Critical Care Rotations

Critical care medicine education involves 12 months of ICU focused training. The majority of time is spent in the medical ICU, with time also spent in UK's trauma surgery ICU, neuro-ICU, and CV-ICU. The medical ICU months are spent in either the University of Kentucky or the Lexington VA Hospital. These blocks are divided into two weeks and include resident supervision, procedural time, and night rotations. Fellows have the opportunity to see an array of high acuity patients at a busy academic hospital. As a tertiary referral center, UK encounters the most critically ill patients from the eastern part of the state. Clinical experience helps cement skills in resuscitation, mechanical ventilation, POCUS, and team leadership.

Clinical Rotations

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.

Transplant Service

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.  

Ultrasound Training

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.

Elective Rotations

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.