2019-2020 M3/M4 Course Syllabi
Internal Medicine
COURSE NUMBER:
07 23 06
TITLE:
NEPHROLGY & HYPRTEN UH -IM -ICE
This elective provides a basic experience in inpatient and outpatient nephrology and hypertension through active participation with independence and supervision appropriate to the level of training, interest and capabilities demonstrated. All facets of nephrology are encountered: acute and chronic renal failure; fluid and electrolyte disorders; peritoneal and hemodialysis, etc.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP)

Review of Renal Physiology, Pathology, and Pharmacology of diuretics and anti hypertensive drugs.

Must be fourth year student.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
YES
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: YES
COURSE LENGTH:
4 wks
DIRECTOR:
Satwant Singh, MD
singhs@ucmail.uc.edu
558-5471
MSB, 6214
ADMINISTRATIVE SUPPORT PERSON:
Julie Karpe
Julie.Karpe@uc.edu
558-2426
MSB, 3504
INSTRUCTOR:
AjaySrivastava, MD
SITE(S):
UCMC - University of Cincinnati Medical Center
VAMC
MAX ENROLL:
2  MAX/YR: 22
ROTATIONS:
Rotation Dates Max
1 07/08/2019 - 08/02/2019 2
2 08/05/2019 - 08/30/2019 2
3 09/03/2019 - 09/27/2019 2
4 09/30/2019 - 10/25/2019 2
5 10/28/2019 - 11/22/2019 2
6 11/25/2019 - 12/20/2019 2
7 01/06/2020 - 01/31/2020 2
8 02/03/2020 - 02/28/2020 2
9 03/02/2020 - 03/27/2020 2
10 03/30/2020 - 04/24/2020 2
11 04/27/2020 - 05/22/2020 2
12 05/25/2020 - 06/30/2020 2

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00AM-5:00PM, Mon-Fri; 8:00AM-12:00PM, Sat
REPORT 1ST DAY:

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
ORIENTATION:
Attending
TEACHING:
75% Attending Physician
25% Senior Resident
FEEDBACK:
Faculty
ASSESSMENT:
FINAL GRADE:
70% Clinical work performance evaluations
15% Attitude, e.g., professionalism, motivation etc
15% Topic presentation
GRADE ASSIGNED BY: Course director

OBJECTIVES

Attitudes :

1. Recognize the importance of effective communication between the consultant and the patient and family members and the primary care providers.

2. Recognize the important teaching role the consultant plays for both the patient and the primary care physician.

3. Recognize the importance of practicing evidence based medicine through the development of critical literature appraisal skills and developing self directed learning.

4. Importance of professionalism in the practice of medicine.

Curricular Resources :

Renal Ward Syllabus - a compilation of key articles

Renal and Electrolyte Disorder, R. W. Schrier, ed., Little Brown and Co.

Knowledge/Skills:

1. Recognize and describe clinical problems of the kidney and urinary tract, water-electrolyte metabolism, acid-base homeostasis and hypertension.

2. Enrich the skills of history taking and physical examination related to the above clinical problems.

3. Enrich the urinalysis techniques and its interpretation.

4. Interpret other laboratory tests including radiography useful in the assessment of renal problems with understanding of their limits.

5. Formulate conservative management plans for acute and chronic renal failure, with emphasis on nutritional management.

6. Enunciate indications for dialysis (hemo and peritoneal) in acute and chronic renal failure.

7. Modify the use of drugs in renal failure.

8. Formulate diagnostic and therapeutic plans for hypertension in outpatient and inpatient setting.

9. State cost-effectiveness and risks/benefits of common diagnostic and therapeutic strategies.

10. Enunciate preventive measures in renal disease and hypertension.

11. Discuss ethical issues as relevant to circumstances of the patient with special emphasis in situations involving life sustaining therapies like dialysis.

Main Course Topics :

  1.  Renal physiology

  2.  Urinalysis

  3.  Hematuria

  4.  Nutrition in renal disease

  5.  Hyponatremia and hypoosmolar states

  6.  Hypernatremia and hyperosmolar states

  7.  Volume depletion

  8.  Volume expansion/edema status

  9.  Metabolic acidosis

 10.  Metabolic alkalosis

11.  Acute kidney injury

12.  Chronic kidney diseases

13.  Hypertension

14.  Diabetic nephropathy

15.  Urinary tract Infections

16.  Dialysis - hemo, peritoneal & continuous

17.  Procedures (temporary vascular access and renal biopsy)

18.  Modification of drug dose in renal failure

19.  Prevention of renal disease

20.  Cost effectiveness and risk-benefit ratios of various diagnostic and therapeutic options

21.  Critical appraisal of literature

22.  Ethical issues

23.  End of life care issues

Objectives:

See other objectives.

Other Resources - Audiovisuals:

In Fellow's office.

Other Resources - Computer resources:

Rose & Burton: Update in Nephrology CD Rom teaching aid (available in Fellows’ Office) and all computers in MSB and hospital.

 

Other Resources - Other :

Urinalysis station

Procedures:

1. Perform proper urinalysis

2. Observe the following procedures:

    a. Temporary vascular access for hemodialysis

    b. Hemodialysis

    c. Peritoneal dialysis

    d. Renal biopsy (variable)

SAMPLE WEEK

Monday:
9:00AM 1:00PM Rounds*
1:00PM 2:00PM Physiology Review/Journal Club
2:00PM 5:00PM Reading time/Article Review w/ Fellows/ "Class Rm" Teaching w/ Attending
Tuesday:
8:00AM 8:30AM VA Housestaff Teaching 4 North
8:30AM 12:00PM VA Renal Consult Service
12:30PM 1:30PM Clinical Conference MSB 3457
2:00PM 5:00PM Rounds*
Wednesday:
9:00AM 12:00PM Rounds*
12:00PM 1:00PM Medical Grand Rounds MSB 7051
2:00PM 5:00PM Reading Time/ Article Review w/ Fellows/ "Class Rm" Teaching w/ Attending
Thursday:
8:00AM 9:00AM Fellow's Conference (Core Lecture Series) MSB 3457
9:00AM 12:00PM UH Renal Consult Service
1:00PM 5:00PM Hypertension Clinic Hoxworth Center 2307
Friday:
9:00AM 12:00PM Rounds*
1:00PM 2:00PM Journal Club/ Research Conference MSB 6051
2:00PM 5:00PM Reading Time/ Article Review w/ Fellows/ "Class Rm" Teaching w/ Attending
SCHEDULE NOTE:

Saturday 9:00-12:00 Rounds*

* Actual times vary from attending to attending.

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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