The goal of this program is to provide trainees with opportunities to develop clinical competence in the fields of nephrology, hypertension, and renal replacements therapies. To achieve this goal, ample numbers of new and follow-up patients of appropriate ages, including the adolescent and geriatric age groups, and of both genders are available for each trainee. Throughout the training period within the program, trainees are allowed increasing responsibility in the performance of procedures and in the decision-making process in patient care. Toward the end of the program, they are allowed to make independent decisions that are then discussed with faculty.
UK/VA Non-ICU Consult Service:
During their two years of training, nephrology fellows spend approximately 5 to 6 months on this service. Under direct faculty supervision, the trainees, and other members of the team, evaluate approximately 45–60 consults per month. We currently care for approximately 175 chronic hemodialysis patients (HD) and 35 chronic ambulatory peritoneal dialysis (PD) patients. In addition, our institution is a major referral center for the tertiary care of many ESRD patients followed by outside nephrologists in central and southeastern Kentucky.
UK/VA ICU Consult Service:
During their two years of training, nephrology fellows spend approximately 5 to 6 months on this service. Under direct faculty supervision, the trainee evaluates approximately 20–25 new UK and 5-10 new VA ICU consults per month. On average, the trainee will care for 6-8 UK and 1-3 VA ICU patients per day.
During their two years of training, nephrology fellows spend approximately 3-4 months on this service. Under direct faculty supervision, the trainee evaluates approximately 4-5 new transplant patients and 25-30 hospitalized transplant patients per month. On the average, the trainee will care for 6-10 hospitalized transplant patients per day.
Formal and organized nephrology ultrasound program. Focuses on renal ultrasound and point of care ultrasound (POCUS) for assessment of volume status and renal failure evaluation. Combines didactics with hands on training, allowing fellows to accumulate experience and image portfolios.
Ambulatory Medical Experience:
Parallel to the clinical rotations described above, trainees participate in ambulatory medical care for patients with all stages of kidney disease, including ESRD.
Out-Patient Dialysis Experience:
Throughout the duration of their training and under direct faculty supervision, trainees assume responsibilities of the out-patient management of 8-12 HD patients. The dialysis staff are instructed to contact first the designated renal fellow for any question or concern regarding these patients. In addition, nephrology trainees assume the responsibility of the out-patient management of 30-35 home PD patients for 5-6 months during their training.
Longitudinal Out Patient Clinic Experience:
Trainees spend throughout their two years of training two-half days per week in the renal clinics to gain experience in consultative as well as continuing care. On average, trainees are responsible for 1-3 new patients and 8-12 return patients per week.
One month during their first clinical year and 1 to 2 months during their second year, trainees are permitted to take any of the following elective rotations: Renal Pathology (4 weeks) Renal Radiology (2-4 weeks) Pediatric Nephrology (4 weeks)