Clinical Rotations: Fellows
Fellows will rotate through 5 clinical services at 3 training sites, roughly in equal proportion during the clinical training period. In addition to a continuity clinic, fellows will be assigned to various outpatient clinics, which will compliment training during each rotation.
Stanford Hospital and Clinics Facilities
Stanford Consult Service
The fellow is exposed to a wide variety of hospital-based nehprological problems with emphasis on critically ill patients with renal failure, usually acute, in the various intensive care units of the hospital.
Stanford Inpatient Kidney and Pancreas Transplantation Service
This rotation introduces Nephrology fellows to the treatment of end-stage renal disease with kidney transplantation and the treatment of insulin-dependent diabetes mellitus with pancreas transplantation. The fellow gains experience in solid organ transplantation and immunosuppression, as well as skill in performing and interpreting transplant kidney biopsy and laboratory and radiologic/imaging procedures tests.
Veterans Affairs Palo Alto Health Care System
VA In-Patient Consultative and Outpatient Dialysis Service
The in-patient consultative service will provide the fellow experience managing acute renal failure and managing dialysis needs of patients undergoing various procedures. The fellow will also be expected to provide guidance to primary medical teams with regard to blood pressure and volume management, acid-base and electrolyte disorders as well as medication dosing. Resolving ethical dilemmas and awareness of social issues are part of the experience.
The Dialysis Unit of the VA has 30 hemodialysis patients, and continuous ambulatory peritoneal dialysis patients. The VA provides contract care to an addtional 100 hemodialysis patients at outside units.
Santa Clara Valley In-Patient Consultation Services
This rotation provides diagnosis and management of a wide range of nephrologic problems primarily involving inpatients on a Nephrology consultative service. The fellow will learn to diagnose and manage patients with acute renal failure, chronic renal failure, glomerulopathies, hypertension, fluid and electrolyte problems and those requiring acute dialysis or plasma exchange. Resolving ethical dilemmas and awareness of social issues are part of the experience.
Outpatient Dialysis Service at Santa Clara Valley Medical Center
The renal fellow learns to manage all aspects of outpatient dialysis. Urgent outpatient general Nephrology consultation is also part of the experience. The SCVMC nephrologists care for approximately 215 dialysis patients, of which approximately 40 receive peritoneal dialysis and the remainder, receives hemodialysis. Approximately 185 of the patients receive dialysis via the Renal Care Center and the remainder receives dialysis in various dialysis units in the community.