Rotation: Nephrology Elective
Site:
- Physician's Office (also includes NWTH, dialysis unit)
Instructors:
- Georges Maliha, M.D., Milton Giron, M.D., all Nephrology clinical faculty members of Texas Tech
Makeup of team (responsibility of each team member):
- One resident (PGY-1, 2 or 3), One attending
Days per week (night call):
- Monday through Friday. No night or weekend duties. (except one upper level ICU night call per month possible)
Usual time of attending rounds (meeting place):
- Before or after Morning Report, Northwest Texas Hospital (please contact attending ahead of time for specifics).
Types of patients encountered:
- Inpatient and outpatient consultations; specific populations include renal failure and renal transplantation patients
Educational goals/competencies:
Patient care:
Evaluation includes outpatient consultation of patients with renal disease and difficult to control hypertension. Inpatient consultation includes patients with acute renal failure, electrolyte disorders and medical complications of chronic renal failure/renal transplantation.
Procedures include urinalysis interpretation and insertion of acute hemodialysis access (supervised by Drs. Oltermann and Kelleher).
Medical knowledge:
Knowledge base includes management of hypertension, diagnosis and treatment of acute renal failure, diagnosis and treatment of electrolyte disorders, diagnosis of parenchymal renal diseases, and diagnosis and treatment of the medical complications of chronic renal failure and renal transplantation.
Interpersonal/communication skills:
This rotation emphasizes the art of consultation, focusing on serving both the patient and primary care physician. Additionally, communication with a unique group of patients with chronic and permanent illness is stressed.
Professionalism:
This rotation emphasizes a team approach to patient care.Weekly conferences including physicians, nurses, a social worker, and a dietician regarding specific patient needs provide the resident with a view of multidisciplinary care.
Practice-based learning and improvement:
Midway through the rotation, the resident receives feedback regarding strengths and weaknesses. The resident is introduced to the annual Annals of Internal Medicine "Updates in Nephrology", as well as the text referenced in a later section.
Systems-based practice:
The nephrology rotation emphasizes the Medicare mandated multidisciplinary approach to patient care. Understanding of the Medicare system regarding patient benefits and provider reimbursement is included.
Text/references to be consulted:
Nephrology Secrets; Hricik, Sedor, Ganz; Hanley & Belfus, Inc., Medical Publishers, The Nephrology section of Harrison's Textbook of Internal Medicine, and The Nephrology MKSAP.
Methods of evaluation:
An evaluation with appropriate feedback is provided by Dr. Maliha to each resident. The resident's interest in caring for the patient, enthusiasm in participating in the learning process, and evidence of outside reading in nephrology will serve as a basis for the written evaluation.