Internal Medicine
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), 26931373 (INTERNAL MEDICINE CORE CLKSP)
Successfully complete the Internal Medicine Core Clerkship.
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GENERAL INFORMATION
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
STATUS:
Full-Time
OFFERED AS FULL-TIME AND PART-TIME:
NO
ALLOWS OVERLAP:
NO
DIRECTOR:
Amit Govil, MD
govilat@ucmail.uc.edu
558-5471
MSB, 6213
ADMINISTRATIVE SUPPORT PERSON:
Gabriela Ionascu
ionascgi@ucmail.uc.edu
513-558-2592
MSB, 6055A
SITE(S):
UCMC - University of Cincinnati Medical Center
ROTATIONS:
Rotation |
Dates |
Max |
1 |
05/06/2024 - 05/31/2024 |
2 |
2 |
06/03/2024 - 06/28/2024 |
2 |
3 |
07/01/2024 - 07/26/2024 |
2 |
4 |
07/29/2024 - 08/23/2024 |
2 |
5 |
08/26/2024 - 09/20/2024 |
2 |
6 |
09/23/2024 - 10/18/2024 |
2 |
7 |
10/21/2024 - 11/15/2024 |
2 |
8 |
11/18/2024 - 12/13/2024 |
2 |
9 |
12/16/2024 - 01/10/2025 |
0 |
10 |
01/13/2025 - 02/07/2025 |
2 |
11 |
02/10/2025 - 03/07/2025 |
2 |
12 |
03/10/2025 - 04/04/2025 |
2 |
13 |
04/07/2025 - 05/02/2025 |
0 |
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:
8:00 AM - 5:00 PM, Mon-Fri
REPORT 1ST DAY:
Will get email with detailed information prior to the first day.
INSTRUCTION
LEARNING ACTIVITIES:
- Case-Based Instruction/Learning
- Clinical Experience - Ambulatory
- 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.
TEACHING:
75% |
Attending Physician |
25% |
Fellow Physician |
ASSESSMENT:
Evaluation by Faculty
ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Narrative Assessment
FINAL GRADE:
GRADE ASSIGNED BY:
Course director
OBJECTIVES
Curricular Resources :
- National Kidney Foundation's Primer on Kidney Diseases. Gilbert, Scott J, Weiner, Daniel E., et al. 8th Edition, 2022.
- Rose & Burton: Update in Nephrology. Available on all computers in the MSB and hospital.
Instructional Methods:
- Clinical Experience - Inpatient
- Clinical Experience - Ambulatory
- Discussion-Small Group (Small Group (=12)
- Independent Learning
- Patient Presentation--Learner
- Self-Directed Learning
- Ward Rounds
Knowledge/Skills:
- Recognize and describe clinical problems of the kidney and urinary tract, water-electrolyte metabolism, acid-base homeostasis and hypertension.
- Enrich the skills of history taking and physical examination related to the above clinical problems.
- Enrich the urinalysis techniques and its interpretation.
- Interpret other laboratory tests including radiography useful in the assessment of renal problems with understanding of their limits.
- Formulate conservative management plans for acute and chronic renal failure, with emphasis on nutritional management.
- Enunciate indications for dialysis (hemo and peritoneal) in acute and chronic renal failure.
- Modify the use of drugs in renal failure.
- Formulate diagnostic and therapeutic plans for hypertension in outpatient and inpatient setting.
- State cost-effectiveness and risks/benefits of common diagnostic and therapeutic strategies.
- Enunciate preventive measures in renal disease and hypertension.
- Discuss ethical issues as relevant to circumstances of the patient with special emphasis in situations involving life sustaining therapies like dialysis.
Main Course Topics :
- Renal physiology
- Urinalysis
- Hematuria
- Nutrition in renal disease
- Hyponatremia and hypoosmolar states
- Hypernatremia and hyperosmolar states
- Volume depletion
- Volume expansion/edema status
- Metabolic acidosis
- Metabolic alkalosis
- Acute kidney injury
- Chronic kidney diseases
- Hypertension
- Diabetic nephropathy
- Urinary tract Infections
- Dialysis - hemo, peritoneal & continuous
- Procedures (temporary vascular access and renal biopsy)
- Modification of drug dose in renal failure
- Prevention of renal disease
- Cost effectiveness and risk-benefit ratios of various diagnostic and therapeutic options
- Critical appraisal of literature
- Ethical issues
- End of life care issues
Procedures:
1. Perform proper urinalysis
2. Observe the following procedures as available:
a. Temporary vascular access for hemodialysis
b. Hemodialysis
c. Peritoneal dialysis
d. Renal biopsy
SAMPLE WEEK
Monday:
8:30AM |
12:00PM |
Consult Rounds |
12:00PM |
1:00PM |
Monday Lecture Series (variable) |
1:00PM |
4:00PM |
Consult Rounds |
4:00PM |
5:00PM |
Independent Study with Fellows/Residents |
Tuesday:
8:30AM |
12:30PM |
Consult Rounds |
12:30PM |
1:30PM |
Clinical Conference Series |
1:30PM |
3:30PM |
Consult Rounds/Follow up |
4:00PM |
5:00PM |
Independent Study with Fellows/Residents |
Wednesday:
8:00AM |
9:00AM |
Core Curriculum Conference |
9:00AM |
12:00PM |
Consult Rounds |
12:00PM |
1:00PM |
Medical Grand Rounds (5051 or 7051 changes seasonally) |
1:30PM |
4:00PM |
Consult Rounds/Follow up |
4:00PM |
5:00PM |
Independent Study with Fellows/Residents |
Thursday:
8:30AM |
1:00PM |
Consult Rounds |
1:00PM |
5:00PM |
Hoxworth Renal Clinic, 2nd Floor |
Friday:
8:30AM |
12:30PM |
Consult Rounds |
12:30PM |
1:30PM |
Kidney CARE Grand Rounds |
1:30PM |
3:30PM |
Consult Rounds/Follow up |
4:00PM |
5:00PM |
Independent Study with Fellows/Residents |
SCHEDULE NOTE:
Actual rounding times vary from attending to attending.
Nephrology fellows' office is MSB 6102
Email Theresa Huber at marlowta@ucmail.uc.edu if the conference schedule is needed.
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.