Background

• Nephrology is a foundational component of Internal Medicine, given the high prevalence of CKD, hypertension, electrolyte and acid-base disorders, and kidney involvement in systemic diseases.

• Increased resident participation also strengthens interdisciplinary learning and exposes trainees to the complexity and rewards of nephrology early in their training.

Elective Structure & Expectations

Patient Care

• Learners will carry 3–4 patients daily, with a maximum of one new consult per day (flexible based on census and learning needs).

• They are expected to pre-round on those patients, discuss with the fellow (if time allows), present during rounds, and write progress notes on these patients.

Role & Responsibilities

• This elective is a dedicated learning rotation and should not be used as a backup or jeopardy block. Dr. Cervantes confirmed with the Osler and Bayview program directors that we will be notified first if a resident needs to leave.

• Residents are expected to participate in rounds, contribute to discussions, and engage actively in clinical decision making. The goal is to balance autonomy with supervision and ensure a manageable workload.

Learning Goals

Residents will be expected to:

• Understand the definition of an acute kidney injury and differentiate common causes of AKI and their respective evaluations. CKD/ESKD and comorbid conditions to be included.

• Interpret acid-base disorders based upon blood gas and basic metabolic panel values

• Describe an organized approach to evaluate a patient with hyponatremia

• Additional learning goal set by each individual learner.

Educational Deliverables:

• Mini Chalk Talk:Residents will prepare and deliver a 5–10 minute teaching session on a topic inspired by cases during their week (e.g., interpreting urine electrolytes, managing hyponatremia, etc.).
• Urine Sediment:Residents will examine at least one urine sediment with guidance from the fellow or attending.
• Pathology Slide:If an inpatient kidney biopsy is performed during the rotation, residents will review the slide with the fellow, attending nephrologist and pathologists.

Curated Evidence-Based Reading List for Medical Students & Residents 

• NephSIM – Interactive cases ideal for residents and med students