During the 36 month training period, each fellow will spend 12 months on our inpatient clinical service. The remaining months of fellowship are reserved for scholarly activity and electives (Pediatric Urology, Renal Pathology, and Renal Radiology). Throughout training fellows spend 1 afternoon each week in a continuity outpatient clinic and an additional afternoon in a rotating sub-specialty clinic such as transplant or hypertension. Though each fellow’s schedule is individualized, a basic outline is provided below.
The first year serves to create a solid clinical base in pediatric nephrology. This year is also used to begin basic coursework in the Clinical Research Curriculum, and to work with a mentor to begin to narrow the scope of scholarly interests. As the fellow on the nephrology service for 3-4 months, you will receive hands-on training in managing patients admitted to the nephrology service at Children’s Memorial Hermann Hospital. In addition, you will gain expertise in providing consultation to other services including the PICU, NICU, general pediatrics, and all other teams. We also provide consultation services to the University of Texas MD Anderson Cancer Center, the Women’s Hospital of Texas, and LBJ Hospital (the Harris County Hospital for indigent patients). Fellows learn to manage many disorders, including acute kidney injury and chronic kidney disease, hypertension, fluid and electrolyte imbalances, acid-base disorders, new and relapsing nephrotic syndrome, acute and chronic glomerulonephritis, hemolytic-uremic syndrome, new and established renal transplant recipients, as well as both peritoneal and hemodialysis patients. Our fellows learn to manage all acute dialytic modalities hemodialysis, peritoneal dialysis, and continuous renal replacements in the form of both CRRT and SLED.
Though not always completed in the first year, two months of fellowship are devoted to the outpatient Pediatric Dialysis Unit. The fellow works with dialysis nurses and our faculty to learn the technical aspects of dialysis procedures, vascular access, how to set up and troubleshoot dialysis machines, and understand some of the duties of the dialysis Medical Director.
During the first year, fellows also identify their chosen research tract: basic or clinical scientist. They select members of the Scientific Oversight Committee (SOC) and begin the early phases of their research project.
The second year of fellowship is devoted more to pursuit of scholarly activity. Fellows ideally complete the clinical research training provided in the Clinical Research Curriculum and may opt to begin advanced coursework by pursuing a Masters in Clinical Research through the Center for Clinical Research and Evidence-Based Medicine. They will begin work on their research project under the guidance of their mentors and SOC. Clinical responsibilities will include outpatient clinics two days a week, 3-4 months of inpatient nephrology service, and monthly weekend coverage.
The fellow will complete his or her research projects and write the related abstracts and manuscripts. In addition to their main scholarly project, many fellows often use this time to also publish case reports, present posters at national scientific meetings, and coauthor book chapters and review articles. Fellows complete the rest of their required service time, with the final inpatient month spent as “acting attending”, in which they will supervise residents in a capacity similar to an attending, with ongoing support from the nephrology attending.