Nephrology Fellowship Curriculum
The clinical rotations give a solid foundation for all competencies required by ACGME for training in nephrology. There is intentional focus on providing both ample inpatient and outpatient clinical exposure to model a typical nephrology career. Each trainee works with a variety of nephrology faculty to gain different perspectives on management of complicated nephrology conditions. As a tertiary care referral center, our fellows are exposed to the highest acuity patients in the region, which will include a variety of pathologies and rare diseases. Based on your career path, we can individualize your second year of training to focus on your individualized goals.
UK/VA Non-ICU Consult Service
This consult rotation provides exposure to common inpatient nephrology conditions, including acute kidney injury, electrolyte imbalances, and dialytic therapies. These weeks include supervision of resident trainees and teaching opportunities. A separate service focuses on patients with end-stage kidney disease and allows for advanced learning about dialytic therapies, water treatment, vascular access, and volume assessment using point of care ultrasound.
UK/VA ICU Consult Service
This rotation provides consultation for the highest acuity patients in the region. We manage 20-30 CRRT state of the art machines and assist with patients in medicine, surgery, trauma, neurology, and cardiothoracic intensive care units. This rotation is assisted with an advanced practice provider. Opportunities for temporary dialysis access are shared with our critical care colleagues.
This consult service manages all patients with kidney disease in the setting of an organ transplant, which includes new kidney transplant recipients. There is opportunity to attend committee meetings and learn about patient selection for kidney transplant and donor selection. From immunosuppressives to complications of transplant, this rotation is high yield for all our fellows.
Our formal and organized nephrology ultrasound program focuses on renal ultrasound and point-of-care ultrasound (POCUS) for assessment of volume status and renal failure evaluation. It combines didactics with hands-on training, allowing fellows to accumulate experience and image portfolios.
Ambulatory Medical Experience
These weeks are designed to give you exposure to our many specialty clinics. Included options are glomerulonephritis, hypertension, onconephrology, stone, transplant, and bone metabolism. These weeks also give more intensive exposure to peritoneal dialysis and home hemodialysis. In addition, these weeks can offer enhanced time off for scholarship, including quality improvement projects and research. Ambulatory weeks are designed to meet your individualized goals.
Outpatient Dialysis Experience
Throughout the duration of their training and under direct faculty supervision, trainees assume responsibilities of the outpatient management of eight to 12 hemodialysis patients. The dialysis staff are instructed to first contact the designated renal fellow for any question or concern regarding these patients. In addition, nephrology trainees assume the responsibility of the outpatient management of 30-35 home peritoneal dialysis patients for five to six months during their training.
Longitudinal Outpatient Clinic Experience
During your fellowship, you will follow a set of patients with common nephrology conditions, including diabetic kidney disease, hypertension, and advanced chronic kidney disease. Each week you will have one afternoon clinic supervised by a nephrology faculty mentor. This provides opportunity to learn about education for dialysis modalities, conservative care management, and preparation of vascular access. We partner with specialized nephrology pharmacy team members that help manage complex patients.
Fellows can select from a subspecialty area of interest, and program leadership will design individualized weeks to focus on this topic. The week will include scholarship, teaching cases, and clinical experiences. Areas may include may include outpatient dialysis, interventional nephrology, glomerulonephritis, point of care ultrasound, transplant, or medical education.