Renal Fellowship

Summary of Core Competency Goals for the BWH/MGH Joint Nephrology Fellowship Program

Patient Care

·Efficiently perform and document a comprehensive evaluation and exam of patients with acute and chronic kidney in inpatient, ICU, and outpatient settings
·Develop and document a comprehensive differential diagnosis for acute kidney injury, chronic kidney failure, renal transplant complications, hypertension, and fluid and electrolyte and acid-base disorders
·Demonstrate competency in performing transplant donor (living and cadaver) and recipient evaluations
·Fully consent and safely perform renal biopsies and place temporary central venous catheters for dialysis
·Supervise and manage acute continuous and intermittent and chronic hemodialysis as well as peritoneal dialysis treatments

Medical Knowledge

·Understand renal physiology including fluid and electrolyte and acid-base physiology
·Have knowledge of comprehensive differential diagnoses for acute kidney injury, chronic kidney failure, renal transplant and dialysis complications, hypertension, and fluid and electrolyte and acid-base disorders
·Understand the pathophysiology and pathology of renal diseases
·Understand the rationale for and the use of therapies for renal diseases and renal replacement modalities and which modalities are optimal under given conditions
·Understand mechanisms of action of immunosuppressive agents in renal transplant and their interactions with other drugs

Practice Based Learning and Improvement

·Review of caseload and practice in a systematic manner including triage of consult cases by urgency
·Identify gaps in personal knowledge and skills in all areas of medicine
·Acknowledge one’s limitations and know when to ask for help from others
·Recognize and demonstrate initiative for continuing life-long learning
·Use of up to date evidence based information to maintain high level of quality of care for patients
·Critically evaluate and apply scientific literature to quality improvement in patient care

Interpersonal and Communication Skills

·Develop and maintain positive therapeutic relationships with patients
·Work collaboratively with health professionals in a team approach to patient care
·Demonstrate a productive attitude including ability to list, negotiate, communicate both verbally (daily and formal case presentations at conferences) and in writing
·Effectively educate patients, their families, and other healthcare professionals
·Maintain medico-legal records that are legible and timely
·Work successfully within a multidisciplinary team
·Produce timely and clear recommendations as a consultant to referring physicians in inpatient and outpatient settings
·Develop teaching skills to communicate knowledge to others including students and residents

Professionalism

·Complete timely communication with patients and health professionals and have appropriate coverage by colleagues when not available
·Demonstrate respect for patients and colleagues, including cultural sensitivity in dealing with individuals of diverse backgrounds
·Exhibit continual self evaluation for improvement in all aspects of practice
·Adhere to the highest standards of integrity in interpersonal interactions and in research
·Maintain confidentiality and be led by high ethical standards
·Be constructive in suggesting ways to improve patient care and professional interactions

Systems-Based Practice

·Understand the principles of cost-effective health care and resource allocation specific to the renal field, including involvement of other physicians (especially from vascular surgery, interventional radiology, general medicine physicians, and other specialists) and health professionals (dialysis nurses, intensive care nurses, renal dietician, renal social workers and care coordinators) in optimal care for these patients
·Understand public policy issues important for renal patient care, such as pay for performance, Medicare guidelines, the roles of national organizations, such as the ASN, NKF, ISN, RPA in improvements in care of renal patients.