Gain clinical experience as a consulting physician in the care of patients with a variety of renal diagnoses.
Initial admission/consult notes on inpatients in a timely manner after consultation request
Daily evaluation and notes on inpatients
Urinalysis and urine microscopy preparation and examination
Native kidney biopsies
Communication of findings directly to primary care team
Identification of patients needing acute renal replacement
Write HD, plasmapheresis, and CVVH orders daily as needed on inpatients
Need to come into hospital for acute consultations in the hospital and/or ED and/or emergency dialysis (should always discuss with attending before calling in the on-call HD nurse)
Learn from the experience of patient care, from exposure to experts among the attending staff, to develop self-directed learning skills. Fellows should read and critically appraise primary literature and review material and be able to use that knowledge to teach residents and medical students.
Gain a broad exposure to in-patient nephrology problems including acute kidney injury, hypertensive crises, glomerular and vascular renal diseases, advanced chronic renal failure and end-stage renal failure and initiating renal replacement, fluid and electrolyte disorders, management of intoxications, renal issues in pregnancy, UTI, disorders of mineral metabolism including nephrolithiasis and renal osteodystrophy, tubulointerstitial renal diseases, disorders of drug metabolism, pharmacokinetics and nephrotoxicity, genetic and inherited renal disorders, and geriatric aspects of nephrology including disorders of the aging kidney and urinary tract.
Appraise and assimilate scientific knowledge in these areas listed above in order to effectively manage and improve care of these patients.
Indications and knowledge for plasmapheresis therapy in renal disease
Indications for hemodialysis vs. CRRT vs. peritoneal dialysis
Management of renal disorders in non-renal transplantation
Interpretation of radiology studies including renal ultrasound and vascular access
Renal pathology including common glomerular and vascular diseases
Identify gaps in personal knowledge and skills in renal consult medicine.
Locate, appraise, and use scientific data to improve care of the renal consult inpatient.
Understand the level of scientific evidence supporting various treatment options and standards of care for the renal consult patients.
Apply knowledge of rigorous scientific principles, study design and statistical methods to evaluate published clinical studies and plan clinicopathologic investigations.
Interpersonal and Communication Skills
Communicate effectively with patients and families across a broad range of socioeconomic and ethnic backgrounds concerning issues relating to renal consult patients, specifically:
Benefits and risks of acute renal replacement
Importance of renal medications and follow up.
Common adverse effects of frequently used medications.
Communicate effectively with physician colleagues and members of other health care professions to assure comprehensive patient care
Behave professionally toward patients, families, colleagues and all members of the renal health care team
Understand and adhere to ethical principles and potentially culturally sensitive issues
Systems Based Practice
Understand the principles of health care and resource allocation specific to the renal field, including involvement of other physicians (especially from vascular surgery and interventional radiology) and health professionals (dialysis nurses, intensive care nurses, renal dietician, renal social workers and care coordinators) in optimal care for these patients.
To understand the importance of communication among all healthcare providers for the care of the inpatient with renal disease.