Nephrology Fellowship (ACGME) - What to Expect & Rotations

Overall Goals of Nephrology Fellowship Training Program

The overall goal of the Nephrology Fellowship training program at Kaiser Permanente in San Francisco is to educate and train the next generation of clinician leaders.

Specific Goals

1. To provide two years of subspecialty training so trainees acquire clinical skills and knowledge beyond the minimal requirements stipulated by ABIM for subspecialty certification.
2. Foster an environment of intellectual curiosity and investigation that promotes scholarship and clinical research during fellowship and promotes life-long self-learning.
3. To develop the many humanistic qualities and interpersonal skills, critical thinking skills, and professional attitudes that enable trainees to excel as Nephrology specialists.
4. To promote wellness during fellowship including support for a work-life balance through monitoring work and call duty hours.
5. To instill in trainees the desire and skills to educate colleagues, junior trainees, students, other medical staff members, patients, and patient families about electrolyte abnormalities, chronic kidney disease, acute kidney injury, dialysis therapies, glomerular disease, and kidney transplant.
6. To assist trainees in their research pursuits and help guide them to design and complete research that helps them on the road to achieving future career aspirations.
7. To train fellows in communicating with patients about end of life topics in a manner that is compassionate and empathetic.

Sample schedule by fellowship year

General principles include:

Outpatient clinic

Continuity Clinic runs throughout the year for one-half day per week. There are additional half-day outpatient clinics for transplant clinic, in-center hemodialysis, peritoneal dialysis, and home hemodialysis. Fellows will also have protected time to attend the Glomerular Diseases and Polycystic Disease regional boards when not on inpatient consult services.

Training sites

Most clinical duties will be at KP San Francisco’s main campus (2425 Geary Boulevard, located in the center of San Francisco). One month of Inpatient consults in your first & second year will occur at Kaiser Oakland, a 45-minute commute by car or mass transit from KP San Francisco Medical Center. One month of Outpatient Home Dialysis in your first year will occur at KP Santa Clara, a 1-hour commute by car. A two-month kidney transplant rotation will be at UCSF each year, a 10-minute commute from the main KP San Francisco Campus. Each year, there will also be a 2-week rotation in the Stone Clinic at KP South San Francisco (currently virtual), along with 2 weeks in Renal Pathology at Stanford University which will be a hybrid of virtual and in-person. There will be no on-call responsibilities at the San Francisco medical center when at these locations.

Conferences

A 40-week comprehensive nephrology introduction and review course on key topics will be held every year taught by local faculty, regional or outside experts. There will be rotating weekly or twice weekly conferences including journal club, M&M case review, QA/QI, research review.

Research

Our Regional Glomerular Disease Program encompasses 13 nephrologists, a dedicated glomerular disease clinic, and weekly multidisciplinary glomerular disease case reviews with pathologists and other medical specialties (e.g., rheumatology, genetics, oncology, high-risk maternal-fetal medicine). This regional glomerular disease program is actively involved in caring for ~400 patients with complex glomerular disorders and oversees the population health program of approximately 6000 patients with glomerular diseases. Our glomerular disease program has established a registry to assess and improve renal biopsies’ outcomes, is creating a glomerular disease registry for comparative effectiveness studies and has initiated two clinical trials for patients with glomerular disease. This program will provide fellows the opportunity to engage in quality improvement/quality assurance initiatives and scholarly activities.

Rotation Schedule