At University of Maryland School of Medicine, we are training future Nephrologists to be ready for any challenges in the management of their patients, and acquiring clinical skills is a major part of it. All fellows are trained and achieve proficiency in the following skills:
HD Catheter Placement
HD catheter placement is a clinical skill every Nephrologist should have and is an ACGME requirement as well. Fellows perform placement of 3 femoral and 3 IJ catheters under ultrasonic guidance with attending supervision during their ICU rotations. This is the minimum number and fellows can perform more procedures if they so desire. Second year fellows also have an Interventional Nephrology elective where they can learn more about Tunneld HD catheters and their placement.The fellows are also trained in the simulation lab at the MASTRI center at Univ of Maryland medical center to be familiarized in the palcement of HD catheters.
A useful clinical skill is performance of a quick, bedside ultrasound, keeping in view what is essential for a Nephrologist managing ICU patients. The fellows will be trained to check a quick kidney ultrasound, to r/o hydronephrosis, or structural kidney problems, and learn to perform a quick bedside Echocardiogram with assessment of IVC to have an idea of the cardiac function and intravascular volume status.
The fellows perform a large number of diagnostic native and transplant kidney biopsies during their training. All renal biopsies are reviewed on a daily basis with the nephrologists, nephrology fellows, and nephropathologist. In addition, they actively participate in the weekly multidisciplinary meetings to review all the kidney and pancreas transplant biopsies of the week and monthly meeting for an in-depth discussion of selected cases undergone native kidney biopsy