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)
|Prim||Txp||West Penn||Amb||Rsrch||Acc Cent||Dialys Unit||Path/
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.
During this rotation the nephrology subspecialty fellow cares for outpatients, providing nephrology consultations and follow-up in multiple outpatient settings.
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.
During this rotation the nephrology subspecialty fellow gains “hands-on” experience performing interventional nephrology procedures including balloon angioplasty, declotting procedures, tunneled dialysis catheter placement, venogram, vein mapping, and stent placement.
Dialysis Unit Rotation
During this one month rotation, first year nephrology fellows will gain “hands-on” experience and knowledge of the following procedures: 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.
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 patient 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.
Dialysis Panel Patients: The nephrology subspecialty fellows is assigned to follow a subset of dialysis outpatients on a longitudinal basis to provide continuity of care throughout the two year training program. First year nephrology fellows follow up to six (6) hemodialysis patients and two (2) peritoneal dialysis patients. Second year nephrology fellows follow up to nine (9) hemodialysis patients and two to three (2 to 3) peritoneal dialysis patients. Residents provide first-call coverage to their dialysis panel patients with back-up from the nephrology faculty.
Multidisciplinary Patient Care Meetings: Nephrology subspecialty fellows attend a multidisciplinary meeting twice per year on each of their dialysis panel patients. During this meeting the attending physician, fellow, nurse manager, nurse coordinator, dietitian, and social worker meet to discuss adequacy of dialysis care and provide recommendations for improvements.
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.