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The mission of the Analysis of Nephrology Fellowship training affairs is to aftermath physicians who are clinically competent in the abounding acreage of Nephrology; awful able in a arrangement of analytic settings; and admission habits of life-long acquirements to acquiesce for connected advance in knowledge, abilities and added aspects of a able career in Nephrology.
Responsibilities of the renal Adolescent on this circling include, but are not bound to:
The Adolescent on the displace breadth account will accept an befalling to do a cardinal of renal displace biopsies (15-20/month is not unusual), apprentice the basics of immunosuppression, see a arrangement of post-transplant complications (medical and surgical), participate in their management, and if interested, appearance renal transplants in the operating room. Exposure to accepted capacity in transplantation will be provided through accord in account conferences committed to altercation of accepted assay accessories apropos to transplantation.
UAB is one of the few programs in the country that offers a abstracted Nephrology displace Fellowship to absorbed and motivated Nephrology Fellows. Successful achievement of the accepted Nephrology Fellowship, forth with achievement of the displace Fellowship is currently adequate to become board-certified in displace Nephrology by the American Society of Transplantation.UAB Nephrology Displace Argue ServiceIn 2007 the Displace argue account was accustomed for 2nd year Nephrology Fellows. This circling will accord the 2nd year Fellows connected acknowledgment to Displace topics. The Adolescent will advice added teams administer displace patients not accepted to the medical Displace floor. Consults will usually abide of displace patients accepted to ICUs or surgical floors alfresco of S7s. The Argue Displace Adolescent will additionally aid in outpatient displace biopsies performed on S7 in the mornings.UAB Nephrology Displace Appraisal ServiceThe Analysis of Displace Nephrology is additionally amenable for the pre-operative appraisal of both abeyant displace recipients and abeyant active donors. This account gives Fellows the befalling to accretion acquaintance in the appraisal of patients with end date renal ache (ESRD) for renal transplantation. The goals of this acquaintance are to apprentice to appraise ESRD patients to actuate if they are abeyant and adequate candidates, to apprentice the adapted work-up of ESRD patients for either active donor transplantation or adjustment on the body list, to apprentice the adapted work-up of individuals as abeyant active accompanying and active non-related donors, and apprentice the fundamentals of HLA analogous and histocompatibility testing. The appraisal account is an outpatient dispensary that coordinates a multidisciplinary accumulation of consultants bare for displace evaluation, including Nephrology, surgery, and amusing services. The displace appraisal Adolescent will see patients and abode an evaluation, analogous the after-effects of an interview, medical, class and radiologic advice into a academic displace evaluation. The Adolescent will be amenable for presenting these patients at a account displace appraisal conference, abounding by assembly from displace Nephrology, displace surgery, claret coffer and tissue typing, and amusing services. An accomplished displace Nephrology Accessory staffs the appraisal clinic.
Also, the Displace Appraisal Adolescent will additionally be amenable for assuming outpatient built-in renal biopsies in the outpatient vascular/heart centermost on the 6th attic of the North Pavilion. Patients about admission at 6:30 AM. The Accessory Physician should be contacted back the accommodating has been evaluated and is accessible for biopsy. The biopsy will be performed and carefully monitored in accretion in the aforementioned area.The Outpatient Dialysis ExperienceAll outpatient hemodialysis activities are supervised by the specific outpatient dialysis unit’s Medical Director. Anniversary Second-Year Adolescent will be assigned to an outpatient dialysis assemblage and is accepted to annular on an assigned about-face of patients alert a month. Adolescent responsibilities accommodate autograph and afterlight hemodialysis orders, appraisal and administration of patients’ hemodialysis accesses, dry weights, claret pressures and extracellular aqueous balances, hemodialysis prescriptions, comestible status, osteodystrophy status, anemia status; and reviewing account and added non-routine labs and cultures. The Adolescent will additionally abode and triage accommodating medical complaints. Circuit will be fabricated with the Medical Director. As a aftereffect of these accommodating evaluations, addendum are fabricated on anniversary accommodating by the Fellow, which abode the aloft issues. The Adolescent will additionally accommodated with the hemodialysis agents to analysis the baptize assay accessories and the accoutrement and active of a dialysis apparatus and appear account patient-care conferences. These are multidisciplinary conferences abounding by the arch nurse, the on-site amusing worker, and the Medical Director. The purpose of the appointment is to analysis all medical, social, and comestible issues that affect to a accommodating on abiding hemodialysis and to abode Quality Assurance and Quality Improvement.
Second year Fellows are adapted to appear UAB’s Peritoneal Dialysis Academy (PDA) in October. This is a three day all day appointment in which Fellows will accept all-encompassing training in peritoneal dialysis. The class for PDA includes peritoneal dialysis lectures by able bedfellow lecturers, alternate botheration sessions, and hands-on workshops. Fellows will be absolved from all analytic activities during this time. Fellows from added training programs are arrive to attend. Afterward PDA, Dr. Zipporah Krishnasami, the Medical Director of the HTU, will accredit to anniversary Adolescent at atomic three peritoneal dialysis patients to chase for the blow of the year. Fellows will see and appraise these patients in the HTU as bare and address to the patient’s Accessory Physician. Fellows will be complex in adjusting peritoneal dialysis prescriptions and acclamation admission issues, dry weights, claret pressure, extracellular aqueous balance, comestible status, dialysis adequacy, osteodystrophy status, and anemia status. The Adolescent will additionally be amenable for reviewing assay of a patient’s peritonitis or avenue armpit infection if applicable.
Some Aboriginal Year Fellows may additionally accept a ages connected befalling to accelerate time in one of our outpatient dialysis units. This will serve as an accession to the basics of hemodialysis, dialysis adequacy, calcium/phosphorus management, diet management, and added issues including baptize management. This circling will additionally acquiesce the Fellows to see and appraise grafts, fistulas, and permcaths. The Ambulant Nephrology ExperienceAll Fellows will be adapted to advance the agnate of a half-day dispensary per anniversary at the Kirklin Dispensary during anniversary year of Fellowship to see patients with renal diseases and problems accompanying to renal disease. This dispensary sees new outpatient consultations and connected aftereffect of accustomed patients. This acquaintance will abide with accelerating albatross through the Fellowship and will be appropriately supervised by committed Accessory adroitness members. The ambition of this acquaintance will be for the Fellows to accretion ability in the outpatient appraisal and administration of branch problems. The acquaintance provides an befalling to advance an compassionate of the accustomed history of these altitude over an continued aeon of time. Anniversary Adolescent should, on average, be amenable for four to eight patients during anniversary bisected day session. After initially evaluating the patient, Fellows will present the accommodating to the Dispensary Attending, altercate the patient, and again appraise the accommodating with the Dispensary Attending. Fellows are amenable for dictating accommodating encounters through the UAB buzz dictation system. Dictations are electronically transcribed into the UAB CDA arrangement and are accessible for alteration by the Nephrology Accessory aural 1 to 2 canicule of dictation. Dictations charge be completed aural 24 hours. The addendum are electronically active by the Dispensary Attending. Of agenda there are two altered dictations systems acclimated by the Dispensary Attendings in our division. All Fellows will be amenable for contacting their specific Attending’s secretary to acquisition out which arrangement their attendings use.
All Fellows will additionally accept the befalling to participate in account half-day Nephrology clinics at the VA and Cooper Green Hospital.
In addition, Additional Year Fellows will absorb a half-day dispensary per anniversary in Nephrology displace dispensary at the Kirklin Clinic. Through the displace clinics, Fellows will access outpatient longitudinal aftereffect renal displace experience. Fellows will chase no beneath than 20 patients as adapted by the ACGME. The goals of this acquaintance are to apprentice about immunosuppressive drugs and regimens acclimated in the administration of renal transplants, to apprentice the ancillary effects, complications and biologic interactions of immunosuppressive drugs, to apprentice to appraise and amusement post-transplant complications including infection, hypertension, malignancy, de novo glomerular ache and alternate glomerular disease, to apprentice to accept and amusement astute rejection, to apprentice to accept and amusement abiding rejection, and finally, to apprentice the fundamentals of HLA analogous and histocompatibility testing.
Interdisciplinary InteractionsThe Adolescent additionally will be provided with befalling to accompany adventures in added disciplines whose ability is adapted in the affliction of patients with Nephrology diseases. These disciplines include: 1) accelerated affliction medicine, 2) cardiology, 3) Nephrology transplantation surgery, 4) accepted and vascular surgery, 5) pediatric Nephrology 6) Nephrology imaging, and 7) urology. The ambition of these adventures is for the Adolescent to acknowledge the access to the specific altitude that chronicle to Nephrology disorders aural these subspecialties. These interdisciplinary interactions can action in the anatomy of a analytic rotation, multidisciplinary conference, etc. Analytic adventures should be beneath the administration of Accessory Physicians in the corresponding specialty or subspecialty who participate absolutely in the educational goals of the rotation.
In addition, the Plasmapheresis circling is a four anniversary constituent supervised by Dr. Marisa Marques. The goals of the circling are for the Adolescent to accept the fundamentals of plasmapheresis, including indications, technique, complications, and effectiveness. This circling is offered to absorbed Additional Year Fellows
Finally, Additional Year Fellows can accept to alternation in Interventional Nephrology with Dr. Roman Shingarev. This circling is about 2-6 months of acknowledgment depending on the Fellow’s goals. Fellows will be apparent to permcath placement, vascath placement, permcath exchange, fistula and affix thrombectomies and angioplasties, PD catheter insertion, Ligations of grafts and fistulas, and stent adjustment in Grafts and Fistulas.
Didatic ConferencesConferences will be captivated on a consistently appointed base with appearance adapted of all Fellows and bounded faculty. These conferences are usually able and because of the attributes of capacity beneath discussion, awning a aggregate of tasks and capacity including but not bound to abstract review, altercation of analytic cases, appraisal and presentation of research, and concepts of Nephrology basal science. Account conferences accommodate the Nephrology Assay and Training Centermost conference, a assay conference; Fellows’ Conference, a subspecialty appointment accustomed by the Fellows on clinically accordant topics; Fellows’ Journal Club, a clinically aggressive appointment for altercation of accepted accessories in Nephrology and accordant centralized anesthetic literature; and the Nephrology Histopathology (biopsy) conference. These conferences will occasionally accommodate lectures from adroitness in capacity alfresco of Nephrology or alfresco of the Administration of Anesthetic and bedfellow adroitness who are visiting UAB.
VA abiding Dialysis UnitThe ten-station Abiding Dialysis Assemblage amid in the VA Hospital is advised to accommodate in-center dialysis abutment for about 34 veterans and back dialysis abutment for about 40 patients apprenticed to private, nongovernmental dialysis throughout the state. The VA dialysis assemblage additionally provides astute dialytic abutment for inpatients throughout the VA Hospital with astute renal abortion and added medical altitude astute dialysis. The VA dialysis assemblage serves those veterans with end-stage renal ache accepted to the hospital with added problems. The baby admeasurement of the assemblage allows the Nephrology Fellows to apprentice how to administer dialysis patients in the outpatient ambience and advance the all-important abilities to administer a dialysis unit.
The VA Appointment ServiceThe VA Appointment Account is staffed by a second-year adolescent and advance by one of the VA accessory physicians. This account provides the adolescent a different befalling to collaborate with a adroitness affiliate in a one-on-one fashion.
The VA Displace ServiceInpatient casework are provided by the argue service. outpatient casework are provided by the VA adroitness led by Dr. Roslyn Mannon.
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