Clinical Training Pathway
Clinical Curriculum: 2 Years
The 24-month Clinical Curriculum consists of:
- 9 months of inpatient general nephrology consultation
- 3 months of inpatient transplant nephrology consultation
- 2 months of outpatient nephrology clinic and dialysis
- 1 month of outpatient transplant nephrology clinic
- 5 months of research
- 1 month of dialysis training
- 1 - 2 months of elective
Fellows have 2 months vacation. During elective months, fellows may receive additional training and experience in the areas of Pediatric Nephrology, renal histopathology, radiology, ultrasonography, urology, transplantation and interventional techniques.
Fellows will be assigned 6 – 7 chronic outpatient hemodialysis patients at the in campus hemodialysis unit. They are required to follow these patients throughout their two year fellowship training. Fellows will participate in the monthly outpatient multidisciplinary hemodialysis rounds to discuss patient care
In the clinical pathway, six to seven months are devoted to research.
In August of the first year, potential faculty-sponsored research projects are presented to the fellows. By mid-September of the first year, fellows and faculty mentors are expected to have selected a research project that is approved by the program director.
At the end of two years, fellows are expected to present the results of research in a seminar and to have completed a manuscript on their work.
Peritoneal Dialysis Curriculum
The purpose of the Peritoneal Dialysis (PD) Curriculum is to provide:
- A comprehensive and longitudinal clinical experience in the care of patients on peritoneal dialysis
- An understanding of the principles and practice of peritoneal dialysis including the indications, contraindications, complications, cost-effectiveness, and application of PD to patient care
Over the course of two years of fellowship, topics related to peritoneal dialysis are covered through a combination of didactic and clinical experiences including case management conferences, lectures, journal club discussions, workshops, and direct patient care in the inpatient and outpatient settings. Clinical experiences entail supervised involvement in decision-making for patients undergoing PD.
Opportunities exist for fellows to pursue in-depth investigation of specific topics in peritoneal dialysis through ongoing and future clinical research with the Director of the PD Program.
To provide a longitudinal experience in care and management of outpatients on PD, each fellow follows at least three to four patients throughout the two-year training period. Fellows see their patients in routine PD clinic visits at least every other month and are directly supervised by the Medical Director of the PD program during these clinic visits. Fellows are thus trained in a broad scope of clinical topics and gain an appreciation for evolving issues related to PD (e.g., loss of residual renal function and its effect on dialysis adequacy). Fellows participate in the development of both short- and long-term care plans for their patients. All outpatient experiences involve supervised decision-making for patients. Patients with chronic kidney disease who are followed in Nephrology Clinic and choose PD when renal replacement therapy is required continue to be followed by the same fellow when the patient is on PD.
While rotating on the chronic inpatient service, fellows prescribe PD for chronic PD patients who are hospitalized. The use of PD in the setting of acute renal failure is part of each fellow's training.
There are typically several conferences held throughout the week:
See our Schedule of Conferences and Teaching Activities for more information.
Summer Core Curriculum: A core nephrology curriculum is provided at the beginning of each academic year. This 2-month curriculum is intended to provide fundamental practical concepts in various topics in nephrology early in the training program. This permits the accelerated acquisition of core information used in management of outpatients and inpatients. Topics may vary from year to year but include: evaluation of renal function, hemodialysis (including continuous hemodialysis), peritoneal dialysis, evaluation and management of patients with acute and chronic renal failure, evaluation and management of acid-base and electrolyte disorders, evaluation and management of renal transplant patients and others.
Following two years of training, the trainee will have confidence in evaluating and managing patients with a wide variety of kidney disorders, and will have had in-depth training in acute and chronic hemodialysis, continuous renal replacement therapy (CVVHD), renal biopsy, apheresis, dialysis catheter placement, ultrasound and renal biopsies. Each fellow performs approximately 20 renal biopsies during his/her training period.
Mock Board Examination: At the end of the first year of training, our fellows take a mock board examination to determine their level of knowledge acquisition during the first year of training. Exam results are used to focus an individual's education to address any deficiencies.