Nephrology

MEMORIAL UNIVERSITY SUB-SPECIALITY TRAINING PROGRAM IN NEPHROLOGY

**NOTE: ALL APPLICATIONS MUST BE SUBMITTED THROUGH CARMS ONLY**

The Sub-Specialty Training Program in Nephrology is accredited by the Royal College of Physicians of Canada and has been accepted by the American Board for Nephrology in the past.  Training usually lasts for two (2) years, but candidates are accepted for training for one year at a time.  Reapplication for the second year of training is required, but as permitted by funding, acceptance is assured for candidates whose performance in the first year of training has been satisfactory.
 
The program accepts applicants who have completed at least three (3) core years of training in Internal Medicine (acceptable to the Royal College).  Selection will take place following review of application and possible interview.  Applicants must have qualifications acceptable to the College of Physicians and Surgeons of Newfoundland and Labrador for the granting of an Educational License.  In accordance with Canadian immigration requirements, applicants must be either Canadian citizens or permanent residents of Canada.  Memorial University is committed to employment equity.

The resident will work as part of a team that includes six full-time nephrology university faculty and three other staff nephrologists.  Progressive responsibility is assigned in proportion to the level of training.  Experience will be gained in clinical nephrology both on an in-patient and ambulatory basis.  At times the trainee will be expected to provide consultation services in Nephrology as part of the duties.  Experience will be gained in all aspects of dialysis therapy, including acute and maintenance hemodialysis, peritoneal dialysis and other blood purification techniques, especially in an Intensive Care setting.  On site training will be provided with regard to almost all aspects of renal transplantation.  Since the province does not have an active renal transplant program of it's own, trainees undertake a mandatory period of at least one month at a Royal College approved transplant centre of choice (usually Halifax) to gain the necessary experience in acute transplant management.  Electives in pediatric and community nephrology are also encouraged for trainees wishing to pursue extra experience in these areas.
 
The program has access to a renal pathologist, a designated renal laboratory and an interventional radiology service.  Trainees generally rotate through one month blocks.  The sequence and content of the training is individualized to the needs of the trainee, but will consist of about 10 months of clinical training in the first year and 4 to 10 clinical months in the second year.  Rotations of roughly equal duration will involve in-patient/consultation, out-patient hemodialysis, out-patient PD and transplant.  Trainees will have between 2 and 10 months of non-clinical time, depending on their interest and needs, to devote to research, quality improvement and other academic pursuits.  Trainees are on call from home only.  Currently, each trainee is on call one weekend a month.  The trainee will also provide first call for the nephrology service at night Monday to Thursday when assigned to the ward service.  The trainee will be on call for internal medicine one night per weekend on call and about one to two other nights per month only when on the ward service.
 
Academic teaching occurs in patient problem discussion rounds, at the bedside, at journal club and in a series of academic seminars devoted to a whole range of topics in nephrology.  Formative evaluation is by assessment in training by preceptors and also by Royal College type written exams twice a year.

The Nephrology Program at Memorial actively encourages and supports the performance of clinical research by trainees.  Faculty have been successful in obtaining peer reviewed funding for many years and have recently formed partnerships with industry and governmental agencies to perform a broad range of research.  Particular interests of the division of Nephrology have included research on cardiac disease in dialysis patients, anemia management, vascular access complications, toxic nephropathy due to radiocontrast media, genetic renal diseases, hypertension, cost effective renal care, issues pertaining to quality of life for patients with end stage renal disease, and optimization of pre-dialysis care.  Trainees are encouraged to become involved in the ongoing research of the division.  This has usually been integrated throughout the 2-year program with blocks of time allotted for research in proportion to the interests of the trainee.  It is possible for trainees to pursue a Master of Science degree in Clinical Epidemiology on a part time basis coincident with their training in Nephrology (pending successful separate application to Memorial University’s Graduate School).  Faculty from Nephrology play a major role in the teaching for this degree, which provides a theoretical foundation for much clinical research.