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Methodist Dallas Medical CenterNephrology Fellowship ProgramACGME Accredited since 2012Program Director: Dr. Roberto aldonado@mhd.com@collazor1
Nephrology Program Overview 2 Year ACGME-accredited clinical program We are doing the self-study for accreditation, and we areexpecting a site visit in 2019 Number of Fellows: 2 per year Nephrology Board Passing Rate: 100%2
Nephrology Fellowship2 year clinical program that offers extensive training in: General, clinical and intensive care nephrologyHemodialysis (including home hemodialysis); continuous renalreplacement therapies; inpatient and outpatient kidneytransplant experiencesKidney stones and metabolic bone diseasePeritoneal dialysisGlomerular diseasesHypertensionAcid base and electrolyte disordersInterventional nephrologyNephropathologyNxStage machine and PD modalities3
CurriculumROTATIONS1ST YEAR2ND YEARMethodist Consult4 months4 monthsCharlton Consult2 months1 monthsTransplant (inpatient)2 months1 monthDallas Transplant Institute (outpatient)2 months1 monthHome Hemo/PD1 monthResearch1 month1 monthElectives1 month2 monthsICU1 monthCONTINUITY CLINICS1ST YEAR2ND YEAROutpatient Hemodialysis Rotation6 months6 monthsPeritoneal Dialysis Rotation12 months12 monthsChronic Kidney Disease Clinic (Golden Cross)12 months12 months4
Methodist Dallas Consult Rotation Rounding with Dr. Collazo, Dr. Chowdhury, Dr. Linenfelser, or Dr. Pariti (full-timefaculty)Fellows will round, write progress notes and orders and discuss cases withattendingsDiscuss biopsies with renal pathologistDaily census of 10-20 patientsConsults come from MICU, SICU, OBGYN, Internal Medicine, ER1.5 – 2 days of admitting per weekGeneral, clinical and intensive care nephrologyInpatient hemodialysisAll kinds of continuous renal replacement therapiesKidney stones and metabolic bone diseasePeritoneal diseasesGlomerular diseasesHypertensionAcid base electrolyte disordersNephropathology5
Methodist Charlton Rotation Methodist Charlton is a 305-bed hospital located eleven miles southof Methodist Dallas Rounding with Dr. Pancorvo, Dr. Skluzacek, Dr. Fuquay, or Dr. Kodali Fellows will round, write progress notes and orders and discusscases with the attendings Daily census of 10-20 patients Consults mainly from ICU, Internal Medicine and the ER 1.5 – 2 days of admitting per week General, clinical and intensive care nephrologyInpatient hemodialysisAll kinds of continuous renal replacement therapiesKidney stones and metabolic bone diseasePeritoneal diseasesGlomerular diseasesHypertensionAcid base electrolyte disordersNephropathology 6
Inpatient Transplant Rotation Rounding with Dr. Castillo, Dr. Fa, Dr. Qureshi, Dr. UmberFellows will round, write progress notes and orders and discusscases with the attendingsDiscuss transplant biopsies with renal pathologistDaily census of 10-20 patientsSee transplant consults (kidney, pancreas and liver)Fellows are usually the primary physicians and manageimmunosuppressionNew and chronic transplant recipientsConsult for patients with end-stage liver disease and liver transplantpatientsAll kinds of continuous renal replacement therapiesInpatient and outpatient kidney transplant experiencesNephropathology7
DTI (Outpatient Transplant) Outpatient transplant continuity clinicFollow-up transplant patientsCentralize in post-transplant patient careDiscuss cases with Dr. Nesser and other transplantnephrologistsAllscripts notesLight rotation compared to Inpatient Transplant8
Home Hemo/PD (2nd Year Only) Rotate with Dr. Shetty, Dr.Velez, Dr. Sebastian and Dr. Fuquay,or Dr. PancorvoHome hemodialysis and PD patientsBecome familiar with NxStage machine and various homedialysis modalitiesICU Rotation (New Rotation for 2nd Year Only) Rotate in ICU with consult nephrologistsSee all Nephrology ICU consultsPlace temporary Dialysis CathetersRound with Intensivists and IM ResidentsNo week night on callRound on Saturdays, AM only, except Saturdays after weekend on-call9
Research Rotation You will be assigned to work with an attending physicianon a project such as: A case report A research paper A poster presentation at a conference Complete online CITI Training for research You will meet weekly with a proctor to discuss progressof your project10
Elective Rotations Interventional nephrologyPeritoneal dialysis or home hemodialysisClinic rotations with Dr. Sebastian (outpatient nephrology)Additional month in transplantationAdditional month of researchInpatient and outpatient kidney transplant experiencesKidney stone and metabolic bone diseasePeritoneal dialysis and home hemodialysisHypertensionInterventional nephrologyNephropathologyNxStage machine and PD modalities11
Continuity Clinics Fellows have outpatient CKD clinics every Thursdayafternoon from 1-5 pm at the Golden Cross AcademicClinicAttending physicians: Dr. Sebastian and Dr. CollazoClinic is equipped with a centrifuge and microscope foron-site urinalysisFellows assist each other during clinicsManagement of patients with CKD, glomerular diseases,kidney stones, hypertension and electrolyte disorders12
Outpatient Hemodialysis Rotation Fellow is assigned to a Dialysis Unit with Dr. Sebastian, Dr.Velez, or Dr. Chowdhury to cover one dialysis shiftMonday AM shiftsOne year of weekly shifts, beginning January of your firstyear and ending December of your second yearEach fellow will have their own dialysis shift (10-20patients); make weekly rounds and attend a monthlyquality meeting with the attending physician and nursingstaffThis prepares fellows for private practiceHemodialysis (including home hemodialysis)NxStage machine and PD modalities13
Peritoneal Dialysis Rotation Each fellow spends one Thursday afternoon per month atthe Outpatient Peritoneal Dialysis Clinic under thesupervision of Dr. Shetty (they do not attend GoldenCross Clinic on this day)Each fellow will follow an average of 5-10 patients permonthPeritoneal dialysisNxStage machine and PD modalities14
ProceduresFirst Year Procedures: Temporary dialysis catheter placement Urinalysis & Urine Sediment Kidney Biopsy Peritoneal dialysis Hemodialysis, PD, CRRT and SLED count as procedures Fellows are responsible for logging procedures in MedHubSecond Year Procedures: Plasmapheresis Kidney biopsy Fellows are responsible for logging procedures in MedHub15
Conferences Usually 3 conferences per week Hemodialysis, CKD, GNs, Acid/Base, Electrolytes, Transplant, etc.Monthly Journal ClubsOne fellow presentation, per month, starting in September ofyour 1st yearMonthly Nephropathology Lectures with Dr. Lytvak (RenalPathologist)Monthly Grand RoundsNephrology Board and In-Training Exam review sessionsNephSap review sessionsLunch is served at all conferences16
Hospital Involvement Each fellow will be assigned (on an annual basis) to participatein at least one of the hospital ‘quality of care’ meetings such as:PCAR, IM QA, GMEC We encourage our fellows to participate in other academicconferences including Medicine Grand Rounds, M&MConference, and CPC We have a monthly fellows’ meeting, usually on the firstThursday of each month, where we discuss our monthly callschedule and lecture schedule, and we want to hear anddiscuss any issues. This is a meeting for the fellows to have avoice!!17
Calls Home Calls1st Year2nd YearWeeknights3/month (Monday/Thursday)2/month (Tuesday)Weekends1/month (Saturday)1/month (Saturday) Weekend rounds are Saturday/Sunday; fellows are on-callSaturday night ONLYFriday and Sunday nights are FREEAfter weeknight calls, fellows round and then go home by12 pm. ACGME rulesPrivate call room is located on the 3rd floor, room 3368.18
afternoon from 1-5 pm at the Golden Cross Academic Clinic Attending physicians: Dr. Sebastian and Dr. Collazo Clinic is equipped with a centrifuge and microscope for on-site urinalysis Fellows assist each other during clinics Management of patients with CKD, glomerular diseases, kidney stones, hypertension and electrolyte disorders 12
