The Nephrology training program is composed of inpatient and ambulatory training. The inpatient nephrology service at NYHQ is divided into two rotations both of which provide dialytic, consultative and primary care experience. The fellow rotates on each service, each for one month intervals, for a total inpatient experience of 6 months per year. The patient population differs on the two rotations but in total comprise private and non-private renal consultations and primary care nephrology and dialysis patients on the medical and surgical services as well as in the intensive care units. The fellow gains experience in critical care nephrologic problems, electrolyte and acid-base disorders, acute and chronic renal diseases, hypertensive emergencies, ESRD patient complications and all forms or dialysis and other extra-corporeal treatments. The fellow functions as an consultant and primary care physician for renal patients under the guidance and supervision of a board certified rounding nephrologist. The renal fellow closely interacts with other services such as surgery, interventional radiology and pathology during these rotations. The renal fellow functions as a junior attending on the renal floor, where the majority of nephrologic patients are admitted. The fellow guides the care of the medical residents assigned to the renal floor service as well as the residents rotating on the renal elective. The fellow directs the management of the consultations, supervises the residents patient care, and plays an active role in educating the medical housestaff. During these inpatient rotations the fellow also cares for patients in the inpatient dialysis unit. The fellow is responsible for writing dialysis prescriptions, dialysis scheduling and caring for the dialytic and medical issues that arise. Daily rounds with an assigned attending occurs 6 days a week. The sessions are divided into patient care work rounds as well as informal teaching sessions on selected topics guided by the cases presented. The fellow will gain expertise for a variety of nephrologic skills during these rotations. An attending is always available for supervision and training of all procedures such as placement of central dialysis catheters, renal biopsies, bone biopsies, placement of acute peritoneal catheters, dialysis and extra-corporeal procedures, and plasma pheresis.
The outpatient experience occurs at the Trude Weishaupt Satellite Dialysis Center where 206 hemodialysis patients and 50 peritoneal dialysis patients are treated in a state of the art facility. During this rotation, for 5 months per year, the trainee gains experience in outpatient hemodialysis and peritoneal dialysis patient care. The trainee also becomes familiar with the water treatment systems, dialysis equipment, and ESRD regulations and requirements. The trainee participates in interdisciplinary patient care meetings and CQI conferences. The fellow gains further ambulatory nephrology experience by participating in several ambulatory care sessions: 1) Throughout both years the fellow attends weekly renal and HTN clinics where he/she cares for a panel of patients 2)During the outpatient experience the fellow attends CAPD dialysis clinics twice per week and 3)Throughout the training program the fellow attends weekly faculty practice office hours where the trainee follows a panel of chronic transplant patients. The trainee is also encouraged to participate in lithotripsy sessions at NYHQ under the guidance of the Urology faculty, and observe non-invasive and invasive radiology procedures.