Curriculum
Clinical training
The Onco-Nephrology Advanced Nephrology Fellowship curriculum encompasses rotations that maximize your experience with patients with both oncologic-hematologic and renal issues.
Rotation schedule
| Rotation | Length |
|---|---|
| BMT hospital | 2 weeks |
| BMT outpatient clinic | 1 week |
| Dysproteinemia clinic | 1 month |
| Heme 1 hospital service | 2 weeks |
| Heme 3 hospital service | 2 weeks |
| Mayo Clinic Hospital - Rochester, Methodist Campus | 2 months |
| Medical oncology/GU team outpatient clinic | 3 weeks |
| Oncology pharmacy | 2 weeks |
| Palliative care | 2 weeks |
| Research | 6 months |
| Uro-oncology clinic | 1 week |
*Bone marrow transplant (BMT)
Rotation descriptions
BMT hospital
Trainees will rotate on the BMT inpatient service. This rotation is designed to familiarize the trainee to the entire process of hematopoietic stem cell transplantation from mobilization to engraftment, different types of stages of stem cell transplantation and how it may affect the kidney, and complications or treatments that may affect the kidney.
BMT outpatient clinic
Patients with hematopoietic stem cell transplantation are seen in this outpatient clinic, where you are exposed to kidney complications and have the opportunity to actively manage and participate in the care of these patients.
Dysproteinemia clinic
This outpatient rotation provides experience in managing patients with monoclonal gammopathy of undetermined significance, monoclonal gammopathy of renal significance, smoldering multiple myeloma, multiple myeloma, and Waldenstrom's macroglobulinemia.
Heme 1 hospital
This rotation is designed to familiarize the trainee to chemotherapy treatment received by patients with hematologic conditions. The trainee will learn about chemotherapy, the mechanism of action, side effects, use in the treatment of hematologic conditions, nephrotoxicities, and renal dosing.
Heme 3 hospital
This rotation is designed to familiarize the trainee with common complications of hematological malignancy. In addition, trainees will learn the various renal- and electrolyte-related diseases seen in these patients. Fellows will evaluate and manage the patients from hematology standpoint as well and this will help familiarize them with main hematology concepts and pathologies as a future onco-nephrologist.
Mayo Clinic Hospital — Rochester, Methodist Campus
This inpatient service exposes you to patients with hematologic or oncologic malignancies who develop kidney diseases. You learn to recognize and deal with the kidney disease as well as its complications in these patients.
Medical Oncology/GU Care Team Outpatient Clinic
Trainees will rotate through three major clinics in Oncology: GI Cancer, Lung Cancer, GU including renal cancer, and Skin Cancer. This rotation allows the trainee to gain experience with the clinical course of patients with different types of cancer as well as the various treatments and complications that may occur. (I added GU because I had urology rotation as well, which was helpful).
Oncology pharmacy
This rotation is designed to give you a better understanding of the pharmacodynamics and pharmacokinetics of chemotherapy as they relate to patients with chronic kidney disease, end-stage renal disease, and kidney transplantation.
Palliative Care
During this inpatient consultative service, you gain experience with end-of-life issues in patients with kidney disease and malignancy.
Research
You are required to participate in a research project pertaining to one of the disciplines of onco-nephrology. This would include topics in pharmacology, chronic kidney disease in patients with hematologic or oncologic concerns, kidney transplantation in patients with malignancy or MGRS, or kidney diseases in patients with malignancy or MGRS.
Uro-oncology clinic
This outpatient service offers exposure to patients with urologic malignancies and resulting renal complications.
The entire department is committed to our education, and our academic conferences are a testament to this. We have a unique opportunity to learn and work with the experts in the field. For instance, when I am caring for a patient with a complex onco-nephrology issue, I know I can count on someone to review the case with me and give me their opinion, even if they were not involved in the patient's care."
Sandhya Manohar, M.B.B.S.
Program graduate
Call frequency
Your call schedule is different for each rotation, but does not exceed one in four days for any rotation. Mayo Clinic College of Medicine and Science follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME).
Moonlighting
You may moonlight with program director approval, but only during outpatient rotations. Moonlighting should not interfere with required learning and must not violate the duty-hour rules of the Accreditation Council for Graduate Medical Education (ACGME) or visa regulations.
Didactic training
In addition to clinical rotations, fellows are expected to attend conferences for didactic teaching:
- Renal Biopsy Conference
- Nephrology and Hypertension Grand Rounds
- Hematology Thursday Morning Clinical Conference
- Oncology Wednesday Morning Core Conference
- Nephrology Core Conference
- Kidney transplant recipient review conferences
- Research forum
Teaching opportunities
You share responsibility for resident supervision and teaching on the inpatient service. You also present at conferences such as Grand Rounds and Journal Club.
Evaluation
To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Onco-Nephrology Advanced Nephrology Fellowship. Competency-based electronic evaluations are completed by supervising faculty members on a regular basis, and you meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.