Clinical Training

General nephrology clinical training is designed to enable fellows to achieve the knowledge, skills and attitudes of competent nephrologists. Renal fellows are expected to gain proficiency in the diagnosis and management of inpatient and outpatient medical problems at a level typical of a well-qualified nephrologist.

Diverse Inpatient Rotations Provide Expert Clinical Training

Nephrology Consult Service

During the nephrology consult service at University Hospitals Cleveland Medical Center, fellows and nephrology attending provide consultation and treatments to patients with renal problems in a variety of settings, including those hospitalized on the non-renal healthcare teams such as:

• Medicine services
• OB/GYN services
• Oncology services at UH Seidman Cancer Center
• Cystic fibrosis at UH Rainbow Babies & Children's Hospital
• Surgical services

During the renal transplant service, nephrology fellows and the transplant nephrology attending are part of a combined medical-surgical team and provide consultative services to the transplant surgical service.

During the Louis Stokes Cleveland VA Medical Center nephrology consult service, fellows work with a faculty member to provide inpatient nephrology, hypertension and dialysis consultation to our veterans. Fellows also join the VA Outpatient Nephrology Clinic one half-day every week to gain additional exposure to outpatient nephrology care.

During the nephrology consult service at MetroHealth Medical Center, fellows and attending physicians provide consultation for inpatients with chronic kidney diseases as well as acute renal-electrolyte problems in the following areas:

• Burn intensive care unit
• Highly specialized level 1 trauma center
• Surgical and medical wards

Outpatient Rotations Provide Dialysis Training

Home Dialysis Rotation

During the home dialysis rotation, fellows at UH Cleveland Medical Center attend outpatient peritoneal dialysis and home hemodialysis clinic every other week and participate in the peritoneal dialysis training of all new patients. Fellows also follow all home dialysis patients admitted to the hospital.

Farnsworth Dialysis Rotation

Fellows on the Farnsworth dialysis rotation, through MetroHealth Medical Center, are assigned a shift of hemodialysis outpatients that they manage under the supervision of an attending nephrologist.

Training in Nephrology Procedures

Fellows have the opportunity to learn procedures during both inpatient and outpatient rotations, under the direct supervision of attending nephrologists. These procedures include:

• Continuous renal replacement therapies (SCUF, CVVH, CVVHD)
• Intermittent acute and chronic dialysis
• Interpretation of urinalysis
• Peritoneal dialysis
• Placement of temporary dialysis catheter
• Renal biopsies

Outpatient Clinics

In the first year, all nephrology fellows attend one half-day continuity clinic, at UH Cleveland Medical Center or at MetroHealth Medical Center under the supervision of a faculty member. A second half-day clinic is added during the second year of fellowship: six-month renal transplant and six months home dialysis clinic.