& Clinical Immunology
NIAID Grant — The Asthma, Allergy & Clinical Immunology Division at UVA is a recent recipient of an Asthma and Allergic Disease Center Grant from the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health. UVA is one of only 15 centers so recognized in the country. Additionally, Division faculty have three RO-1 grants for studies on the mechanisms of allergy and asthma.
Major Heart & Vascular Center Renovations — Significant investment in the clinical infrastructure of the Heart and Vascular Center are underway which will result in a new, integrated outpatient clinic facility. Together with all new faculty office space, a new cardiovascular reporting system, and new non-invasive laboratories, the clinical enterprise has been greatly enhanced and includes new state-of-the-art cardiac catheterization and electrophysiology laboratories.
Atrial Fibrillation Center — The UVA Atrial Fibrillation Center serves as a comprehensive source for education; medical, ablative, and surgical treatments; translational and clinical research; and outcome measures for the management of atrial fibrillation.
Valvular and Adult Congenital Heart Disease — In close collaboration with the Departments of Pediatrics and Surgery, the division runs a vibrant and integrated program in adult congenital and valvular heart disease. We are one of only a few institutions in the country with active programs in percutaneous aortic and mitral valve disease.
Fellowship Training — The division of Cardiovascular Medicine runs an active fellowship training program as well as sub-specialty training in electrophysiology and interventional cardiology. A core group of Division faculty members was awarded an NIH T-32 Training Grant in Cardiovascular Imaging; the mission of training is to be at the leading edge of new technology, but with an abiding interest in using new technology to understand mechanisms of heart disease, physiology, and pathophysiology.
Endocrinology & Metabolism
Zhenqi Liu, M.D., Division Chief
Professor of Medicine
Nationally Top Ranked Program — The Endocrinology & Metabolism program consistently ranks in the top programs in the nation in the U.S. News & World Report on Top U.S. Hospitals.
First Islet Cell Transplant in Virginia — UVA performed the first islet cell transplant in the state of Virginia for a patient with Type 1 Diabetes Mellitus. Through the work of numerous clinicians and scientists and led by our division, along with the Department of Surgery (Dr. Kenneth Brayman), we have a fully active islet cell core.
Diabetes and Obesity Program — Under the guidance of Drs. Eugene Barrett, Anthony McCall, Susan Kirk and Michael Thorner, we offer a comprehensive program in management of diabetes and weight disorders. The clinical management of diabetes mellitus, along with cutting edge science in diabetes and metabolism as led by Drs. Eugene Barrett, Zhenqi Liu and Anthony McCall, comprises another key component of this activity.
Neuroendocrine Center — UVA offers a world-recognized multidisciplinary clinic for patients with pituitary disease. Drs. Michael Thorner, John Marshall and Mary Lee Vance, in conjunction with members of the Department of Neurosurgery (Drs. Edward Oldfield and John Jane, Jr.), and gamma knife surgeons Drs. Landislau Steiner and Jason Sheehan, have a complete program for the evaluation and management of these complex patients.
Thyroid Diseases — We have a comprehensive program for the evaluation of patients with various thyroid diseases including abnormal thyroid function, thyroid nodule and thyroid cancer. Led by the clinical efforts of Drs. Zhenqi Liu, Stacey Anderson, Richard Santen, and Christopher McCartney, we are a key referral point for care of these patients.
Metabolic Bone Disease — We offer a comprehensive program in the evaluation of patients with low bone mineral density and disorders of calcium metabolism. Led by the clinical efforts of Drs. Sue Brown and Alan Dalkin, we are a key referral point for care of these patients.
Infertility — Our division provides care for patients with infertility. Dr. William Evans has developed a comprehensive program for evaluation of the infertile couple and provides longitudinal care for women undergoing ovulation induction and assisted conception. In addition, Drs. Evans, Marshall and Christopher McCartney have expertise in the evaluation and management of polycystic ovary syndrome.
Endocrine Hypertension — Led by Drs. Robert Carey, Helmy Siragy, and Shetal Padia, we have a highly regarded program, both clinically and in the research laboratory, in this arena.
Gastroenterology & Hepatology
Strong Fellowship Program — Our division has earned a reputation for excellence in training, research, and clinical care. We have a strong drive to advance the science and practice of gastroenterology. This starts with an emphasis on teaching all levels of learners. We have one of the largest fellowship programs in the nation, producing academic leaders, and are fortunate to offer support with an NIH training grant. Our program is pleased to be on a six-year cycle of review by the ACGME (the longest possible review cycle provided to programs with the highest level of compliance with ACGME guidelines). Current faculty includes the former President of the American Gastroenterological Association and others who hold high level leadership positions in the American Association for the Study of Liver Disease and the American Society for Gastrointestinal Endoscopy. Fellows receive consistent mentorship beginning even prior to their arrival, and training is overseen by clinical and research mentors, as well as a Chief Fellow, and strong Program and Associate Program Directors. More than 60% of recent fellowship graduates hold full-time faculty positions throughout the U.S.
Nationally Recognized Core Research Center — The Division's research achievements have earned substantial NIH funding (about $10M), from multiple R01s to a Program Project in Intestinal Immunity. The quality and importance of our basic and translational research in inflammatory bowel disease (IBD) and other domains led the NIH to name UVA as one of 16 national centers recognized as prestigious Silvio O. Conte Digestive Disease Core Research Centers. The list of clinical accomplishments of our Division date back to Dr. Barry Marshall's description of Helicobacter pylori, which won him the Nobel Prize in Medicine in 2005.
Innovative Programs — UVA performs the largest volume of ERCPs in the Commonwealth of Virginia and has developed innovative approaches to pancreatico-biliary and luminal diseases. Our hepatology faculty includes some of the premier experts in non-alcoholic steatohepatitis, coagulation abnormalities in liver disease, and hepatocellular carcinoma. One of our faculty leads a nationwide, multi-center NIH research project in living-donor liver transplants. Along with cutting-edge clinical trials, our clinical IBD program offers a top-caliber multi-disciplinary team with collaborative care provided by colorectal surgeons, pathologists, radiologists, nutritionists and others.
General Medicine, Geriatrics
& Palliative Care
UMA General Medicine "Firm" — The University Medical Associates (UMA) ambulatory clinic has completed a highly successful transition from a traditional residents' clinic to a model program based on the firm system, allowing UMA to provide innovative primary care to underserved patients and resulting in some of the highest quality indicators in the state.
Geriatrics Care Unit & Palliative Care Unit — UVA has an inpatient Geriatrics Care Unit (GCU) and an expanded Geriatrics Inpatient Consultation Service. Division geriatricians work at a number of nursing homes in our local community and surrounding counties. There is a 7-bed dedicated Palliative Care Inpatient Unit where patients requiring acute symptom management are cared for by the palliative care team. The Palliative Care Consult service is increasingly consulted.
Innovative Models for Care & Education — With the support of a Health Resource and Services Administration (HRSA) Academic Administrative Unit grant and a chronic care grant from Partners in Quality Education, the Section of General Medicine has developed a model systems-based practice for the care of chronic illness among underserved patients and a model curriculum for residents in the “new” competencies of systems-based care and practice-based learning.
With support from the Academy of Distinguished educators and the GME Innovations grant, Division faculty are developing an innovative patient safety curriculum involving residents in a “hand-on” approach to improving patient safety and reducing errors.
The Geriatrics program is currently expanding its fellowship program and, in collaboration with Palliative Care, is offering a new medical student clerkship in geriatrics and palliative care. Through a recent Hartford Foundation Grant, General Medicine and Geriatrics have joined on a project to improve geriatric prescribing and to enhance the training of internal medicine residents in geriatrics through education and a model collaborative practice. Palliative Care continues to offer elective rotations for residents and med students, with a goal of establishing a fellowship program within the next two years.
Ongoing and Future Interests of the Division include chronic illness care, patient safety, falls in the elderly, geriatric prescribing, medical education, and ACGME competency assessment.
Hematology & Oncology
New Cancer Care Center — Opened in 2011, the five-story, 150,000-square-foot Emily Couric Clinical Cancer Center provides the full range of state-of-the-art therapies and comprehensive cancer care − all under one roof, in an inviting and invigorating space designed for the needs of patients and their families. Clinics housed within the facility include Gynecologic Oncology, Infusion Center, Neuro-Oncology Center, and Radiation Oncology. UVA is the first center in the nation to offer TomoHD™, the latest version of the TomoTherapy system which delivers precisely targeted radiation treatments that preserve more healthy tissue. Other advanced services available include the CT on Rails brachytherapy suite where patients with gynecologic and prostate cancers can get treatment in a single, more comfortable location instead of needing to be moved to multiple locations; the Varian TrueBeam™ linear accelerator, first of its kind in Virginia; and a new SPECT/CT device combining single photo emission computed tomography (SPECT) with CT for improved diagnosis in one scan.
Latest Research — Physicians of the Division and scientists of the Department of Microbiology and Molecular Genetics have shown that rituximab, a monoclonal antibody to the CD20 antigen on chronic lymphocytic leukemia, "shaves" the antigen from the leukemia cell rendering it a poor target for therapy. By lowering the dosage of the drug and giving it more frequently, the shaving phenomenon is circumvented and the drug is more effective.
New High-Dose Interleukin-2 Treatment Program — The Division runs a treatment program in high-dose interleukin-2, an immunotherapy for the treatment of metastatic renal cell carcinoma and malignant melanoma. This therapy serves as the basis for clinical investigations of high-dose immunotherapy combined with targeted therapy of cancer.
Infectious Diseases &
UVA Priority — Study of infectious diseases is a traditional area of strength at UVA. Currently, I.D. research comprises one-fifth of all School of Medicine extramural research funding. Infectious Diseases and International Health is one of 10 "Research Themes" of the School of Medicine 10 year Strategic Plan, one of 4 central themes of the Department of Medicine strategic plan, and an area of expansion within the Departments of Microbiology, Pathology and Cell Biology.
Research programs in bacteriology, virology, eukaryotic pathogens, and international health are present in the Division, with extramural funding in excess of $15 million annually. Opportunities for residents to pursue research exist at the lab bench, clinic and international sites (Brazil, Bangladesh, Tanzania, South Africa, India, Uganda and Haiti). Faculty research programs are listed on the fellowship site.
New Infectious Diseases Building — An exciting example of institutional support, the Harrison-Carter Medical Research Building was completed in 2009. The Infectious Diseases division occupies 23,800SF of lab and support space and a 4,375SF BSL3/aBSL3 biocontainment lab suite.
Excellence in Clinical Practice & Education — Division faculty receive major teaching awards annually and have authored or edited many of the major infectious diseases texts including Principles and Practice of Infectious Diseases, Tropical Infectious Diseases, Infections of the Central Nervous System, Clinical Virology, and Medical Parasitology.
Clinical Fellowship — This research- and clinically-intensive program fulfills the requirements for specialization in adult Infectious Diseases over a 3-year period. 90% of our graduates are on faculty at U.S. medical schools. The first year is devoted entirely to research and the second begins the required two-year HIV/AIDS continuity clinic (one afternoon per week). 100% of graduates have passed the subspecialty exam on first try, with average scores in the top 10th percentile.
Infectious Diseases Clinic — Our clinic cares for 800 individuals with HIV/AIDS as well as patients with other infectious diseases. Program graduates Brian Wispelwey, M.D. and Greg Townsend, M.D., direct the clinic. Research conducted at the clinic includes participation in antiretroviral protocols, approaches to improve adherence to therapy, and evaluation of therapies for opportunistic infections.
Center for Global Health — Established in 1978 by Richard Guerrant, M.D., as one of four original Rockefeller Foundation supported programs, the Center is home to the Gates Foundation-supported Malnutrition and Enteric Diseases project that is studying the cause of malnutrition in infants in Brazil, Tanzania, South Africa and Bangladesh. The Center's research focuses on emerging enteric and protozoan infections, with both laboratory and field components. Additional major projects include the NIH International Collaborations for Infectious Diseases Research (ICIDR) "Long-Term Impact & Intervention for Diarrhea in Brazil" and the NIH Tropical Medicine Research Centers (TMRC) "Pathogenesis of Leishmaniasis". Center faculty teach trainees in a growing Travelers' Clinic, conduct international electives for students, and have developed international collaborations with sister institutions the Federal University of Ceara in northeastern Brazil, the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh, and the University of Ghana Medical School in Accra.
Certification in Tropical Medicine & Travelers Health — UVA is one of just a few programs nationwide that offer this certification training. Administered by the American Society of Tropical Medicine and Hygiene, the course includes seminars, conferences, laboratory training, and outpatient experience, and provides added emphasis on tropical medicine.
Nephrology, Center for Immunity, Inflammation and Regenerative Medicine
The Division of Nephrology and Center for Immunity, Inflammation and Regenerative Medicine — In December 2008, The Center for Immunity, Inflammation and Regenerative Medicine (CIIR) merged with the Division of Nephrology to create a thematic group of clinicians, educators and investigators who provide educational, research and clinical opportunities in the area of kidney disease and inflammation. The Division and CIIR draw from the expertise of internationally and nationally acclaimed faculty investigators in kidney disease and basic immunology. NIH-funded laboratories and the Nephrology Clinical Research Center provide opportunities for trainees to participate in state-of-the-art research in basic, translational or clinical research.
Training the Next Generation of Researchers in Kidney Disease and Inflammation — In 2006, the Division was awarded a NIH T32 postdoctoral training grant entitled "Kidney Disease and Inflammation". This program is aimed at training investigators in kidney disease and inflammation for academic careers in research. Twenty-nine faculty members with research interests consistent with the training grant provide a wealth of research opportunities. Residents interested in research opportunities are encouraged to discuss options with the program director or division chief.
Clinical Fellowship and Education — Our fellowship program is organized into a traditional two-year clinical fellowship program or a combined clinical/research fellowship program. Wide-ranging clinical practices within the Division and CIIR provide training in all aspects of clinical nephrology including a special interest in geriatric nephrology. We have a large academic outpatient dialysis program with over 750 patients, and a nocturnal dialysis facility headed by a leading authority in this form of dialysis. We provide training in all forms of renal replacement therapies. Our faculty are national leaders in acute kidney injury, glomerulonephritis, fluid and electrolyte disorders, transplantation and therapeutic apheresis, and have distinguished themselves as outstanding educators and clinicians through Department of Medicine and School of Medicine Teaching awards and Clinical Excellence Awards. Several faculty have been selected to the Academy of Distinguished Educators, are diplomats of the Leadership in Academic Medicine Program at UVA, and are listed as America's Top Doctors.
Innovative Programs — We have expanded our transplantation program with the addition of two new faculty. We perform 100-120 kidney and combined kidney/pancreas transplants per year, including ABO incompatible transplantation that provides transplant options for those with limited matched donors. We have incorporated therapeutic apheresis into our program and offer a yearly therapeutic apheresis academy in the fall to trainees from across the country. Special outpatient clinics in polycystic kidney disease and stone disease have been established. A new lupus nephritis clinic is in planning for the near future.
Pulmonary & Critical Care Medicine
Popular Teachers — The Division's nine faculty members include three of the top 15 teachers as ranked by the residents and interns. Focus areas for clinical care and resident instruction include: general pulmonary medicine, critical care, sleep, lung transplant, cystic fibrosis, interstitial lung disease, pulmonary hypertension and medical as well as surgical treatment of COPD. Additionally, the division offers experiences at a Long Term Acute Care Hospital and in Palliative Care.
Wide-Ranging Research & Clinical Trials — Our faculty participates in both clinical and bench research. Current areas of interest and exploration include: PI for the ARDSnet site; NIH sponsored clinical trials in acute lung injury, sleep medicine as it relates to children, chemokines in asthma, and the role of serine proteinases in lung injury; multi-center trials in mechanical ventilation weaning, sepsis, and intrabronchial valves for COPD; pharmaceutical trials in Asthma, COPD, Interstitial Lung Disease, Pulmonary Hypertension and Cystic Fibrosis; and a federally-funded study to evaluate biomarkers in airway inflammation.
Clinical Expertise — The Division's faculty has expertise in the full range of diseases within the realm of clinical rheumatology. The outpatient clinics are busy with patients from across the state and region.
Teaching Commitment — Division Faculty are dedicated to teaching the next generation of clinicians in rheumatology. The Division has a highly competitive training program in clinical rheumatology. We accept two fellows per year who participate in very active ambulatory care clinics as well as a hospital-based consult service. All fellows are similarly immersed in scientific investigation along with the clinical rotations during their first and second years of post-graduate work. Trainees may elect to remain for a third year of training with a strong emphasis on research if their career path includes academic advancement and they have secured funding to support their work.