Internal Medicine - Nephrology

General Information
Facilities and Resources
Clinical Rotations
Seminars
Research Programs
Information for New Applicants

Welcome to the University of Kentucky Nephrology Fellowship page. In this section you will find general information about the fellowship program, the various clinical rotations, conference schedule as well as pertinent information to prospective applicants who are interested in our program. We are proud that many outstanding nephrologists were graduated from this program with a 100% 5-year pass rate in the ABIM subspecialty board.

Sincerely,

Peter Sawaya, MD, FACP, FASN
Professor of Medicine
Fellowship Program Director

General Information

The Division of Nephrology, Bone and Mineral Metabolism at the University of Kentucky Medical Center (UKMC) offers training for fellows interested in both clinical practice and academic medicine.  The clinical experience includes opportunities to observe and manage patients with a wide variety of kidney-related diseases on an inpatient and outpatient basis.  The trainees are given opportunities to assume continued responsibility for both acute and chronically ill patients in order to learn the nature and history of renal diseases as well as the effectiveness of therapeutic approaches.  They also actively participate in various seminars offered in the program.  The objective of the clinical training is to provide fellows with a comprehensive experience in all aspects of clinical nephrology to enable them at the end of the training period to approach any renal problem with confidence.

The duration of the training is two years with a minimum of 18 months devoted to clinical experience.  An additional third year of experience may be extended for further training in basic research. Currently we accept 2 fellows per year. Please see the section  “Information to Prospective Fellows” for further guidance about the application process.

Facilities and Resources

Fellows in training rotate at the University of Kentucky A.B. Chandler Medical Center (UKMC) and the adjacent VA Medical Center (VAMC). UKMC consists of 440 beds with 8 intensive care units and a burn unit. It also has an acute dialysis unit with 8 stations and a capability of performing 5 simultaneous bedside acute dialyses. The VAMC has 290 beds with two intensive care units. It also has a dialysis unit with 8 chronic and 4 acute stations and a capability of performing 3 simultaneous bedside acute dialyses. Both hospitals are modern and state-of-the-art.

The program also includes an active transplantation service, allowing trainees to gain extensive and supervised experience in renal transplantation and immunosuppression.  There are also facilities for performing plasmapheresis all types of continuous renal replacement therapies.

In addition to the above, the following facilities and services are available: modern invasive radiology service, diagnostic radionuclide laboratory, fully equipped laboratory services, a pathology department with a full-time renal pathologist and on-site electronmicroscopy. A meaningful working relationship exists with all the surgical subspecialities including the Departments of Urology and Vascular Surgery, as well as the Departments of Obstetrics/Gynecology, Pediatric Nephrology, and a team of renal nutritionists and social worker services.

Clinical Rotations

The goal of this program is to provide trainees with opportunities to develop clinical competence in the fields of nephrology, hypertension, and renal replacements therapies. To achieve this goal, ample numbers of new and follow-up patients of appropriate ages, including the adolescent and geriatric age groups, and of both genders are available for each trainee. Throughout the training period within the program, trainees are allowed increasing responsibility in the performance of procedures and in the decision-making process in patient care. Toward the end of the program, they are allowed to make independent decisions that are then discussed with faculty.

UK/VA Non-ICU Consult Service:

During their two years of training, nephrology fellows spend approximately 5 to 6 months on this service. Under direct faculty supervision, the trainees, and other members of the team, evaluate approximately 45–60 consults per month. We currently care for approximately 175 chronic hemodialysis patients (HD) and 35 chronic ambulatory peritoneal dialysis (PD) patients. In addition, our institution is a major referral center for the tertiary care of many ESRD patients followed by outside nephrologists in central and southeastern Kentucky.

UK/VA ICU Consult Service:

During their two years of training, nephrology fellows spend approximately 5 to 6 months on this service. Under direct faculty supervision, the trainee evaluates approximately 20–25 new UK and 5-10 new VA ICU consults per month. On average, the trainee will care for 6-8 UK and 1-3 VA ICU patients per day.

Transplant Service:

During their two years of training, nephrology fellows spend approximately 3-4 months on this service. Under direct faculty supervision, the trainee evaluates approximately 4-5 new transplant patients and 25-30 hospitalized transplant patients per month. On the average, the trainee will care for 6-10 hospitalized transplant patients per day.

Ambulatory Medical Experience:

Parallel to the clinical rotations described above, trainees participate in ambulatory medical care for patients with all stages of kidney disease, including ESRD.

Out-Patient Dialysis Experience:

Throughout the duration of their training and under direct faculty supervision, trainees assume responsibilities of the out-patient management of 8-12 HD patients. The dialysis staff are instructed to contact first the designated renal fellow for any question or concern regarding these patients. In addition, nephrology trainees assume the responsibility of the out-patient management of 30-35 home PD patients for 5-6 months during their training.

Longitudinal Out Patient Clinic Experience: 

Trainees spend throughout their two years of training two-half days per week in the renal clinics to gain experience in consultative as well as continuing care. On average, trainees are responsible for 1-3 new patients and 8-12 return patients per week.

Elective Rotations:

One month during their first clinical year and 1 to 2 months during their second year, trainees are permitted to take any of the following elective rotations:

Renal Pathology (4 weeks)

Renal Radiology (2-4 weeks)

Pediatric Nephrology (4 weeks)