A big part of the recruitment pitch is clear. At Iowa, candidates interested in subspecialty training past residency can find growing cohorts, expanded accreditations, and a menu of opportunities for multidisciplinary training tailored to their career goals. The numbers don’t lie: UI Health Care Internal Medicine’s Fellowship Programs have grown more robust, with expansion still to come. As the department nears the Dec. 4 fellowship match date, planning for next year’s recruitment is already underway.

“From a big picture standpoint, when a fellowship program is expanding, it’s a sign of strong health,” said Brian Gehlbach, MD, Associate Director of Internal Medicine Fellowship Programs. “All these different programs are doing well and are therefore capable of expanding.”

While program success is a factor for growth, patient needs also incentivize expansion. Gehlbach notes that electrophysiology, a program set to double its cohort, has historically been a difficult medical service for Iowans to access. UI Health Care enhances its services by investing in fellowship programs, as fellows provide patient care and trainee mentorship, and then often advance to faculty positions.

Here is an overview of our recent expansions and what is on the horizon:

Cardiac-Electrophysiology
Program expansion from 3 to 4 fellows (FY26)
Program expansion from 4 to 5 fellows (FY27)

Cardiac-Advanced Noninvasive Cardiac Imaging
Start of non-accredited 1-year program, one fellow/year (FY23)

Gastroenterology-Hepatology Transplant
Start of non-accredited 1-year program, one fellow/year (FY26)

Hematology and Medical Oncology
Program expansion from 12 to 18 fellows. Increases fellows by two fellows/year for 3 years (FY23)

Infectious Diseases
Program expansion from 4 to 6 fellows. Increases fellows by one fellow/year for 2 years (FY23)

Nephrology-Critical Care
Start of accredited 2-year program, one fellow/year (FY27)

Nephrology-Genetics
Start of non-accredited 1-year program, one fellow/year (FY26)

Nephrology-Transplant
Moving from non-accredited to accredited (FY27)

Pulmonary and Critical Care
Program expansion from 12 to 15 fellows. Increases fellows by one fellow/year for three years (FY26)

Pulmonary – Advanced Lung Disease/Transplant
Start of non-accredited 1-year program, one fellow/year (FY23)

Rheumatology
Program expansion from 4 to 6 fellows. Increases fellows by one fellow/year for two years (FY26)

One fellowship program in particular will expand into some unique subspecialties, attracting a motivated candidate population that can provide Iowa patients with specialized care.

For example, the Division of Nephrology and Hypertension has leveraged its existing infrastructure to support new Nephrology-Genetics and Nephrology-Critical Care fellowship programs. The critical care program launched on July 1, 2025, and renal genetics will welcome its first cohort member in 2026.

There is an ever-growing demand for renal interventionists across the nation, but Nephrology Fellowship Program Associate Director Jonathan Nizar, MD, anticipates that many fellows matching at Iowa will fall in love with the state and continue their careers here.

Nizar said that the development of the renal critical care program would not have been possible without collaboration between the Nephrology and Pulmonary and Critical Care program leadership teams. Specifically, he credits the work of Nephrology Fellowship Program Director Lisa Antes, MD; Ben Griffin, MD, assistant professor in Nephrology, and Alicia Gerke, MD, MBA, Director of the Pulmonary and Critical Care Fellowship Program.

Nizar emphasized that coordination between the Nephrology and Pumonary faculty members has already proven exceptional. The teams are currently integrating components from both existing curricula into a streamlined curriculum, with leadership closely monitoring its efficacy and progress.

Developing the renal genetics program also involved cross-division collaboration. Christie Thomas, MBBS, took the lead in creating the program and its curriculum alongside Lama Noureddine, MD, clinical associate professor in Nephrology; Chou-Long Huang, MD, PhD, professor in Nephrology; Carla Nester, MD, MSA, FASN, professor of pediatrics-nephrology, and Hatem-el Shanti, MD, professor in the Department of Pediatrics; Division of Medical Genetics & Genomics.

With specialists nationwide identifying more kidney diseases linked to genetics, the new program’s reach could extend beyond Iowa. Nephrology Program leadership aims for the renal genetics fellowship to serve as a template for programs at other institutions. So, the work fellows do in this emerging program now may help patients in different states gain access to appropriate screening and expertise in the future.

“It has become apparent that the tools for genetic testing and screening have become available before there had been adequate foundational knowledge among practicing nephrologists to deploy these tools responsibly,” Nizar said. “Our nephrology division has taken on the challenge of training a new generation of nephrogeneticists with this genetics fellowship, which should better equip them for nephrology practice in Iowa and elsewhere. We are excited to foster this advanced training in Iowa City for the benefit of Iowans and spread our expertise to academic institutions elsewhere.”

The positive compounding effect that renal subspeciality fellows can spark starts at the division level. These fellows bridge divisions, benefitting both the fellow and surrounding teams.

“When you create these combined training programs, the hope is that it fosters connections between the two divisions,” Gehlbach said. “In a training program where fellows are spending part of their time in nephrology, and the other part in critical care, for example, then suddenly, you have a connector between divisions. This person can leverage their growing expertise from one area of their training into another, which benefits everyone. We haven’t had this person yet, so we are excited to see what happens.”

Though based in separate divisions, faculty members will not mentor trainees in silos. Instead, they will provide instruction on how to integrate learning across divisions. And interdisciplinary skill-development in training has a cascading effect, enhancing the performance of faculty, residents, medical students, nurses, and all those who contribute to patient care.

Fellows in the traditional Nephrology and Pulmonary and Critical Care programs will also benefit from the inception of these subspecialty programs. For instance, Gehlbach said that when mentors develop new renal genetics curricula, they can also share this cross-disciplinary instruction with the general nephrology fellowship. Distributing advanced curriculum in this way creates meaningful challenges across multiple programs, and this rigor ultimately improves patient care and research.

Helping to coordinate these new program opportunities behind the scenes, Nephrology Fellowship Coordinator Lisa Novak described the process of expansion as time-consuming. However, she believes these developments are an essential step toward a new future for fellows.

“We want every fellow to succeed. Hopefully, fellows remain local, but the bigger picture includes everyone, no matter where they go next,” Novak said. “This is the wave of the future – collaboration with more sides of nephrology.”