Nephrology Fellowship Curriculum
Rotations and Clinics
Consult rotations
The inpatient nephrology consult rotations are based at Lehigh Valley Hospital–Cedar Crest. The nephrology consult team consists of an attending, a fellow, and sometimes an internal medicine resident and/or medical student. Nephrology fellows are trained to provide care for hospitalized patients with acute kidney injury, acid-base and electrolyte disturbances, malignant hypertension, glomerular disease and chronic kidney disease. Fellows are trained in hemodialysis, continuous renal replacement therapy, peritoneal dialysis, plasmapheresis, placement of intravenous access for renal replacement therapy and native renal biopsy.
Transplant rotations
Lehigh Valley Health Network (LVHN) has a robust kidney transplant program, with more than 100 kidney transplants performed annually. Fellows work closely with general nephrologists, transplant nephrologists and transplant surgeons in both inpatient and outpatient settings to obtain a diverse experience with patients with kidney transplantation.
Outpatient dialysis rotation
During their second year, fellows follow a panel of outpatients with end-stage kidney disease on hemodialysis, peritoneal dialysis and home hemodialysis in a community dialysis clinic. The outpatient dialysis rotation also includes opportunities for training in interventional nephrology, including tunneled dialysis catheter placement, angiograms/fistulagrams and balloon angioplasty.
Continuity clinic
The nephrology fellows’ office practice is based at the Valley Kidney Specialists Cedar Crest. The fellow follows his or her own panel of patients longitudinally, providing continuity of care one half-day per week throughout the two-year fellowship. Fellows are precepted by nephrology division faculty.
Scholarly activity
In the second year, six months are designated for scholarly activity. During this time, fellows work on mentored research projects, quality improvement projects, review articles or case reports, or self-arranged electives.
A typical day on the consult service at LVHN
7 a.m., Work rounds
The typical day starts with the fellow pre-rounding and writing notes on each of the patients on the consult service. Fellows supervise and coordinate pre-rounding by any medical residents or medical students on the consult team. New, urgent consults also are evaluated and/or distributed to residents/students during this time.
10:30 a.m., Attending rounds
Each day, bedside teaching rounds are led by one of our nephrology faculty members.
12 p.m., Conference
Nephrology conferences are scheduled 12-1 p.m. approximately three days per week. Conferences include a case-based conference (renal rounds), core fellows conference, journal club, research conference, morbidity and mortality conference, physiology conference and pathology conference. Conferences are led by fellows or nephrology faculty.
1–5 p.m., Complete attending rounds, new consultations and follow up on morning activities
Afternoons entail time for completing clinical work, including conferring with referring team regarding our recommendations, following up on studies, re-evaluating patients and seeing new consultations. The afternoons also are time for more directed didactic teaching by the teaching attending, often in the context of new consultations.
Call Structure
Fellows take at-home (pager) call approximately 1:4 weeknights and 1:4 weekends. On weekend call, the fellow rounds on the consult service both Saturday and Sunday, with supervision and assistance by two faculty members. The fellow takes at-home (pager) call Saturday and Sunday nights. Fellows are dismissed by noon on Monday following weekend call.
Days off
During weekends not on call, fellows are off Saturday and Sunday with no clinical responsibilities. In addition, each fellow has 19 days of paid time off and at least five days for educational conferences each year.