners
    • Assessment by interprofessionals

Azim Gangji

Medicine, Nephrology
Azim Gangji
Director, Nephrology and Transplant Fellowship Program; Committee Chair, Medicine Specialty Programs; Vice President, Education, St. Joseph's Healthcare Hamilton


Wendy Clark

Medicine, Nephrology
Clark, Wendy
Nephrology Residency and Fellowship Program Coordinator


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