PGY4/5 Adult Nephrology Residency Training Program WARD Rotation-Specific Training Objectives Overview 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. Communicator 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 family. Rev07.21.15 1|Page PGY4/5 Adult Nephrology Residency Training Program Provide patients and families with sufficient information regarding the risks and benefits of treatment alternatives Collaborator 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. Leader 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. Scholar 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. Professional 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 feedback. Exhibit proper professional behaviour (e.g. meeting deadlines and being punctual) Ward Curriculum Please see Appendix A for a comprehensive rotation curriculum Reviewed & approved by RPC Date Rev07.21.15 2|Page