Curriculum & Training

Clinical Training

The first year of pediatric nephrology fellowship is dedicated to clinical service, providing inpatient and outpatient experience in all aspects of pediatric nephrology, including dialysis and transplantation. All pediatric nephrology patients are cared for by pediatric housestaff on a general pediatrics service, with nephrology fellows and attendings providing consultative services. Fellows have many opportunities for teaching, as there are usually 2-3 learners (students and residents) on the renal rotation (the rotation is very popular among students and residents!). Our outpatient nephrology clinic sees over 2,000 visits annually, and fellows have a continuity clinic of outpatients that they follow throughout fellowship.

Chronic dialysis exposure and experience is gained through dialysis centers in the surrounding community: usually, we have about 3-6 children on chronic home peritoneal dialysis, and 3-5 children on in-center hemodialysis, and at times we may have 1-2 adolescents or young adults on home hemodialysis. During inpatient weeks, fellows provide acute intermittent hemodialysis, as well as CRRT, including CRRT through an ECMO circuit. We have NxStage and Aquadex machines for continuous renal replacement.

Transplant experience is gained through the inpatient service. Number of transplants per year is variable: three of the last 5 years we have transplanted 10 children, the other two years we transplanted 2 each year. Children who are transplanted each have a fellow assigned as their primary nephrologist upon leaving the hospital, who follows them throughout the rest of fellowship with the support and supervision of our faculty.

Fellows can further expect to develop competency in performing ultrasound-guided renal biopsies (~20 in the first year).

Fellowship Schedule 

Fellows spend 18-20 weeks of their first year on the inpatient consult service. For half of those weeks, they are on long call (24 hours a day 5-6 days a week) and for half of those weeks they are on short call (24/2 for the weekends, and 7am-5pm M-F).

Outpatient weeks: When they are not on service, fellows have one full day of continuity clinic weekly, see patients who are urgently referred, see and manage outpatient dialysis patients at the community dialysis centers (both hemodialysis and peritoneal dialysis), and attend clinical and didactic conferences.

The rest of the weeks of the year are reserved for electives (see below for a list), at least one week of which may be designed by the fellow pursuant to their own interests.

There are four weeks of vacation per year.

Electives during first year:

Scholarly pursuits (3 weeks)
Radiology (1 week)
Urology, including OR time (2 weeks)
Renal block (teaching 2nd year medical students, 2 weeks)
Transplant, including OR time (1 week)
Self-designed electives (1 week)