CRITERIA FOR SUCCESSFUL COMPLETION OF 2ND YEAR CLINICAL FELLOW
The second year of training is designed to further prepare the fellow for a career in academic nephrology or private practice by developing more extensive experience in outpatient and inpatient nephrology to develop independence as a clinical nephrologist, and by engaging in nephrology research and scholarly activity. Second year nephrology fellows through their rotations continue to provide care of hemodialysis, peritoneal dialysis, and renal transplant patients with supervising teaching faculty members throughout the year. The fellows continue in the continuity clinic to gain additional longitudinal experience with outpatients. It is anticipated that trainees in their 2nd year will assume a greater role in decision making and will offer supervision to 1st year trainees.
The specific educational goals for the second year of training are similar to and build upon the goals of the first year of training. However, second year trainees are expected to take a more independent role in clinical decision making and to focus more of their attention on teaching first year fellows, residents and students. The curriculum topics listed for each rotation and others covered in clinical and didactic settings, are the same for second year fellows.
Specific competency-based goals for the second year of training in Nephrology (by rotation subtype):
1. Continuity Clinics/Outpatient Rotations/Dialysis Rotations
a. Patient care: Fellows will continue to evaluate a mix of patients, both for their initial visit as well as in follow-up (see patient mix above). We expect all history and physical examinations to be complete and accurate in terms of the entire renal evaluation by the completion of this year. Similarly, we expect that the second year trainee will be able to establish appropriate diagnostic and therapeutic care plans and present those concepts to the faculty.
b. Medical knowledge: Fellows are expected to continue to read widely regarding their patient encounters. At the completion of the year, second year trainees should be able to site relevant literature and provide a scientific basis for their decisions.
c. Practice-based learning and improvement: All fellows will gain experience in the analysis of practice patterns and decision making both through critique in the clinic and discussions in conference. We expect second year trainees to be able to recognize areas in which practice decisions may not be clear-cut and to identify proper practice through their reasoning skills and re-evaluation of clinical experience.
d. Interpersonal skills and communication skills: We fully expect second year trainees to interact in a respectful and productive way with all patients. Similarly, a year 2 trainee will be able to discuss in a collegial and concise fashion patient care with referring physicians. All communications, either written or verbal, will be at the level of a faculty member by the completion of the second year of training.
e. Professionalism: Similar to interpersonal skills, we expect that our fellows, from the initial time of their training, will maintain a highly professional attitude with patients, medical staff, peers and faculty.
f. Systems-based practice: Year 2 trainees will be familiar with the full spectrum of diagnostic studies employed at the University of Texas Southwestern Medical Center and be able to integrate those capabilities into their discussions with physicians from outside of the university. Similarly, second year trainees will recognize the regulations/requirements of our regional healthcare insurers and thereby be facile in selecting appropriate medical care for most situations.
2. Consultative service/Transplantation Service
a. Patient care: Fellows will provide the initial evaluation for all patients, both for their initial evaluation as well as in follow-up during their hospital stay. For the second year trainee, we expect all history and physical examinations to be complete and accurate in terms of the renal diagnosis and all related issues. Fellows will convey all medical decisions to the consulting service and serve as the liaison to the renal clinic for follow-up after discharge. By the completion of the second year we expect fellows to recognize renal emergencies, direct appropriate renal care and provide patients with needed medical support as well as to document proper follow-up.
b. Medical knowledge: As in the outpatient setting, fellows are expected to read widely regarding their patient encounters. By the completion of their second year, we expect fellows to have the knowledge to independently formulate a complete differential diagnosis, outline required studies needed to identify causative conditions and recognize the appropriate care plan for each individual. Presentations to faculty will be thorough, thoughtful and contain predictions as to patient outcomes/performance. Year 2 trainees will be able to provide decisions regarding diagnostic or care plans on an independent basis before review of the case by the faculty member.
c. Practice-based learning and improvement: fellows will continue to gain experience in the analysis of practice patterns and decision making both through critique in the clinic and discussions in conference. Through discussion of the medical literature, we expect second year trainees to be able to refine their skills such that analysis of patient care and outcomes is an integral part to their decision-making abilities.
d. Interpersonal skills and communication skills: We fully expect second year trainees to interact in a respectful and productive way with all patients. Similarly, all communications with other physicians, either via written work (dictations) or direct verbal contact is appropriate and effective.
e. Professionalism: Similar to interpersonal skills, we expect that our fellows, from the initial time of their training, will maintain a highly professional attitude with patients, medical staff, peers and faculty. Year 2 trainees are expected to have mastered the need for clear and concise transmission of information to those also participating in any patient’s care.
f. Systems-based practice: Year 2 trainees will be familiar with the full spectrum of diagnostic studies employed at the various teaching hospitals and be able to integrate those capabilities into their discussions with physicians from outside of the training program.
Created November 21, 2006 Updated by Megan Johnson
