The fellow spends seven months in the inpatient section, gaining experience in the care of early post-transplant patients, immunosuppression management and collaborative management, working alongside the surgeons in a multidisciplinary setting.
Transplant nephrologists attend two inpatient transplant services:
- Inpatient transplant medicine service – staffed by an internal medicine resident and intern, as well as a nurse practitioner who assists with patient management and discharges
- Transplant consult service – provides care for all transplanted patients in the medical center admitted to other services, including the transplant surgery services
- Daily multidisciplinary bedside rounds on all new post-transplant recipients
- Daily notes in the electronic medical records (EMR) on all new consults and follow-up patients
- Performing procedures, including dialysis and transplant renal biopsies
- Assisting in the education and supervision of house staff
The fellow attends one early post-transplant management clinic and one longterm management clinic each week, under supervision.
In this setting, the fellow has the opportunity to evaluate and manage immunosuppression regimens as well as common post-transplant complications such as glucose intolerance, hypertension and opportunistic infection.
Attending the longterm management clinic allows the fellow to understand the concepts of safe immunosuppression reduction to prevent cardiovascular morbidity and manage the various metabolic complications associated with longterm immunosuppression.
Each of the four transplant nephrologists has two half-day clinics every week covering living donor evaluations, pre-transplant kidney and pancreas evaluations and post-transplant follow-ups. The transplant fellow will be assigned to two half-day continuity clinics every week, one to do pre-transplant evaluations and the other to do post-transplant follow-ups.
The fellow will be responsible for the overall care of the patients seen in the clinic for the duration of the training year – vis-à-vis monitoring of the labs, modifying immunosuppression and answering any questions raised the patients.
This format will offer independence in decision making and experience in continuity of care for the patients. Since there are outpatient clinics every day, there will ample opportunities for both the transplant and the general nephrology fellow to work independent of each other.
Fellows participate in a variety of ongoing or new clinical research projects related to kidney disease or kidney and pancreas transplantation.
The following are some of the primary materials that the transplant fellow is expected to use for training. In addition, journal articles will be used as supplementary materials on a regular basis.
- Handbook of Kidney Transplantation, fifth edition – Danovitch G.
- Primer on Transplantation, third edition – Hricik D.
- Transplant Nephrology Core Curriculum by the American Society of Nephrology