DEPARTMENT OF INTERNAL MEDICINE
SECTION OF NEPHROLOGY
NEPHROLOGY FELLOWSHIP
TRAINING PROGRAM
Revised year 2004
I. OBJECTIVES:
-
To provide excellent training and learning experience to the trainee in all aspects
of adult clinical nephrology
-
To produce competent, knowledgeable and responsible nephrologists dedicated to the
care of renal patient
II. INSTITUTION
The Chinese General Hospital and Medical Center is a tertiary hospital serving as
many as 600 private and service in-patients and 30 service medical outpatients (excluding
hemodialysis patients) per day. It has a PCP accredited Internal Medicine Residency
Training Program with a medical resident staff of 22.
The facilities of the hospital include:
a.
An emergency room, out patient clinics, intensive and coronary care units (total
of 18 beds), operating room, endoscopy unit, telemetry, cardiovascular OR and RR,
cardiac catheterization laboratory, Cobalt therapy (linear acceleration) unit
b.
Clinical and pathological laboratory, radiology, ultrasonography, CT scan, MRI,
and nuclear medicine
c.
An 18 station hemodialysis unit serving 30 - 40 patients per day with a total of
100 - 150 patients per week
d.
CAPD clinic
e.
Medical library
f.
Medical conference room
III. FACULTIES AND LIST OF GRADUATES
There are five active nephrologists who are all diplomate/fellows of both Philippine
College of Physician and Philippine Society of Nephrology, and six visiting nephrology
consultants.
Active Consultants:
1.
Dr. Alberto Chua - Section Head
2.
Dr. Florencio Ong - Head, Hemodialysis Unit
3.
Dr. Jose Garcia - Head, Kidney Transplantation Committee
4.
Dr. Ruby Lim - Training Officer
5.
Dr. Erleen Ngo - Research Coordinator
Visiting Consultants:
1.
Dr. Josephine Go-Yap
2.
Dr. Arlene Crisostomo- Cabutaje
3.
Dr. Evelyn Sey Go - Service OPD Coordinator
4.
Dr. Ray Tan
5.
Dr. Arnel Chua - Assistant Training Officer
6.
Dr. Dave Tan
List of Graduates of Fellowship Training:
1.
Dr. Erleen Ngo
2.
Dr. Gigi Co
3.
Dr. Manuela Pareno
4.
Dr. Dabbie Que
5.
Dr. Evelyn Sey - Go
6.
Dr. Rachel Chua
7.
Dr. Helen Villaret
Nephrology Fellows in Training: year 2004
1.
Dr. Marites B. Madrazo - Second year fellow
2.
Dr. Jeanne Marie Michel Monzon - First year fellow
IV. Qualification of Trainee Entering Fellowship Training Program
- He/She must complete a three
year residency training program in Internal Medicine, duly accredited by the Philippine
College of Physician
- Preferably a Diplomate of Philippine
College of Physician
V. Target Competencies for Renal Fellows as Recommended by the PSN
First Year Level
1. Thorough knowledge and understanding of:
a.
Elements of normal anatomy and physiology of the kidneys
b.
Pathogenesis and pathophysiology of renal diseases and its complications
c.
The basic principles in peritoneal dialysis and hemodialysis
d.
Indications, contraindications and complications of renal biopsy
2. Development of sufficient skills in:
a.
Obtaining an accurate and thorough nephrological history and physical examination
b.
Choosing appropriate laboratory and diagnostic tools
c.
Integrating, interpreting and analyzing data to establish
a diagnosis (including special diagnostic tools)
- Urinalysis
- X-ray, ultrasound and scan of kidneys and urinary tract
- Renal histopathology (Light microscopy interpretation)
d.
The management of:
- 10 syndromes in nephrology ( AN, NS, AU, ARF, CRF, UTI, UO, NL, TD,
HPN)
- Fluids and electrolyte problems
- Acid base disorders
3. Clinical exposure in:
a.
Acute and chronic peritoneal dialysis (including peritoneal access placement)
b.
Acute and chronic hemodialysis (including vascular access placement)
c.
Research:
· An approved prospective study proposal within the first year
4. Development of the following attitudes:
a.
Integrity, respect and compassion for patients and their families
b.
Desire to learn and update knowledge and skills
c.
Dedication to duty and commitment to patient care
d.
Desire to teach and share knowledge
e.
Consistent demonstration of high standard of moral and ethical behavior
Second Year Level
At the end of the second year, the trainee is expected to have:
1.
The same competencies as the first year level but with
greater proficiency. He/She must have full comprehension and in-depth knowledge
of the science of Nephrology, including recent researches and development. With
this knowledge, he/she should be able to serve as a Nephrology specialty consultant
and teacher. Furthermore, he/she should have:
· Basic knowledge of transplant immunology
· Adequate knowledge on the indications and contraindications for renal transplantation
· Basic knowledge of transplant-related medical problems
· Clinical exposure in:
i. Chronic peritoneal dialysis catheter insertion
ii. Dual lumen jugular, subclavian or femoral catheter insertion
iii. Other extracorporeal dialysis modalities ( Continuous Renal Replacement Therapy
e.g. CVVH, CVVHD, SCUF etc)
2.
Development of same skills as the first year level
but with greater proficiency.
Furthermore, he/she is expected to have developed skills in:
a. Performing percutaneous kidney biopsy
b. Research: at least one prospective study output
3.
Development of the same attitudes as the first year level but with the demonstration
of confidence in utilizing his/her knowledge and skills in nephrology
VI. ACTIVITIES
A. Conferences
There will be regular lectures/conferences conducted by the trainee under the supervision
of the nephrology consultants.
Schedule as follows:
First Wednesday of the month ----- Renal Physiology Seminars (Brenners)
Second Wednesday of the month ----- Special Conferences (Urology, Renal
Pathology, Radiology etc.)
Third Wednesday of the month ----- Journal Club
Fourth Wednesday of the month ----- Grandrounds
Fifth Wednesday of the month ----- Consultant's Lecture
First Friday of the month ----- Service OPD and Ward Census and
Morbidity and Mortality Conference
B. Clinical Rounds (Duties and Responsibilities)
·
The
trainee shall conduct teaching and working rounds on all patients admitted at the
nephrology service with the medical residents and interns rotating under the nephrology
subspecialty, and shall be in charge of all patients under the nephrology service
in coordination with the attending nephrologists.
·
He/She
shall be responsible for the patients referred to the nephrology service and shall
answer all consults promptly.
·
All
service patients shall be directly under the care of the nephrology fellow with
the supervision of the consultant on call.
·
He/She
shall make rounds at the dialysis unit and attend to the medical needs of these
patients in the absence of the nephrology consultants.
·
He/She
shall see patients at the OPD Charity Nephrology subspecialty clinic on their designated
days (half-day per week per trainee).
·
The
trainees are encouraged to actively participate in the care of all renal patients
and to interact with the nephrology consultants.
·
He/She
shall be responsible for the submission of the renal disease registry given every
quarter to the Renal Registry Committee.
·
The
trainee will be required to have a logbook for all the cases he/she has handled,
conferences attended/conducted and procedures done while in training.
C. Procedures:
The trainee is expected to assist and perform basic procedures like:
1.
Renal Biopsy
2.
Placement of PD Catheter
3.
Placement of vascular access (subclavian, jugular and femoral)
D. Rotation:
The Nephrology fellow will rotate at the National Kidney Institute and Transplant
Center for one month as a requisite for renal transplantation exposure.
Likewise, elective rotations in ultrasonography. CT scans and renal pathology will
be arranged with the respective department.
E. Evaluation:
1.
Written examinations will be given to the trainee twice a year.
2.
Completed research paper in the field of nephrology shall be submitted at the end
of the academic year of training as a requirement for promotion and/or graduation.
3.
The overall performance of the trainee in the above activities and with respect
to the expected target competencies shall be evaluated periodically by the faculty
and feedback shell be given to the trainee accordingly.