UPMC Children’s Fellow Profile: Megan Gates, MD, MS — Dual Training in Neonatal-Perinatal Medicine and Pediatric Nephrology

Megan Gates, MD, MS, is completing a combined four-year fellowship in neonatal-perinatal medicine and pediatric nephrology at UPMC Children’s Hospital of Pittsburgh and UPMC Magee-Womens Hospital. Her clinical and research work focuses on kidney development and renal vulnerability in premature infants, with the goal of improving early risk identification and informing long-term care planning for children at risk of chronic kidney disease.

Dr. Gates’s training represents an emerging model for bridging neonatology and pediatric nephrology through an integrated curriculum supported by both Divisions. The program was developed under the leadership of Jacqueline Ho, MD, MS, chief, Division of Pediatric Nephrology and previous director of the Pediatric Nephrology Fellowship, and Nicole Dobson, MD, director, Neonatal-Perinatal Medicine Fellowship in the UPMC Division of Newborn Medicine.

The dual fellowship condenses two traditionally separate three-year programs into a unified four-year track approved by the American Board of Pediatrics (ABP). Dr. Gates is the second dual neonatal-perinatal medicine and pediatric nephrology fellow to take part in this joint training program. Tara Beck, DO, the first dual trainee is in her fourth year of training and is expected to graduate in June 2026.

“Having the support of both divisions was a major reason I came to UPMC,” Dr. Gates says. “The nephrology team understood that my focus would be narrower than general pediatric nephrology, and they welcomed that. And clinically, the neonatal intensive care unit volume and complexity here is unmatched.”

Academic and Clinical Training

Dr. Gates earned her undergraduate degree from the University of Louisiana, where she was a Division I athlete on the nationally ranked softball team. She remained at the university to complete a master’s degree in biology with a concentration in molecular and genetic engineering, where she became increasingly interested in the biological foundations of disease and development.

After completing her master’s program, Dr. Gates spent a year teaching middle school science in Houston. The experience reinforced her passion for science and for guiding learners through complex material, but it also clarified that her long-term career interests lay in medicine and research.

Dr. Gates next earned a master’s degree in graduate medical sciences at Texas Tech University Health Sciences Center, where she worked alongside medical students and helped design and teach elements of their curriculum. Working in the environment of a medical school deepened her interest in medicine as a career path and motivated her to pursue a medical degree, also at Texas Tech.

Dr. Gates completed her pediatrics residency at the Harriet Lane Pediatric Residency Program at Johns Hopkins Children’s Center, where she developed overlapping interests in neonatal-perinatal medicine and nephrology. Her exposure to kidney-related conditions in the neonatal setting, including caring for infants enrolled in the Renal Anhydramnios Fetal Therapy (RAFT) trial, directly led to her current research and clinical focus.

“In those cases, infants would be born with severely underdeveloped lungs and require dialysis immediately after birth,” Dr. Gates says. “I became engaged in the care of those infants, and it changed the way I thought about the connection between the kidney and the developing neonate.”

Program Design and Institutional Support

Dr. Gates began her fellowship training at UPMC and the University of Pittsburgh in 2023, completing her first year exclusively in neonatal-perinatal medicine before beginning pediatric nephrology rotations in her second year. The dual-track program allows fellows to meet all ABP training requirements for both disciplines while pursuing focused academic and research interests that cross specialty areas.

“The volume, the acuity, and the faculty investment here made this dual fellowship opportunity possible,” Dr. Gates says. “There is institutional support for building the kind of career that spans both fields, and there are not a lot of places that you can do that in the United States. UPMC is one of them.”

UPMC’s high volume of births, approximately 10,000 births annually at UPMC Magee, and the comprehensive pediatric subspecialty services at UPMC Children’s create a supportive environment for the type of dual training model Dr. Gates has undertaken. Fellows like Dr. Gates benefit from an integrated approach to mentorship, grant preparation, and translational research design across both Divisions.

Research Focus: Renal Reserve and Early Risk Stratification

Dr. Gates’s primary research focus is the study of renal reserve and nephron development in premature infants. Nephrogenesis, which typically completes between 34 and 36 weeks of gestation, is often interrupted in infants born extremely preterm, leaving them at increased risk for long-term renal dysfunction. Dr. Gates’ work aims to develop a biomarker-based screening tool to identify high-risk infants before discharge from the neonatal intensive care unit.

“Studies suggest that up to 50% of infants born between 24 and 28 weeks develop chronic kidney disease by the age of 2,” Dr. Gates says. “However, we currently lack the tools and data that can reliably stratify that risk before discharge.”

Her current project is investigating serum and urinary biomarkers that may reflect nephron-specific development or injury.

“There is a clear lack of normative data in this population,” Dr. Gates says. “We do not know what a normal value is for a 26-week infant compared to a term infant, and we do not know how long those differences persist.”

By mapping biomarker expression to nephron regions, such as in the proximal tubules and collecting ducts, the goal is to establish physiologic reference ranges that could guide follow-up and medication management in premature infants after neonatal intensive care unit discharge.

Parallel Work in Longitudinal Kidney Outcomes

In addition to her fellowship research project, Dr. Gates also contributes to a longitudinal cohort study led by Dr. Ho, which is part of a broader Division of Pediatric Nephrology project working to establish a pediatric nephrology center of excellence at UPMC Children’s. The project follows children born with congenital anomalies of the kidney and urinary tract or a history of neonatal acute kidney injury to evaluate kidney and cardiovascular outcomes over time.

“Working on that study has helped me think more critically about the long-term impacts of early renal vulnerability,” Dr. Gates says. “It reinforces the importance of developing better tools to identify risk as early as possible.”

Her work aligns with national research priorities identified at a 2024 National Institutes of Health–sponsored consensus conference, which highlighted neonatal renal reserve assessment as a key area for development.

“We have neuroprotective guidelines for the brain and lung-protective ventilation strategies,” Dr. Gates says. “We do not yet have comparable evidence-based protocols for protecting the kidney, even though the risk is well known.”

Collaborative Training Environment

The fellowship training environment at UPMC Children’s and UPMC Magee has proven to be highly collaborative, according to Dr. Gates, with extensive faculty mentorship and integration across divisions. Both the Division of Pediatric Nephrology and the Division of Newborn Medicine emphasize individualized training pathways and support for translational research development. This cross-institution flexibility and mentorship structure has enabled Dr. Gates to pursue a multidisciplinary career path that spans critical care medicine, nephrology, and neonatal-perinatal medicine.

“The ability to train at the intersection of neonatology and nephrology depends on having programs that are both large enough and invested enough to make it possible,” Dr. Gates says.

Plans After Fellowship

Dr. Gates will complete her combined fellowship in 2028 and plans to remain in academic medicine. Her long-term goal is to integrate her clinical practice across both specialties with translational research focused on early renal risk identification in premature infants.

“My goal is to keep practicing in both specialties while developing tools that help us intervene earlier,” she says. “If we can identify renal vulnerability before a child becomes symptomatic, we have a chance to change their trajectory.”