First year fellows divide their inpatient time between 3 services: Acute Nephrology, Transplant Nephrology, and VA Nephrology. Additionally, fellows attend a one-half day per week continuity clinic and rotation specific clinics as outlined below.
Second year nephrology fellows divide their time between 6 months of inpatient rotations, and a 6 month block of time which is devoted to research and outpatient dialysis. Research is performed with either clinical or basic science faculty. The outpatient dialysis experience is divided into in-center and home dialysis therapies. Fellows will gain experience in in-center dialysis by following a group of 6-10 patients (under the supervision of attending faculty) for the entire 6 month rotation. As we have active peritoneal and home hemodialysis programs, fellows will spend 2 days per month in peritoneal and home hemodialysis clinics during this 6 month block.
INPATIENT NEPHROLOGY SERVICES
The Acute Nephrology Service is our busiest rotation, providing inpatient consultative nephrology for all hospital services, excluding kidney and kidney pancreas transplant patients. This rotation provides the most exposure to evaluation and management of critical care patients, acute kidney injury, fluid and electrolyte disorders, hemodialysis-related complications, as well as continuous renal replacement therapies. Nephrology fellows on this rotation supervise two Internal Medicine residents. The typical census for this service is typically between 20 and 30 patients.
We have an active transplant center performing approximately 130 kidney and kidney-pancreas transplants yearly. We also provide post-transplant care to over 900 patients, affording fellows exposure to acute and long-term complications of kidney transplantation. The census on the Transplant Nephrology Service averages approximately 10 patients and is equally divided between consults and primary patients. In addition to gaining experience in the management of acutely ill transplant patients, clinics devoted to long-term post-transplant follow up, and donor and recipient evaluation allow fellows to gain experience in the outpatient management of transplant patients.
The VA Nephrology Rotation consists of inpatient and outpatient consultative nephrology. The census averages between 5 and 10 inpatients. While on this service, fellows also participate in two active nephrology clinics composed of general and consultative nephrology and the follow up of VA patients with kidney and kidney-pancreas transplants. These clinics meet a total of two one-half days per week.
NEPHROLOGY FELLOW CONTINUITY CLINIC
Continuity clinic occurs on-half day per week for the duration of the fellowship. Fellows are paired with a single attending physician, and have their own clinic template to ensure that continuity of care is maintained.