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Curriculum

The large volume and broad range of patients seen by Mayo Clinic nephrologists ensure an optimal clinical experience. Nephrology outpatient clinics and hospital services at Mayo Clinic's campus in Jacksonville, Florida, are very active and are supported by state-of-the-art clinical laboratories devoted to renal function testing and renal pathology.

Rotation schedule

During each clinical rotation, you work one-on-one with the supervising staff consultant. Rotation blocks are typically one to two months long.

Year 1

  • Orientation Inpatient: During the first month of the academic year, incoming fellows will have the opportunity to onboard with a second-year fellow serving as the sub-consultant. This structure developed based on fellow feedback provides the opportunity for additional support for incoming fellows beyond the consultant by having an at-the-elbow senior colleague to learn from.
  • Inpatient nephrology: During the general inpatient nephrology rotation, you evaluate and manage renal problems as a consulting team. The inpatient nephrology service is performed at the Mayo Clinic Hospital, which is on-campus and connected to the outpatient clinic buildings. Experiences encompass acute outpatient dialysis, general nephrology, transplant, and intensive care unit patient care. Fellows will receive training on diverse skills including temporary hemodialysis catheter insertion under ultrasound guidance, urine sediment microscopy, native kidney biopsies, intermittent hemodialysis, peritoneal dialysis, and continuous renal replacement therapy.
  • Outpatient ambulatory clinic: The Outpatient experiences in the hemodialysis unit, home dialysis clinic (both peritoneal dialysis and home hemodialysis), and outpatient clinics with chronic kidney disease, transplant, glomerulonephritis, electrolyte disorders, stone and hypertension clinics provide an exposure to a wide variety of patient care problems. Continuity clinics consisting of a panel of your own patients also serve as a core training experience.
  • Renal pathology: During the renal pathology rotation, you learn to interpret renal biopsies through one-on-one interaction with experienced staff renal pathologists. Fellows at Mayo Clinic in Jacksonville, Florida, participate in local biopsy conference throughout the year. In addition, as another example of a truly one institution, tri-state training program, you have combined biopsy-conferences throughout the year with Mayo Rochester general nephrology, transplant nephrology, and renal pathology divisions.
  • Electives: Elective rotations in clinical nutrition, pediatric nephrology, critical care, and other special interest areas are available. In renal imaging, you have the opportunity to learn the technique of ultrasound-guided native kidney and renal allograft biopsy under the supervision of staff interventional radiologists. This will complement the renal biopsy training you receive from staff nephrologists during clinical rotations.
  • Research: Mayo nephrology fellows are given the opportunity to have dedicated, protected time to pursue a quality improvement project and research project during their two years of fellowship. Dedicated research consultants are available and ready to work with fellows to guide fellows in their research, as we appreciate fellows may come with a variety of levels of prior research experience. 
  • Transplant nephrology: You have the opportunity to have hands-on experience taking care of fresh post-transplant patients on the Kidney/Pancreas Transplant service and long-term pre- and post-transplant care in the ambulatory transplant clinic. In addition, you learn important skills as a future general nephrologist in terms of how to manage acute and chronic transplant-related complications in hospitalized patients, whether a patient has a kidney or non-kidney transplant.
  • Continuity clinic: Nephrology fellows will have the opportunity to serve as the primary nephrologist in a general nephrology continuity clinic on a weekly basis throughout the year that encompasses the patient's own fellow. Nephrology fellows also have a transplant continuity clinic weekly on outpatient months. 
  • Outpatient continuity clinic: Fellows will spend dedicated time in the Mayo-owned state of the art dialysis unit. Fellows will learn how to excel as dialysis providers while also learning from top down the multidisciplinary team approach to provide best car for our patients. Fellows will spend time in in-center and the home dialysis clinic (peritoneal dialysis and home hemodialysis). Fellows will also be trained as future leaders in nephrology, such as how to serve in the role of the medical dialysis director. 
  • Hypertension: Mayo nephrology fellows will be trained the indications and utility of 24-hour ambulatory blood pressure monitors, best technique for measuring ambulatory blood pressures, how to apply and interpret a 6-hour and 24-hour ambulatory blood pressure monitor, and the how-to's for setting up a hypertension clinic and becoming a hypertension director for the future. 

Year 2

  • Orientation inpatient: During the first month of the academic year, incoming fellows will have the opportunity to onboard with a second-year fellow serving as the sub-consultant. This structure developed based on bellow feedback provides the opportunity for additional support for incoming fellows beyond the consultant by having an at-the-elbow senior colleague to learn from.
  • Inpatient nephrology: During the general inpatient nephrology rotation, you will evaluate and manage renal problems as a consulting team. The inpatient nephrology service is performed at the Mayo Clinic Hospital, which is on-campus and connected to the outpatient clinic buildings. Experiences encompass acute outpatient dialysis, general nephrology, transplant, and intensive care unit patient care. Fellows will receive training on diverse skills including temporary hemodialysis catheter insertion under ultrasound guidance, urine sediment microscopy, native kidney biopsies, intermittent hemodialysis, peritoneal dialysis, and continuous renal replacement therapy.
  • Research
  • Transplant nephrology: You will be caring for post-transplant patients on the Kidney/Pancreas Transplant Service. In addition, you will be learn to take care of other transplant-related issues via consultations for nephrology issues in non-renal transplant recipients.
  • Continuity clinic: Nephrology fellows will have the opportunity to serve as the primary nephrologist in a general nephrology continuity clinic on a weekly basis throughout the year that encompasses the patient's own fellow. Nephrology fellows also have a transplant continuity clinic weekly on outpatient months.
  • Dialysis continuity clinic: During the second year of fellowship, nephrology fellows will have a dialysis continuity clinic at the outpatient dialysis unit where they serve as the primary nephrologist. 
  • Apheresis: Fellows will learn the fundamentals of apheresis, rationale, indications, and its prescription with trained dedicated physicians. 
  • Point of care ultrasound (POCUS): The nephrology fellow will have dedicated time to develop and build on POCUS skills in order to become competent in the use of bedside ultrasound as part of the armamentarium for the modern nephrologist. 

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, and one-on-one instruction are integral parts of the Nephrology Fellowship.

During your training, you attend:

  • Core curriculum lecture series (weekly)
  • Nephrology grand rounds (three each month)
  • Journal club (monthly)
  • Research conference (monthly)
  • Transplant morbidity and mortality (monthly)
  • Biopsy conferences (both internal and joint conferences with Mayo Clinic Rochester)
  • Dialysis vascular access
  • Physiology study circle (twice monthly)
  • Simulation Center training
  • Board review (monthly)
  • Internal medicine grand rounds (weekly)
  • Rheumatology/nephrology joint conference (quarterly)
  • Wellness session (monthly)
  • General nephrology morbidity and mortality (bi-annually)

Research training

During the fellowship, you are required to identify an area of research interest and complete a research project. You present a research lecture before and after the completion of your research project.

You must complete at least one scholarly project suitable for publication or presentation at a national meeting. The Division of Nephrology and Hypertension at Mayo Clinic's campus in Florida provides scholarship opportunities in ongoing National Institutes of Health-funded research projects, pharmaceutical trials, databases, population registries, and clinical trials. You also learn and participate in a quality improvement project during your fellowship experience.

In addition, you spend one block during the first year and five blocks during the second year on a research block, mentored by a faculty nephrologist. As a fellow, you learn the main research components of the curriculum, including standards of ethical conduct of research, design and interpretation of research studies, responsible use of informed consent, research methodology, and interpretation of data.

Call frequency

Nephrology fellows do not have in-house call. You are assigned to home call once every four days. You are scheduled for home call, on average, 13 of the 52 weekends per year. You will enjoy up to 75% of all weekends free of home call.

When on home call, you are required to come into the hospital and evaluate only emergent consults. During your home call, a supervising attending physician is available at all times to provide back up support.

Conferences

You are required to attend all the core curriculum lectures, clinical conferences, journal clubs, and morbidity and mortality conferences. During the fellowship, you may attend the National Kidney Foundation annual meeting and the American Society of Nephrology annual meeting. You are encouraged to present your research during these conferences.

Mayo Clinic School of Graduate Medical Education recognizes the importance of trainee participation in professional activities away from Mayo Clinic. Such participation develops the individual's professional competence, broadens knowledge, enhances the individual's and Mayo Clinic's reputation, strengthens recruitment, and introduces the trainees to professional groups.

Trips for presentation of work or research done at Mayo Clinic are sponsored by Mayo Clinic. In addition, you are eligible for one trip during the course of your training program for attendance at a recognized society meeting, elective course, or workshop with Category 1 CME credit. Attendance trips are intended to introduce you to national experts and evolving concepts and technology at national society meetings, as well as provide an opportunity to network and make contacts outside the institution.

Dialysis center

The Mayo Clinic Dialysis Center provides dialysis services to Mayo Clinic patients in a comfortable, home-like facility. The unique design of the unit optimizes the staff's ability to observe patients while preserving the quietness and feeling of being in a private room.

The facility design, along with state-of-the-art equipment — featuring real-time, online monitoring — allows staff to observe the patient's progress throughout each dialysis treatment. As a fellow, you provide longitudinal care to your own panel of dialysis patients.

Take a virtual tour of the Dialysis Center

Simulation center

The simulation center transforms clinical medical education by helping educators to develop, implement, and evaluate experiential curricula that advance patient care. Simulation-based medical education provides a controlled environment that imitates a real-life patient care setting. In a simulated situation, learners master skills without putting patients at risk.

Nephrology fellows conduct kidney biopsies, dialysis catheter placement, and other procedures in the simulation center. Nephrology fellows also practice simulated Ob/Gyn clinical cases under the guidance of a nephrology consultant.

Access a video tour of the Simulation Center on Mayo Clinic’s YouTube channel or take a virtual tour of the Simulation Center. 

Teaching opportunities

During hospital rotations, you have the opportunity to supervise and teach internal medicine residents and medical students. You also have the opportunity to learn from and teach ICU fellows. This teaching can be at bedside informally or through formal didactics.

Evaluation

You are evaluated at the completion of each rotation in the Nephrology Fellowship. Evaluations assess competence in:

  • Patient care
  • Medical knowledge
  • Professionalism
  • Systems-based practice
  • Practice-based learning and improvement
  • Interpersonal and communication skills

At least four times per year, the program director meets with you to review evaluations and discuss professional growth. In addition, allied health staff and residents are asked to evaluate your performance periodically.

You are able to view your evaluations electronically. Final cumulative evaluations are compiled upon completion of the program.