Overview
· If you are the FIRST student rotating on Nephrology (first 2 weeks of the pediatric clerkship) please page the Pediatric Nephrologist (either Dr. Rozanksy or Dr. Al-Uzri) after Miller Rounds are done to determine where to meet.
· If you are the SECOND student rotating on Nephrology (last 3 weeks of the pediatric clerkship) please go to morning report (11th floor DCH Collins-Goudy room) at 0830 on Monday where you will meet the peds resident rotating on Nephrology before rounds.
Welcome to the third year medical student pediatric nephrology rotation. The rotation will consist of ten to fifteen days of combined inpatient and outpatient experience in pediatric kidney disease and hypertension. Your input and critique of the experience are important. Please make note areas in which the rotation can improve.
The objectives of this rotation are the following:
1. Improve oral and written presentations for pediatric patients. Remember that effective presentations communicate the essential components of a patient's medical condition and offer a reasoned assessment and, when possible, plan.
2. Improve the medical knowledge base in topics relevant to pediatric nephrology. Areas of special focus should include fluid balance and resuscitation, proteinuria, hematuria, hypertension, chronic kidney disease, nephrotic syndrome, and acute renal failure.
3. Gain an understanding of the difficulties patients and their families face with chronic kidney disease.
The schedule for the inpatient service (rounds, impromptu lectures, etc.) depends on the current census and the schedule of the attending physician (either Dr. Al-Uzri or Dr. Rozansky). Generally these will be held as early as 7:30 am and as late as 9:30 am. Patient assignment will be at the discretion of the attending and the second year resident on the rotation. Since medical student notes "don't matter" for billing purposes, coverage of patients should be based on the perceived educational opportunity a patient provides the resident or the student. The student will also work with the attending and 2nd year resident to complete consults in a timely manner.
The outpatient schedule includes Monday and Thursday afternoon general nephrology clinics with Drs Al-Uzri and Rozansky. When there is a conflict with these clinics and a prearranged 3rd year clerkship event, we will defer to Dr. Bumsted as to where the student be. There is also a weekly Tuesday morning renal transplant clinic. Since this clinic may be of limited educational value, the decision and necessity to attend will be made with the inpatient attending on a weekly basis. There may be opportunities to attend clinics off the hill for chronic peritoneal dialysis and hemodialysis patients, and these will be discussed with you at the beginning of the rotation.
"Competencies," for this rotation consist of a series of assignments that should help round out the experience.
1. Complete two comprehensive written work-ups of nephrology patients, at least one must an inpatient. The write-ups should be no more than four pages and include a reasoned assessment and plan. They should be turned in to Dr. Rozansky by the end of the two week session, or three days before the end of the rotation, whichever applies.
2. Complete a problem set, and review the answers with Dr. Rozansky over a one hour period before the end of the pediatric clerkship. (An appointment should be set up.)
3. Prepare a 15 minute oral presentation on an in-depth topic of your choice, preferably based on an experience you had during your rotation. Feel free to discuss the topic with either Dr. Al-Uzri or Dr. Rozansky. Give the presentation to Dr. Al-Uzri before the end of your pediatric clerkship . (An appointment will need to be arranged with Dr. Al-Uzri.)
There are numerous references that you can use for pediatric nephrology. Our own bias has been to consult general pediatric or pediatric nephrology textbooks and supplement these summaries with UpToDate.Com, a reference that was founded (and is still owned) by a superb nephrologist and educator.
