Course/Rotation Title: Nephrology
Date of Last Review/Update: 03/07
Location of clinical encounters
Inpatient % time = 90%
(Check all that apply)
[X]
Wards
[X]
ICU
[X]
ED
[X]
Other (please specify): Acute renal dialysis unit
Outpatient% time = 10%
(Check all that apply)
[X]
Clinic
[ ]
Home
[X]
Other (please specify): Multidisciplinary dialysis rounds
[X]
Other (please specify): Outpatient dialysis unit
Course/Rotation Director: David Henner, MD
Course/Rotation description with educational purpose/value
The goal of this rotation is to prepare future general internists with the skills and knowledge to
appropriately evaluate, treat, and refer in a timely fashion patients with renal, electrolyte, acidbase, and hypertensive disorders
Residents should review all appropriate policies within the curriculum which may apply to this
rotation.
Types of Clinical Encounters: (PLEASE SPECIFY)
 Inpatient Consultation
 Inpatient Follow Up
 Outpatient Consultation
 Outpatient Follow Up
 New Admissions to Renal Service
 Follow up on Renal Service Patient
 Multidisciplinary Dialysis Rounds
 Dialysis Unit Visits
Types of Patients: (PLEASE SPECIFY)
[X]
[X]
[X]
Adults of all ages
Male
Female
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[ ]
[ ]
Children < 18 years old
Other (please specify)
Mix of Diseases: (PLEASE SPECIFY ANY ADDITIONAL DISEASES
 Acute Renal Failure
 Chronic Renal Failure of any cause including HTN, Diabetes and Autoimmune
 ESRD
 HTN both primary and secondary
 Electrolyte and Acid Base disorders including but not limited (Sodium, Potassium,
Calcium disorders).
 Nephrolithiasis
 Renal transplant – chronic immunosuppressant management and complications
Types of Procedures: (PLEASE SPECIFY):
 Urinalysis microscopy.
 Ophthalmologic exam at the bedside.
 There may be the opportunity to assist in central line placement for dialysis
 There may be the opportunity to assist or to observe a renal biopsy.
Describe the level of supervision by faculty:
[X]
[X]
[X]
[ ]
Attending staff will supervise and precept all patient care activity directly or indirectly.
Attending staff will provide mid rotation feedback
Attending staff will provide end-of-rotation feedback
Other (please specify)
Competency Based Objectives/Expectations. Please see Roman Numeral II with additional
items specific to this rotation as below:
Patient Care
 Articulate a brief clinical summary as would be presented to the consultant, incorporating
relevant aspects of the H&P, laboratory data, and differential diagnosis.
 See office patients; Improve outpatient skills with targeted H&P, assessment and
management of common problems (e.g., HBP; proteinuria; hematuria, stones, etc.)
 Perform inpatient consults; Perform H&P, assess specific renal problems and synthesize
diagnostic and treatment plan
 See Roman Numeral II
Medical Knowledge
 The ABIM MKSAP nephrology syllabus and Q/A will be available for review and a
mandatory end of rotation exam is administered using the MKSAP questions.
 Formulate an approach to the differential diagnosis, and clinical manifestations of acute
renal failure.
 Understand the stages of chronic kidney disease.
 Understand how to calculate and interpret estimated GFR.
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



Understand the general indications for renal replacement therapy.
Understand the basic principles as applied to acid-base and electrolyte disorders (e.g.,
metabolic acidosis; hyponatremia).
Diagnostic evaluation and management of the abnormal urinalysis (also PK).
An approach to the diagnosis and management of hypertension (also PK).
See Roman Numeral II
Practice-Based Learning
 Attend discussion sessions; Perform literature reviews on commonly seen problems
 See Roman Numeral II
Interpersonal and Communication Skills:
 Demonstrate the “art” of interpersonal skills necessary in caring for patients with chronic
debilitating diseases.
 See Roman Numeral II above
Professionalism: (PLEASE SPECIFY)
 See Roman Numeral II above

System-Based Practice: (PLEASE SPECIFY)
 See Roman Numeral II above
Check Any Methods Used For Teaching and Assessment:
[ ] Ambulatory Clinic (feedback written & verbal)
[ ] Annual In-service Exam (feedback written)
[X] Attending Rounds (feedback written & verbal)
[X] Board Review (feedback written examination)
[ ] Cancer Conference
[ ] Case Management Evaluation (360 degree written evaluation)
[X] Chart Stimulated Recall & Feedback (feedback verbal)
[X] Direct Observation and Feedback (feedback written & verbal)
[ ] GME Core Curriculum
[ ] Interns Report (feedback written & verbal)
[ ] Journal Club (feedback written & verbal)
[X] Medical Record Review (feedback written & verbal)
[ ] Mentor Feedback (feedback written & verbal)
[X] Monthly End of Elective Exam (feedback written)
[X] Monthly Mini CEX (feedback written & verbal)
[X] Monthly Competency Based Written Evaluation
[X] Morning Report (feedback written & verbal)
[X] Multidisciplinary Rounds Feedback (feedback verbal)
[ ] Nursing Evaluation (360 degree written evaluation)
[ ] Patient Evaluation (360 degree written evaluation)
[X] Patient Management Discussions (feedback written & verbal)
[X] Procedure Logs
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[X] Performance improvement Multidisciplinary Morbidity and Mortality
(feedback written & verbal)
[ ] Semi Annual Program Director Feedback (feedback written & verbal)
[ ] Student Evaluation (feedback written & verbal)
[ ] Supervised Sign-In Rounds (feedback written & verbal)
[ ] Supervised Sign-Out Rounds (feedback verbal)
[ ] Other _______________________________
[ ] Other _______________________________
[ ] Other _______________________________
[ ] Other _______________________________
Other Policies:
The Course Director recognizes that the trainee is accountable to all BMC Residency and GME
Personnel Policies and Procedures. The Course Director recognizes that the residents are
expected to attend all continuity clinics and mandatory educational conferences unless excused
by the Program Director or Chief Medical Resident with advanced notice.
Check The Educational Materials Used (beyond direct patient care):
[X] Reading List (Please Specify):
1.
Rose, BD. Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th edition,
McGraw-Hill, New York, 2001.
2.
Brenner and Rector. The Kidney, 6th edition, W. B. Saunders, Philadelphia, 2000.
3.
Schrier. Diseases of the Kidney and Urinary Tract, Lippincott, Willliams & Wilkins,
2001.
3.
Kaplan. Clinical Hypertension, 8th edition, Lippincott, Williams & Wilkins, 2002.
5.
Up-to-Date in Medicine on CD ROM - Available in Nephrology office.
6.
“Seventh Report of the JNC on Prevention, Detection, Evaluation & Treatment of High
Blood Pressure,” JAMA, May 21, 2003.
7.
Graff. A Handbook of Routine Analysis, Lippincott & Co, 1983.
 Additional review articles and studies will be provided by the renal attending. Literature
review will be emphasized when appropriate, using the hospital computer and medical
telecommunications database.
[X] Review of Appropriate Radiology Images (Please Specify):
 Renal Ultrasound
 Chest XRAY
[X] Review of Appropriate Pathology (Please Specify):
 Renal Biopsy
 Urinalysis
[ ] Review of Appropriate Laboratory Data (Please Specify):
 Appropriate labs to elective as described above
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[ ] Articles from the Literature (Please Specify):
 As appropriate to patient care
[ ] Case Studies
[ ] Other (Please Specify):
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