The first year of training is dedicated primarily to clinical activities and the second and third years primarily to research, comprising a total of 16 months clinical emphasis and 20 months research. Abundant didactic activities and conferences, as described below, including a formal histopathology course taken with the adult nephrology fellows, provide for a rich learning environment.
FIRST YEAR: The first year of the program is dedicated primarily to clinical training, comprising 10 months, with 2 months allocated to introduction to research. Clinical training includes assignments to the inpatient wards and involves experience managing a wide variety of patients assigned to the nephrology service with disorders such as new and relapsing nephrotic syndrome, acute and chronic glomerulonephritis, hypertension, acute and chronic renal failure, hemolytic-uremic syndrome, new renal transplant recipients and those experiencing complications, and both peritoneal and hemodialysis patients. Fellows learn skills including renal biopsy and ordering of dialysis. During inpatient ward assignments, fellows also provide consultation to other services including the ICU's (PICU, NICU, and CICU) and learn to manage all acute dialysis modalities (hemodialysis, PD, and a high volume of continuous renal replacement predominantly in the form of CVVH). Advanced knowledge of fluid and electrolyte management is taught during these inpatient and consult service rotations. Six weeks of the first year entails full time assignment to our pediatric-specific hemodialysis unit and peritoneal dialysis clinic, a partnership with DaVita Dialysis, wherein fellows have in-depth training in principles, literature, and application of dialysis as well as the opportunity for hands-on familiarity with hemodialysis & peritoneal dialysis equipment & techniques. Similarly, in the ICUs, fellows learn the details of CVVH and are afforded hands-on familiarity with CVVH equipment and setup.
Two months of the first year are dedicated to research orientation with initial opportunity for project selection. In addition, Fellows participate in formal department-wide fellowship courses in Research Fundamentals, Quality Improvement, and Medical Ethics.
SECOND YEAR: The second year begins with consecutive research months during which the fellow finalizes selection of research project(s) and mentor(s). Two months are dedicated to inpatient ward assignments, and additional time is allocated to a mixture of important clinical experiences including coursework with Dr. Charles O'Neill in the Emory Department of Medicine Division of Nephrology learning Ultrasound for the Nephrologist; this course is virtually unique in the country and one that numerous practicing nephrologists have taken with excellent reviews; observations in the Emory HLA lab and with our local organ procurement organization (Lifelink); and experience with our Pediatric Urology colleagues observing voiding dysfunction clinics, urodynamic studies, and other relevant activities. Second year fellows participate in a formal department-wide fellowship course in Teaching to Teach. During clinical assignments in the second and third years, the Fellow assumes increased responsibilities in the evaluation and care of patients and in teaching of pediatric residents and medical students.
THIRD YEAR: The third year of training is dedicated primarily to completion of research projects and writing related abstracts and manuscripts. Two months of this year are spent on the inpatient wards with advanced clinical responsibilities.
During the entire 3-year training period, fellows attend all section conferences and seminars plus they are afforded the responsibility to follow their own cohort of general Nephrology patients in a mentored Fellows’ Continuity Clinic.
WEEKEND/NIGHT CALL: Fellows take weekend call averaging one weekend every fifth week throughout the 3 year training period. Weeknight call averages every fourth or fifth night. Night call is always taken from home. An attending pediatric nephrologist is always on call with the Fellow. Fellows on call round with the attending on the inpatient service during weekends and holidays. Fellows average at least 3 two-day weekends off every 4 weeks. If circumstances arise, the Fellow will be dismissed home from inpatient clinical responsibilities to conform to the 80 hour per week maximum, in keeping with ACGME guidelines. Fellows are entitled to 3 weeks of vacation per year that may be taken at any time during research or outpatient rotation months with approval of the Program Director.ADVOCACY: Each fellow is given the opportunity to attend Camp Independence. Hosted by Children’s Healthcare of Atlanta, Camp Independence is one of the oldest and largest camps in the country for children and adolescents who have been diagnosed with kidney disease, are on dialysis, or have received a solid organ transplant. Camp Independence is a week-long summer camp experience held at Camp Twin Lakes, a unique camp venue that provides year-round recreational, therapeutic and educational programs for children facing serious illnesses and life challenges. For more information about Camp Independence, go to www.choa.org/campindependence.