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Education

Curriculum

The program is organized to provide the fellow with meaningful experiences in clinical nephrology, teaching, and research. Nine distinct experiences have been created to enable this objective.

Fellows Block Rotation Schedule (months)

Year Crit
Care
Prim Txp West Penn Amb Res Access Center Dialysis Unit Path/
Rad
F-1 2 2 1.5 1.5 1 1.5 0 1.5 0
F-2 1 1 1.5 1.5 2 2 1 2 1

 

Critical Care Rotation - Allegheny General Hospital

During this rotation the nephrology subspecialty fellow is provided with the challenges associated with caring for a complex critical care patient population in the Coronary Care, Medical Intensive Care, Surgical Intensive Care, Neurosurgical Intensvie Care, and Trauma Units. The nephrology fellow becomes proficient in nephrologic critical care consultations and follow-up including acute renal failure and oversight of continuous renal replacement therapies for acutely ill patients. The fellow becomes proficient in coordinating the multitiude of complex issues which occur in the ICU setting.

Non-Critical Care Rotation - Allegheny General Hospital and The Western Pennsylvania Hospital

During this rotation the nephrology subspecialty fellow is provided with a diverse inpatient clinical nephrology experience and with the challenges of caring for the complications of inpatients who require ongoing dialysis in a major tertiary care setting (Allegheny General Hospital) and community-based hospital setting (West Penn Hospital). The nephrology fellow becomes proficient in inpatient consultations and follow-up, and the various forms of dialysis therapies including hemodialysis, peritoneal dialysis, and continuous dialysis. The fellow becomes proficient in handling the multitude of issues affecting patients with end-stage renal disease.

Transplant (Txp) Rotation

During this rotation the nephrology subspecialty fellow cares for renal transplant patients. The nephrology fellows are given the unique experience of caring for patients prior to, during and after renal transplantation.

West Penn Rotation

During this rotation first and second year fellows receive experiences not provided at the primary institution (AGH). This includes the care of patients with nephrologic diseases in the Ob-Gyne, Burn, and Bone Marrow units. In addition, fellows diagnose, treat, and manage patients in a primary care hospital setting in the areas of general nephrology, hypertension and end-stage renal disease.

Ambulatory Rotation

During this rotation the nephrology subspecialty fellow cares for outpatients, providing nephrology consultations and follow-up in multiple outpatient settings.

Research Rotation

The nephrology fellow is provided with protected research time during this experience to learn and develop the necessary ethical research practices to allow them to successfully complete assigned research projects.

Interventional Rotation (Access Center)

During this rotation the nephrology subspecialty fellow is provided with exposure to interventional nephrology procedures including balloon angioplasty, declotting procedures, tunneled dialysis catheter placement, venogram, vein mapping, and stent placement.

Dialysis Unit Rotation

During this rotation, first year nephrology fellows will gain “hands-on” experience and knowledge of the technical aspects of a dialysis unit including: performance of dialysis machine set up, alarm triage, and appropriate maintenance schedules; components of a water treatment system with ability to name components, frequency of testing with understanding of safety and consequences of malfunction; preparation of dialysis solutions and appropriate testing; cannulation of dialysis access; set up of home dialysis machines, change of transfer sets for PD, home water treatment systems and appropriate testing, and home dialysis education.

First and second year fellows are assigned to a subset of chronic hemodialysis (HD) and home dialysis (PD and HHD)patients and will be responsible for the management of these patients. Fellows are responsible for coordinating and writing HD, PD, and HHD prescription orders. They will also complete weekly and monthly progress notes and discuss management issues with the dialysis unit faculty attending physician.

Pathology Rotation

During this two-week rotation, second year nephrology fellows will become knowledgeable and experienced in handling and interpreting pathologic specimens related to the care of patients with nephrological disorders. Fellows will gain knowledge in interpreting light microscopy and immunoflorescence findings in diseases of the kidney.

Radiology Ultrasound Rotation

Second year fellows become knowledgeable and experienced in interpreting renal ultrasonography during this two week rotation. Fellows will become knowledgeable in recognizing and identifying the sonographic appearance of the normal kidney, ureter and bladder. They will also learn to interpret the pathologic ultrasound findings in diseases of the native kidney and renal allograft.

Longitudinal Experiences

Nephrology Continuity Clinic – During this experience, the nephrology subspecialty fellow is  responsible for patients in a weekly outpatient clinic setting, providing consultative and follow-up care on a longitudinal basis throughout the two-year fellowship.

Transplant Clinic – During this experience the nephrology fellow is responsible for` patients in a weekly outpatient clinic setting, providing follow-up care to transplanted patients throughout the two-year fellowship.

 

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