WARD Rotation

PGY4/5 Adult Nephrology Residency Training Program
Rotation-Specific Training Objectives
During this rotation, trainees must demonstrate their ability to act in the role of most
responsible physician for patients with significant nephrology and/or non-nephrology
issues. The trainee will also learn to develop a comprehensive plan for discharge
from the hospital (to home, a rehabilitation centre or other type of care).
Key areas may include: acute kidney injury; management of patients with end-stage renal disease and
concurrent medical issues; complications of end-stage renal disease, such as vascular or peritoneal dialysis
access problems, or calciphylaxis; acid-base disorders, fluid and electrolyte disorders and disorders of
divalent cation and mineral metabolism; acute glomerular diseases; hypertension; management of
patients in the early and late post-transplant periods; and pharmacology of drugs in renal disease. The
ability to develop a comprehensive plan for discharge from the hospital (to home, a rehabilitation centre
or other type of care) is also a crucial skill.
At the end of this rotation, the trainee will be able to:
Medical Expert
Complete an accurate and well-organized history-taking and physical
examination of the patient with renal disease.
Formulate an accurate diagnosis and differential diagnosis, plan of
investigation and plan of treatment.
Recognize emergency situations, and use appropriate management strategies
for common nephrology emergencies E.g.: hyperkalemia,
hyper/hyponatremia, and severe hypertension.
Demonstrate adequate knowledge of pathophysiology of common renal
disorders (e.g. fluid and electrolytes disorders, glomerular disorders, acute
and chronic kidney disease, etc.).
Appropriately manage hemodialysis and peritoneal dialysis patients, including
writing dialysis prescriptions and troubleshooting complications that arise.
Demonstrate knowledge of and proficiency in managing transplant patients
including care of the immediate post op patient, immunosuppression protocols
and complications of transplantation
Prioritize patients’ acuity and corresponding management appropriately.
Assimilate relevant sources of information from the patient's family,
caregivers and other professionals when appropriate, and encourage patients
and families to participate in shared decision-making.
Establish a therapeutic relationship with patients and communicate well with
PGY4/5 Adult Nephrology Residency Training Program
Provide patients and families with sufficient information regarding the risks
and benefits of treatment alternatives
Demonstrate knowledge of and respect for the individual team members’
contributions and roles in the care of patients with ESRD/CKD.
Provide thorough handover of all patients during rounds and transfer of care
to other services or physicians.
Carry out clinical services in the context of limited time and resources.
Effectively plan and coordinates patient discharge and follow up from hospital.
Health Advocate
Demonstrate awareness of the role of tests and demonstrate sensitivity to
inconvenience and discomfort to patient.
 Develop a plan for self-improvement
 Maintain and enhance professional activities through ongoing learning.
 Critically evaluate medical information and its sources, and applies this
appropriately to practice domains.
 Carry out duties in a professional manner
 Demonstrate professional behaviour including timeliness, honesty,
compassion and reliability.
 Demonstrate insight into his/her limitations. Responsive to constructive
 Exhibit proper professional behaviour (e.g. meeting deadlines and being
Ward Curriculum
Please see Appendix A for a comprehensive rotation curriculum
Reviewed & approved by RPC
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