First Fellowship Year
The first year of fellowship is largely inpatient consultative exposure. Each fellow rotates through inpatient services at three training sites, each of which provides a diverse clinical experience spanning the spectrum of clinical nephrology.
Each fellow has eight weeks of elective/ambulatory time during the first year. This elective time allows fellows to explore subspecialty clinics, interventional nephrology exposure, pheresis exposure, and other research opportunities. First year fellows also participate in outpatient kidney biopsies during their elective time as well as outpatient vascular clinic.
A longitudinal clinic is started in the first year of fellowship at either the Perelman Center for Advanced Medicine (PCAM) or Penn Presbyterian Medical Center (PPMC). This longitudinal clinic is maintained during the second year of fellowship.
Second Fellowship Year
The second year of training for fellows in the clinical track allows fellows to refine their clinical skills and expertise and prepares them for independent practice. Second year fellows continue to participate in the inpatient consultative service for 10-12 weeks, with increasing independence.
Second year fellows maintain their continuity clinic from first year and also add a second continuity clinic at the VA Medical Center, in order to enhance exposure to outpatient medicine. During this year, fellows maintain a longitudinal dialysis experience in both in-center hemodialysis and home dialysis clinics (peritoneal dialysis and home hemodialysis) at one of the many dialysis clinics in close proximity to the hospitals.
Elective opportunities during the second year include the following:
- Glomerular Disease Clinic
- Onconephrology Clinic
- Complex Hypertension Clinic
- Kidney Stone Clinic
- Pheresis service (inpatient and outpatient)
- GU Radiology
- Critical care inpatient service
- Pediatric nephrology (Childrens Hospital of Pennsylvania)
- Transplant Clinic
- Interventional Radiology
- Palliative nephrology
Scholarship activity in the second year includes participation in a Quality Improvement project and leading a Renal Grand Rounds on a topic of their choice. Many of our fellows are also engaged in research projects with Penn faculty within the division and beyond.
Nephrology Fellowship Curriculum
Regularly scheduled conferences include:
Renal Grand Rounds
12:00-1:00 PM: Medical Grand Rounds
*Case Conferences are led by fellows with attending nephrology support. These conferences include the following:
- Multidisciplinary series, including palliative care, cardiology, critical care colleagues
- Glomerular Disease series
- Renal Physiology series
- Nephrology journal club
- Board Review (2nd half of year)
HUP Consultation Service
Three consultative services are present at HUP, with division based on geographic localization within the hospital. Two consultative services are comprised of one attending nephrologist and one nephrology fellow, and occasionally medical students and rotating medicine residents. These two services are predominantly based in intensive care units, providing consultative services for the several intensive care units housed within HUP, including surgical, cardiothoracic, medicine, neuro, and oncology critical care. The third service is comprised of one attending nephrologist, one nephrology fellow, and a nurse practitioner, with a focus on care of inpatients with end-stage kidney disease requiring dialysis. The HUP consultation service provides care for complex patient needs, including oncologic emergencies, obstetric/gynecology inpatients, critical care to name a few.
HUP Transplant Service
The Transplant service is managed by a transplant nephrologist and includes a transplant fellow, a nephrology fellow, and an advanced practitioner. The transplant service works closely with the Transplant Surgery team to provide care for patients who have undergone solid organ transplantation, including kidney, liver, pancreas, heart, and lung transplant. During this rotation, fellows gain significant exposure to kidney transplant care as well as management of non-kidney solid organ transplant complications.
PPMC Consultation Service
Two consultative services are present at PPMC, including a general consult service and a dialysis consult service. The consult service is comprised of one attending nephrologist and one nephrology fellow and often medical students and rotating medicine residents. The dialysis consult service is staffed by one attending nephrologist and two advanced practitioners.PPMC is the level one trauma center for the University of Pennsylvania Health System and is also home to the Penn Lung Rescue Program, which expands access to ECMO by means of a mobile team.
Philadelphia VAMC Consultation Service
One consultative service is present at the VAMC, with one attending nephrologist and one nephrology fellow as team members. The care provided at the VA focuses on management of chronic illnesses and includes critical care and general nephrology consults.