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First Year Curriculum

Welcome 1st Year Fellows 2017



During the first year of the fellowship program, fellows are immersed in clinical nephrology training to develop the fundamental knowledge and skills required to become an outstanding clinical nephrologist.  Through clinical experiences in the first year, fellows become proficient in the performance and interpretation of urinalyses, various modalities of renal replacement therapy, placement and management of temporary vascular catheters and performance of percutaneous native and transplant kidney biopsies.    

First year fellows participate in five consultative inpatient services, nephrology continuity clinic, and electives at the Johns Hopkins Hospital and the Johns Hopkins Bayview Medical Center.  


JHH Intensive Care Unit Consultation (Acute)

This service consults on patients in all hospital ICUs and those admitted to the Sidney Kimmel Cancer Center.  This team consists of a nephrology fellow, supervising attending, and occasionally a critical care fellow, urology resident, medicine resident, and/or medical student. 

Fellows will gain experience in the diagnosis and management of the following:

  • Acute kidney injury in the context of critical illness due sepsis, liver disease, cardiovascular disease
  • Post-operative renal complications
  • Medication-induced renal failure
  • Renal issues related to oncologic diseases 
  • Acid-base and electrolyte disturbances
  • Patients with advanced chronic kidney disease requiring intensive care

JHH Inpatient Consultation (Chronic)

There are two non-ICU consultation teams each is comprised of a nephrology fellow, a supervising attending, and periodically urology residents, medicine residents, and/or medical students. 

Fellows will encounter a wide spectrum of diseases during this rotation including:

  • Acute kidney injury from various causes (e.g. pre-renal azotemia, pregnancy, urinary tract obstruction)
  • Rapidly progressive glomerulonephritis and vasculitis
  • Primary or secondary nephrotic syndromes
  • Acid-base and electrolyte disturbances
  • Chronic kidney disease of all stages due tvarying etiologies
  • End-stage renal disease and related complications
  • Drug toxicity

JHH Nephrology Transplantation (Transplant)

The Nephrology Transplantation Service is co-managed with the renal transplant surgery team.  The inpatient nephrology transplant team consists of a transplant nephrology fellow, general nephrology fellow, supervising transplant nephrology attending, advanced practitioner, and internal medicine residents.  During this rotation, fellows will gain substantial experience in the management of post-operative and chronic renal transplant patients.  

The following issues will be encountered:

  • Pre-operative evaluation and care of potential renal transplant recipients and donors
  • Post-operative renal complications of renal, pancreas, and hepatic transplant recipients
  • Acute or chronic allograft dysfunction due tvarious causes, including cellular and antibody-mediate rejection and BK nephropathy
  • Metabolic, infectious, and oncologic complications due to immunosuppressive medications

Bayview Inpatient Consultation (Bayview Consult)

This service team is comprised of a nephrology fellow, supervising attending, and occasionally medicine residents and medical students at the Johns Hopkins Bayview Medical Center.  Fellows will see consultations requested by any of the hospital services on the general inpatient and intensive care units, which includes the John R. Burton Geriatric Care Center and Maryland's only regional burn center. 

Additional experiences during this rotation include:

  • Management of acute and chronic kidney disease and their complications, in both the inpatient and intensive care unit settings
  • Rapidly progressive glomerulonephritis, vasculitis, and nephrotic syndrome
  • Use of inpatient hemodialysis, peritoneal dialysis, and continuous renal replacement therapies
  • Management of kidney disease in the geriatric population
  • Acid-base and electrolyte disturbances
  • Complications seen in patients with renal transplants

Night Float

The Nephrology Night Float system was instituted and designed to reduce the destructive fatigue experienced by fellows who were on-call at night, with frequent sleep interruptions and need to come in to the hospital for acute patient evaluations and then working the following day. The night float system enhances fellows' performance both as learners and as practitioners and contributes to fellows' well-being.  The night float fellow is present in-house at Johns Hopkins Hospital from Sunday to Friday 7 pm to 7 am.  Saturday night coverage is provided by the weekend fellow on first call. The night float fellow is expected to finish all sign-out and continuity of care and be able to leave the hospital no later than 8 a.m. each morning.  The responsibility of the night float fellow is to provide fellow coverage for urgent and emergent nephrology issues.   

Outpatient Hemodialysis (Outpatient HD)

This is a 2-week rotation for all first year fellows to become acclimated to dialysis.  They are required to complete the rotation within the first 3-months of their first year.  The fellows will rotate through one of our outpatient dialysis unit becoming familiar with the water treatment, hemodialysis, peritoneal dialysis, home hemodialysis, and vascular access.

Nephrology Continuity Clinic

In this one-half day weekly clinic (on the Bayview campus), fellows evaluate and longitudinally manage ambulatory patients with wide-ranging renal issues under the supervision of nephrology attendings.

Renal issues encountered during this clinic include but are not limited the following:     

  • Acute kidney injury
  • Chronic kidney disease and related complications
  • Chronic post-renal transplantation care
  • Hypertension
  • Fluid, electrolyte, and acid-base disorders
  • Nephrolithiasis
  • Genetic renal diseases
  • Nephrotic and nephritic syndromes
  • Tubulointerstitial disease
  • Abnormalities of the urinary collecting system
  • Drug-related renal toxicity
  • Renovascular diseases


Additional elective experience is arranged for the following areas to suit the fellow's needs and interests:

  • Line Service
  • Meetings with potential mentors
  • Other scholarship (teaching, lecturing, writing)
  • Outpatient hemodialysis and peritoneal dialysis clinics
  • Outpatient vascular access center
  • Renal Pathology
  • Research prep for 2nd year
  • Specialty Clinics
  • Therapeutic apheresis
  • Urology Clinic
  • Vascular Surgery

Learn more about our opportunities for education: 

Nephrology Fellowship
Second Year Curriculum  
Transplant Fellowship

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