A Nephrologist is a doctor who studies how the kidneys work, and looks after people with kidney disease. Nephrologists classically provide quite comprehensive care. So aside from looking after the kidneys, because the kidney’s tend to affect a whole number of other organs in the body nephrologists tend to look after the full patient. At St. Joe’s, as you know, our division has 16 Nephrologists and a lot of us are leaders in the area of research and a lot of us are leaders in the area of education in the country. So you become a transplant nephrologists by first finishing about three years of intro medicine training and then you finish another two years of nephrology training, and then you do an additional one to two years of transplantation. So in many ways its a very different field where you have to learn a lot about immunology and how to look after those very complicated patients. As far as what is a transplant Nephrologist and what’s kind of involved in education, one of the major things that we want to teach our fellows is really how to become a strong patient advocate, how to become a leader, and how to become a innovator. And so how do those fit in Well, lets think about it. As a leader, you are overseeing the care of the patient in full. So you collaborate with a whole host of other different physicians who feedback information to you and then you and the patient can determine if they are appropriate to go ahead with transplantation. As a innovator you would have to decide whether its appropriate for the patient to go ahead with the transplantation and they type of transplantation. So at St. joe’s for example, we do a host of high risk transplantations such as ABO incompatible transplantation, we do very high risks transplantations with cross anti-body, crossing anti-bodies. so that becomes the innovation part of the learning. The third thing and the most important thing is, ensuring that the patients get the best care possible. As a transplant nephrologist, when you meet a patient its not just a one time visit, that visit and the collaboration with that patient goes on over years, since you oversee the patients care really until the end of their lives. So St. Joseph’s Hospital Hamilton is actually integral in collaborating with McMaster University and ensuring that the residents and fellows get an outstanding educational experience. So at St. Josephs Hospital in Hamilton, the largest teaching hospital associated with McMaster University, with regards to the kidney and urinary program St. Josephs is also the largest kidney program across the entire country. So those are very important elements in ensuring that residents and fellows get an outstanding clinical experience. The hospital has been integral in actually collaborating with the transplant program. For example, two years ago we actually obtained the American Society of Transplantation orientation, which is quite a significant recognition title and really required the collaboration with the administration at St. Josephs Hospital Hamilton and McMaster University transplant fellowship program to obtain that. And then most recently we obtained the Royal College Certification So the Royal College of Physicians Canada Certification and accreditation for organ transplantation only two programs across the country have that accreditation and St. Josephs HealthCare Hamilton is one of those two. So without St. Josephs Hospital Hamilton administration their ongoing support of the program, their ongoing mission to support education, really its partnership that eventually builds in to outstanding patient care.