Curriculum

PGY-6 Transplant Nephrology Fellow

• Fellow will spend 10 months on the transplant nephrology consult service conducting history and physical examination and management of patient with solid organ transplant and receiving maintenance immunosuppressive medications
• Fellow is expected to attend daily multidisciplinary clinical rounds with the other members of the transplant team
• Fellow rounds with attending physician and medical resident, if assigned, on a daily basis formulating a detailed problem list, differential diagnosis, and diagnostic evaluation of management plan as it pertains to patients with renal dysfunction after solid organ transplant; these include kidney, pancreas and liver transplant patients
• The fellow will be expected to evaluate and participate in the ongoing care of inpatients on the transplant surgery service as well as consultations from other departments, such as surgery, medicine, psychiatry, OB-GYB. Typically, the fellow will see 2-4 admissions per day and follow up 12-16 inpatients
• Responsible to review of admission history and physicals, admission reports, orders, transfers and discharge orders. 
• Fellow is on-call (home call) a assigned. Fellow will return to hospital when on call if required to respond to patient related issues. 
• One moth spend on the transplant surgery rotation. During that time fellow will accompany the organ procurement team to observe and assist in the process, for a minimal of three procurements per organ system.
• The fellow is required to observe a minimum of 3 kidney implantation procedures, and 3 pancreas implantation procedures. 
• Fellow to observe at least one living donor nephrectomy.
• One moth spent in laboratory rotation during this rotation the fellow will be acquainted with test techniques and method in HLA identification, lmphocytotoxic cell cross matching and other relevant test method used in solid organ transplantation.
• Time will also be spent in renal pathology laboratory, and assist and observe the preparation and interpretation of kidney biopsy specimen. In addition fellow is required to attend weekly pathology conference,  where all biopsies done during that week are being reviewed
• Outpatient kidney transplant clinic. The fellow is expected to take an active part in management of minimal 30 kidney and 5 pancreas patients in the outpatient kidney transplant clinic under supervision of an attending transplant nephrologist. The process involves seeing the patients on two half day clinic sessions per week and review of laboratory results and subsequent adjustments of immunosuppressive medications.
• The fellow is required to see all potential living donor evaluations done at Einstein Healthcare Network, and discuss appropriateness of donation, contraindications for donation  in each potential donor. Minimum of 10 living donors. 
• The fellow will be learning indications for renal transplant biopsy during inpatient rounds and while participating in outpatient clinic.  
• Once biopsy is ordered fellow will coordinate with Interventional radiology of the biopsy time and will be performing renal allograft biopsy under the guidance of the interventional radiologist. Minimum of 10 of renal allograph biopsies. 
• Throughout the year fellow will evaluate potential kidney and pancreas transplant recipients and participate in the listing process, on average fellow will see 2-4 recipient evaluations a week. 
• Fellow is asked to keep a log of procedures and patients seen. 
• Attend and participate in weekly clinical and didactic conferences
• Active participation in clinical research projects
• Every transplant nephrology fellow is strongly encouraged to attend Fellows symposium on Transplantation Medicine as well as American Transplant Congress Meeting.