UT Knoxville Residency Program
Curricula
Areas
1.
Curricular Area: Nephrology
2.
Location: Outpatient:
- Nephrology
Associates of Knoxville, POB C, Suite 460
- Hypertension
Clinic at East TN Baptist Hospital
- Maryville
Dialysis Clinic
- Dialysis
Clinic Incorporated, Martin Mill Pike
Inpatient:
- UTMCK,
various floors,
- Emergency
Dept., Dialysis Unit
3.
Faculty:
- Paul
B. Serrell, MD, Chief, Division of Nephrology
- Rolland
Regester, MD, Retired Chief, Division of Nephrology
- Thomas
R. Miller, MD
- Urath
Suresh , MD
- Denise
Rivers, DO
4.
Schedule:
- Days
- Monday through Friday 8 AM to 5 PM
- Nights
- None
The
resident should attend Morning Report then meet with their assigned
Attending for work rounds at 9 AM . The resident will be expected
to perform a history and physical examination on assigned patients
and to make daily rounds with progress notes on those patients.
Orders will be written by the resident in consultation with the
attending. Residents will participate in the care of ambulatory
patients with Drs. Suresh and Serrell one half day per week in their
private practice. Residents will participate in the Hypertension
Clinic at Baptist Hospital the 1 st Thursday of each month under
the supervision of Dr. Miller. Residents will go with Dr. Serrell
to the Maryville Dialysis Clinic to become familiar with the outpatient
dialysis experience and to the Dialysis Clinic Inc. to learn about
peritoneal dialysis. Dr. Regester will provide small group discussion
sessions on Mondays, Wednesdays and Thursdays from 10:30 AM until
12:00 PM . The resident is expected to attend all Noon Conferences
and Grand Rounds.
5.
Related Conferences/Venues:
6.
Primary Goals: The Resident will be provided a broad
overview of the spectrum of renal disease and related metabolic
principles, as well as practical knowledge and experience in managing
common nephrologic illnesses.
7.
Primary Objectives: The general internist should be
competent to evaluate, provide initial treatment and appropriately
refer patients with glomerular disorders, asymptomatic urine abnormalities,
tubulointerstitial diseases, renal vascular disease, renal failure,
nephrolithiasis, tubular defects, and infection and neoplasms of
the kidneys, bladder and urethra. He/she should be able to manage
fluid, electrolyte and acid-base disorders; manage hypertension
and understand the ways in which systemic diseases may affect the
kidneys; and recognize the potential nephrotoxicity of various therapeutic
and diagnostic agents. The general internist must also be familiar
with the pre-dialysis management of patients with renal failure
and be able to recognize indications for dialysis.
Residents
will learn to recognize abnormalities noted on urinalysis (including
proteinuria, hematuria, bacteriuria, pyuria and cylinduria), discuss
common complaints such as urgency, hesitancy and frequency of urination,
dysuria, edema, flank or suprapubic pain, increased or decreased
urine volume, hematuria and incontinence. The resident should recognize
the presenting features of uremia, renal masses and bruits.
The
resident will learn how to calculate creatinine clearance and the
fractional excretion of sodium. The resident will learn when to
order and how to interpret tests such as imaging, cystoscopy, intravenous
pyelograms, radionuclide renal scans, renal biopsy and various lab
tests.
The
resident is expected to treat every patient with respect and compassion.
A diverse patient population with a wide range of clinical problems
will be encountered; therefore, residents must be sensitive to ethical
principles and be able to fulfill professional responsibilities
in a timely and rational manner. Written notes should be legible
and daily attendance is expected unless prior leave approval has
been granted.
See
Core Competency Table**.
8.
Supplemental References, Suggested Readings :
Braunwald, E. Fauci AS, Kasper, DL, Hauser, SL, Longo, DL, and
Jameson, JL (Editors) Harrison’s Principles of Internal Medicine,
15 th Edition. 2001. New York : McGraw-Hill. RC46.H32
2001 ( Preston ). Read ENTIRE
renal section during rotation.
Rose, BD (Ed); Nephrology, UpToDate, Wellesley ,
MA , 2004. You should read the pertinent
topics for the patients you evaluate. You will present the patient
and discuss the literature review with your assigned attending.
Additional
reference materials are provided for use during the rotation as
follows:
- Schrier,
6 th Edition (renal and electrolyte disorders)
- Halpern
and Goldstein, 3 rd Ed (fluid, electrolyte and acid-base physiology)
- Brady
and Wilcox: Therapy in Nephrology and Hypertension
These
references are located in the UTMCK Dialysis Unit. Please return
all reference material prior to the rotation end.
9.
Procedures: The resident should be able to perform microscopic examination
of urine.
10.
Other Resources: Early in the rotation, the resident
will be given acid-base and electrolyte problems to complete. Dr.
Rivers will review acid-base pathophysiology and the solutions to
the problems. Drs. Suresh and Serrell will review solutions to the
problems found in Halpern.
11.
Research Opportunities: Residents will encounter patients
who are appropriate for case presentation and or poster presentation.
The faculty is available to assist with these efforts.
12.
Method of Resident Evaluation: Residents will be evaluated
in an informal manner by direct clinical observation and case discussion.
At the completion of the rotation, the resident will be evaluated
in a summative manner using New Innovations electronic forms. The
evaluation will be discussed with the resident by the Section Chief
or the assigned attending.
13.
Method of Specialty Evaluation: Residents are asked
to provide feedback regarding concerns at any time to the Section
Chief or supervising attending. They will complete an evaluation
form using New Innovations at the end of the rotation. Cumulative
feedback to the attending faculty member will be given by the Departmental
Chair.
* See
Appendix A, Nephrology Lecture Series
**
See Appendix B, Nephrology Competency Table
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