Overview
The nephrology rotation is a half block or full block preceptorial rotation. The rotation occurs at Memorial Hospital, in the nephrologist’s office, at the dialysis center and in other locations included in the nephrologist’s usual practice. The teaching of nephrology in the program includes this rotation as well as experiences in the Family Medicine Center, the noon conference series and on other rotations (See other curricula.).
Goals
- At the completion of this rotation, the resident will have an understanding of the practice of nephrology in a community setting, which will facilitate appropriate referral practices in the future.
- At the completion of this rotation, the resident will have knowledge and skills in the areas of nephrology pertinent to the practice of family medicine.
Objectives
At the completion of this rotation, the resident will have demonstrated to the satisfaction of the nephrology preceptor:
- medical knowledge in nephrology pertinent to the practice of family medicine, including the appropriate evaluation and treatment of (MK) acute and chronic kidney disease, nephritic and nephrotic diseases, other common conditions (such as hypertension and diabetes) and renal disease, the role of kidneys in acid-base balance, and an understanding and appreciation of when a patient is a candidate for renal replacement therapy.
- the ability to perform an appropriate history and physical examination on the nephrology patient and to present these findings to another physician in an appropriate manner (PC).
- the ability to interpret appropriate data related to the nephrology patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits and risks of diagnostic and therapeutic options and co-managing patients appropriately with other specialists (PC).
- the ability to make appropriate decisions to assure high-quality care in a cost-effective manner ( SBP ).
- communication and interpersonal skills which facilitate positive and therapeutic relationships (ICS).
- the ability to work cooperatively with other health professionals as part of a healthcare team (ICS).
- compassion, respect and integrity; responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society and the profession; a commitment to excellence and on-going professional development (P).
- a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent and business practices (P).
- sensitivity and responsiveness to a patient’s culture, age, gender and disabilities (P).
- There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum, and residents may gain experience meeting these requirements during this rotation.
Implementation
This is a preceptorial rotation, so the resident is assigned to a particular nephrologist or nephrology group. The resident will accompany the nephrologist during his/her professional activities in Memorial Hospital, in the nephrologist’s office and in other locations involved in the preceptor’s usual practice. In the course of seeing patients, the nephrologist will provide experiential learning, role-modeling and one-on-one teaching to the resident. At the discretion of the preceptor, the resident may be assigned to research specific topics in nephrology.
The resident is responsible for contacting the nephrologist prior to the start of the rotation to arrange a schedule for the rotation. The resident must continue to meet usual residency obligations to his/her Family Medicine Center population including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.
Evaluation
The nephrology preceptor will complete an evaluation form at the end of the rotation. Residents will specifically be evaluated on the following ACGME Milestones:
- PC-1: Cares for acutely ill or injured patients in urgent and emergent situations and in all settings.
- PC-2: Cares for patiens with chronic conditions.
- MK-1: Demonstrates medical knowledge of sufficient breadth and depth to practice family medicine.
- PROF-2: Demonstrates professional conduct and accountability.
- C-2: Communicates effectively with patients, families, and the public.
- C-3: Develops relationships and effectively communicates with physicians, other health professionals, and healthcare teams.
