IM Residency

R2s will also develop an understanding of the pathophysiology, clinical presentation, and targeted therapy for the following conditions:

R3s will develop an understanding of the pathophysiology, clinical presentation, and targeted therapy for the above renal conditions, with attention to differences in patient populations where appropriate.

II. R1s will be able to understand the indications for ordering and the interpretation of laboratory and imaging studies:

• Arterial blood gas
• Creatinine clearance, and its significance for drug therapy
• Renal imaging studies: ultrasound, CT, urogram
• Urinalysis
• Urine and serum osmolality
• Urine electrolytes, eosinophils, protein/creatinine

III. R2s will also demonstrate knowledge of the indications for ordering and the interpretation of:

• Renal biopsy
• Renal imaging studies: captopril renal scan, MRI-A, angiogram
• Serologic tests for evaluation of glomerulonephritis

R3s will independently, appropriately order studies and be able to interpret results within the context of patient comorbidities, pretest probability of disease, and patient values.

IV. Residents should become fluent in the issues of health maintenance relevant to renal disease and be able to counsel patients appropriately on:

1. All residents should be able to access current clinical practice guidelines from the National Kidney Foundation, journals, and other sources to apply evidence-based strategies to patient care.
2. R2s should develop skills in evaluating new studies in published literature, through Journal Club and independent study.
3. All residents should learn to function as part of a team, including the nephrologist, nurse, pharmacist, and dietician, and social worker to optimize patient care.
4. All residents should respond with positive changes to feedback from members of the health care team.

1. R1s must demonstrate organized and articulate written (electronic) and verbal communication skills that build rapport with patients and families, convey information to other health care professionals, and provide timely documentation in the chart.
2. R2s must also develop interpersonal skills that facilitate collaboration with patients, their families, and other health professionals.
3. R3s should demonstrate leadership skills to build consensus and coordinate a multidisciplinary approach to patient care.
4. R3s must be able to elicit information or agreement in situations with complex social dynamics, for example, identifying the power of attorney or surrogate decision maker, and resolving conflict among family members with disparate wishes.

1. All residents must demonstrate a commitment to carrying out professional responsibilities.
2. R1s should be able to educate patients in a manner respectful of gender, cultural, religious, economic, and educational differences on choices regarding their care.
3. R2s should be able to use time efficiently in the clinic to see patients and chart information.
4. R2s should be able to counsel patients and families both on diagnostic and treatment decisions and on initiation or withdrawal of dialysis.
5. R3s should be able to provide constructive criticism and feedback to more junior members of the team.

1. R1s must have a basic understanding that their diagnostic and treatment decisions involve cost and risk and affect quality of care.
2. R2s must be able to discuss alternative care strategies and the cost and risks involved in current quality issues in nephrology care, such as the appropriateness of dialysis.
3. R3s must demonstrate an awareness of and responsiveness to established quality measures, risk management strategies, and cost of care within our system.