Inpatient Rotations

Fellows rotate through the following inpatient services:

• Acute Consults: All kinds of kidney-related pathology, excluding end-stage kidney disease patients (dialysis-dependent) or solid organ transplant recipients
• Chronic Dialysis Consults: End-stage kidney disease patients, including hemodialysis and peritoneal dialysis
• Transplant Consults: Solid organ transplant recipients (lung, kidney, pancreas, liver, heart)
• Pallitiave Care: All second-year fellows work with the multi-disciplinary palliative care team to perform consults on patients with kidney disease
• Critical Care Elective: This is with Thoracic Medicine/Critical Care faculty at the Temple Jeanes Campus ICU.  The elective can be done for two weeks in the second-year and focuses on critical care principles.

Fellows help supervise internal medicine residents on the Primary Nephrology “Yellow” Service. This service cares for select patients from Temple’s outpatient dialysis programs (peritoneal dialysis and hemodialysis), CKD clinics, and kidney transplant program.  Our faculty are the “attending of record” for patients admitted to the Yellow Service. The fellow assigned to the Transplant Consultative Service rounds with the Yellow faculty and the PGY-2/3 residents but is not responsible for daily progress notes.  Fellows deliver informal teaching and “chalk talks” to the residents. It’s an opportunity for fellows to hone their skills as educators and team leaders.

Outpatient Rotations

The first year has a “3+1 Structure”−3 weeks of inpatient, followed by 1 week of outpatient continuity clinic and occasional specialty clinics.

Second years have 2 outpatient continuity clinic sessions per week. They also round at their assigned outpatient hemodialysis shift weekly and co-manage a panel of home dialysis patients with their faculty preceptor.  Other outpatient clinics include kidney transplant clinic, glomerular disease, vascular surgery, and high-risk OB. 

Procedures

Fellows participate in native and transplant kidney biopsy on their dedicated biopsy days.  Each fellow has 10 days that are dedicated exclusively to kidney biopsies during the entirety of the fellowship.

Fellows have the opportunity to train in non-tunneled hemodialysis catheter placement. All fellows receive training in our simulation center and can elect to place catheters for patients with acute kidney injury.  However, routinely, non-tunneled hemodialysis catheters are placed by our ICU teams.

There is an opportunity to rotate at an outpatient hemodialysis vascular access center and learn from interventional nephrologists about tunneled dialysis catheter placement, exchange, and fistulogram.

We have point-of-care ultrasounds (POCUS) available in our inpatient dialysis unit and outpatient clinic and have a dedicated POCUS curriculum, which includes simulation and bedside practice sessions.