Educational Activities

Inpatient Rotations

We offer three inpatient consultative service rotations for fellows.  Fellows will rotate in 2-4 week blocks.  Each fellow is paired with one faculty member, and residents and medical students are often rotating on the General Nephrology Service.  In addition, Advanced Practice Providers are incorporated into the consultative services.

Inpatient Service	Patient Population	Team Members	Procedural Competencies Addressed
General (Acute) Nephrology Consult Service	Hospitalized patients with acute kidney injury, hyponatremia, other electrolyte disorders, and ESRD requiring peritoneal dialysis.	Teaching Faculty (1) Fellow (1) APP (0-1) Residents (0-2) Medical Students (0-1)	Hemodialysis Peritoneal Dialysis Native Kidney biopsy Temporary Hemodialysis Catheter Placement
ICU Nephrology Consult Service	Hospitalized patients in the ICU with acute kidney injury, electroyte disorders, and ESRD. Includes MICU, SICU, CVICU, Burn-Trauma ICU, Neuro-ICU.	Teaching Faculty (1) Fellow (1) APP (0-1)	Hemodialysis Continuous Veno-Venous Hemodiafiltration (CVVHDF) Native Kidney Biopsy Temporary Hemodialysis Catheter Placement
Transplant Nephrology Consult Service	Hospitalized patients with solid organ transplants.  Includes immediate post-kidney transplant care, acute rejection, transplant pyelonephritis, hepatorenal syndrome management	Teaching Faculty (1) Fellow (1)	Hemodialysis CVVH Transplant Kidney biopsy Temporary Hemodialysis Catheter Placement

 

Outpatient Continuity Clinic

Our fellows participate in continuity clinic for one afternoon session per week. Faculty supervision is provided in a 1:2 to 1:3 ratio.  Fellows carry their patient panels for the entirety of their training.

Electives and Selectives

In order to achieve core educational goals, our fellows rotate through mandatory outpatient experiences (selectives).  Fellows have the option to participate in a number of additional elective experiences.

Mandatory Ambulatory Experiences (Selectives)

Outpatient Transplantation

Fellows rotate through the immediate post-transplant clinic twice weekly as well as the continuing care transplant clinic once per week. In addition, fellows attend the transplant selection committee meeting weekly, perform pre-operative evaluations for scheduled living donor evaluations, and participate in both recipient and donor evaluations.  Fellows have the opportunity to observe living donor transplantation.

Home dialysis Ambulatory Experience

This elective is designed to provide the fellow experience with peritoneal dialysis and home dialysis patients in the ambulatory setting. All patients are seen in the Freedom Center, which is our home dialysis unit. Fellows may choose to complete this selective in 1 week or two week blocks, but a total of 4 cumulative weeks is required over the course of training.

Fellows should aim to spend at least 3 ½ day clinic sessions per week in the home dialysis unit, preferably seeing a mix of PD and Home Hemodialysis patients. Fellows should aim to experience training for both Home HD and PD at some point during this elective time.

Outpatient Hemodialysis Ambulatory Experience

Starting in the second half of the first year of fellowship, fellows will be assigned a small group of hemodialysis patients to follow monthly. Fellows are paired with a faculty mentor and will be working directly with him/her.  

Research

Fellows must reserve 4 weeks of research time each year, but more time can be devoted if a particular project requires this. Fellows select a research mentor and work directly with this faculty mentor. See here link to fellow publications for list of most recent publications by our fellows

Electives (these are NOT mandatory but are open to fellows)

Palliative Care Elective

Fellows will work directly with one of our faculty members who has dual training in Nephrology and Palliative care, rotating on the inpatient palliative care service and participating in the geriatric nephrology and palliative care clinic.

Critical Care Nephrology/Central Access Experience

Fellows may choose to rotate with the ICU team in order to gain experience with Nephrologic issues experienced by our critical care colleagues. This elective is helpful also to gain experience with central venous access.

Hemodialysis Access Elective

Fellows will rotate in the vascular surgery access clinic, having the opportunity to review ultrasounds and vein mapping as well as assess newly placed hemodialysis access for maturation.

Apheresis

Plasmapheresis is managed through the hematology department. Fellows may choose to gain experience with this procedure as in some institutions it falls under the purview of Nephrology.

Tissue Typing Lab

Fellows spend 1-2 weeks in the tissue typing lab, learning about the techniques used to screen potential living donors and to assess for circulating donor-specific antibody levels.

Renal Pathology

Fellows spend 2-4 weeks reviewing pathology slides and engaging in a tutorial designed to orient the clinical fellow to basic nephropathology. Fellows will participate in Renal Pathology conferences.

Core clinical rotations are divided across the first and second years as outlined in the example below.

Clinical conferences are comprised of lectures delivered by faculty, as well as interactive learning sessions including sentinel article journal clubs, problem sets, clinical case conferences, Division of Nephrology Journal Club, Renal and Department of Medicine Grand Rounds, and Renal Jeopardy sessions.  In addition, fellows participate in Renal Pathology conference once per month.  

Outline of our typical weekly conference schedule

Monday​ 12:00 PM	​Tuesday 12:00 PM	​Wednesday 12:00 PM	​Thursday 8:00 AM	​Friday 12:30 PM
​Core Curriculum Lecture- didactic lecture or problem set delivered by key faculty member	Department of Medicine Grand Rounds	​Clinical Case Conference or Renal Pathology Conference	​Division of Nephrology Journal Club	Nephrology Sign Out Rounds