Fellows rotate through several inpatient and outpatient clinical experiences. Our aim is to provide a breadth of exposure to all areas of General Nephrology.
We offer three inpatient consultative service rotations. 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, Nurse Practitioners are incorporated into the General Consultation team and the Dialysis consultative service.
General Nephrology Consultation Service
Fellows rotating on this service will gain experience in acute kidney injury as well as acute management of electrolyte disorders.
Inpatient Transplant Consultation Service
Fellows on this service will be involved with the immediate post-surgical management of kidney transplant recipients, and will also gain experience in management infectious complications of solid organ transplant and diagnosis and treatment of acute and chronic rejection. Nephrologic complications of other solid organ and bone marrow transplantation are also covered by this consultative service.
Inpatient Dialysis Consultation Service
Fellows rotating on this service will manage renal replacement therapies for any inpatients on chronic hemodialysis or peritoneal dialysis.
Mandatory Ambulatory Experiences (Selectives)
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 will 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.
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
These are NOT mandatory rotations but are available to fellows
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.
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.
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.
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.
Hemodialysis Access Elective
Fellows will rotate in the transplant surgery access clinic, having the opportunity to review ultrasounds and vein mapping as well as assess newly placed hemodialysis access for maturation.