The first year is designed to acclimate new trainees to the unique practice specific to the field of nephrology through hospital service, outpatient clinic and dialysis unit rounds, didactic lectures, and case conferences. During the initial orientation period, fellows attend the Delaware Valley Fellows Symposium, a region-wide “nephrology boot camp” seminar that invites fellows from other training programs in the Philadelphia environs. This two-day program provides introductory didactic lectures and discussions aimed to help transition the new fellow from internist to nephrologist as well as creating an opportunity to network with other nephrology fellows.
The comprehensive learning environment in the first year will help the new fellow develop and hone nephrology-related clinical and technical skills as well as medical knowledge and expertise in the field. In the second half of the first year, the fellows spend three months at the Hospital of the University of Pennsylvania, gaining experience with transplant nephrology. The rotation exposes the fellow to the entire transplant process from initial evaluation of potential kidney transplant recipients and donors to the acute post-transplant period as well as management of long-term kidney transplant recipients. Transplant immunology, pharmacology, and management of complications related to kidney transplantation and immunosuppressive therapies are included in this rotation. During the first year, the fellow will also be introduced to academic projects including performance improvement and research that will continue throughout the following year.
The second year is devoted to consolidation of clinical skills and completion of academic projects. This year is designed to have fewer inpatient responsibilities and more outpatient experiences. More time is available to dedicate to scholarly projects and travel to academic meetings.
In each year, the fellow maintains an outpatient office practice (1/2 day per week), managing continuity patients in the chronic kidney disease clinic under the direct supervision of nephrology faculty. In this clinic, the fellow will gain experience in recognizing and managing a multitude of disorders including (but not limited to) chronic kidney disease and complications thereof, hypertension, electrolyte disturbances, and kidney stones. Fellows will also have rotations through other specialized clinics including glomerular disease clinic and onco-nephrology clinic. Throughout both years, fellows also rotate through in-center hemodialysis shifts as well as home-hemodialysis and peritoneal dialysis clinics. Fellows also have opportunities to learn about responsibilities of being a medical director of a dialysis unit.
Our fellows are trained to perform nephrology-specific procedures including native kidney biopsies and temporary hemodialysis catheter insertions. Fellows gain hands-on experience in ultrasound and CT-guided native kidney biopsies, and typically graduate having performed at least 10 biopsies themselves. Nephrology faculty who is also certified in critical care is the primary fellows educator on dialysis catheter placement.
All trainees are expected to complete a quality improvement project and a scholarly research project by the end of their fellowship. Protected time is provided for each fellow to implement a project of their own under direct faculty guidance and support for publication submission.