Nephrology Fellowship Clinical Training

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The general nephrology clinical training is designed to enable fellows to achieve the knowledge, skills and attitudes of competent nephrologists. Renal fellows are expected to gain proficiency in the diagnosis and management of inpatient and outpatient medical problems at a level typical of a well-qualified nephrologist.

Inpatient Rotations:

  • Nephrology consult service at UH Cleveland Medical Center - fellows and nephrology attending provide consultation to patients with renal, fluid and electrolyte disorders, hypertension or dialysis issues, hospitalized on the non-renal medical teams, surgical services, UH Seidman Cancer Center, ob/gyn service and occasionally, Rainbow Babies & Children’s Hospital.
  • Renal consult service at the Louis Stokes Cleveland VA Medical Center - fellows work with a faculty member to provide inpatient nephrology, hypertension and dialysis consultation to our veterans. Fellows also join the VA outpatient nephrology clinic one half-day every week in order to gain additional exposure to outpatient nephrology care.
  • Renal consult service at MetroHealth Medical Center - fellows and attending physician provide consultation for inpatients with acute renal-electrolyte problems, including dialysis therapy in a highly specialized level 1 trauma center, burn intensive care unit, surgical and medical wards.
  • Renal Transplantation Service at UH Cleveland Medical Center - nephrology fellows and nephrology attending are part of a combined medical surgical team and provide consultative services to the transplant surgical service.

Outpatient Rotations:

  • Home dialysis rotation at UH Cleveland Medical Center - fellows attend weekly outpatient peritoneal dialysis and home hemodialysis clinic and participate in the peritoneal dialysis training of all new patients. fellows also follow all home dialysis patients admitted to the hospital.
  • Farnsworth dialysis rotation through MetroHealth Medical Center - fellows are assigned a shift of hemodialysis outpatients that they manage under the supervision of an attending nephrologist.

Procedures

Fellows have the opportunity to learn procedures during both inpatient and outpatient rotations, under the direct supervision of attending nephrologists. These include intermittent acute and chronic dialysis, peritoneal dialysis (CAPD, CCPD), continuous renal replacement therapies (CVVH, CVVHD, CVVHDF), placement of temporary dialysis catheters, renal biopsies and interpretation of urinalysis.

Outpatient Clinics:

In the first year, all fellows attend one half-day continuity clinic, at UH Cleveland Medical Center or at MetroHealth Medical Center under the supervision of a faculty member. A second half-day clinic is added during the second year of fellowship: six month renal transplant and six months home dialysis clinic.