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The University of Manitoba Nephrology Subspecialty Residency Training Program is a two year program that has been accredited by the Royal College of Physicians and Surgeons of Canada. Its purpose is to train physicians for clinical and academic nephrology practice in both university-based and community-based settings.
Training takes place primarily at two sites: Health Sciences Centre (HSC), and Saint Boniface General Hospital (SBGH).
I. PROGRAM STRUCTURE
A. Clinical Rotations
The PGY4 year consists of the core nephrology rotations: the trainees will spend three months rotating through the Renal Transplantation Service (at HSC), the Peritoneal Dialysis Service (at SBGH), the Hemodialysis Service (at both sites), and the Inpatient Consultative Nephrology Service (at both sites). Trainees gain the necessary expertise in these areas through clinical practice, informal teaching, and self directed-study, under the supervision of the attending staff.
Towards the end of the PGY4 year, each trainee will meet with the Program Director in order to plan their individualized PGY5 year. This may consist of a repeat of some/all of the rotations covered in PGY4, but may also include elective rotations. There is a wide variety of elective rotations available, including those in nephropathology, pediatric nephrology, rural/satellite dialysis, and the nephrology inpatient ward. During PGY5, trainees are also strongly encouraged to develop their research interests, and anywhere from one to twelve months may be granted during the year for this purpose, depending on the scope of the project. Also during PGY5, trainees may opt to complete nephrology electives in other centres (outside of Manitoba).
B. Outpatient Nephrology Clinic
Over the two years, each trainee will attend their own longitudinal outpatient consultative nephrology clinic, under the supervision of a single member of the attending staff. Trainee independence increases gradually over the two years.
C. Rounds, Journal Clubs, and other Non-Clinical Activity
There is a wide variety of structured academic rounds and teaching sessions that are part of the training program:
1. Academic Halfday
This is a two year curriculum of approximately seventy-five topics covering all areas of general nephrology, hypertension, fluid and electrolyte disorders, hemodialysis, peritoneal dialysis, and renal transplantation. There are also sessions on ethics in nephrology and pediatric nephrology. Also built into the schedule is a research methods/study design course. These sessions consist of seminar-type discussions cochaired by a trainee and a member of the attending staff.
2. Nephrology Section Rounds
This occurs every Wednesday morning for 90 minutes. Here, the Nephrology Subspecialty Residents (as well as all medical students and core medical residents rotating through the service) present topics in nephrology in a semi-didactic fashion. In addition, these rounds serve as a forum for presentation of research, as well as for discussion of ethical issues in nephrology.
3. Journal Club
Approximately eight times per year, a nephrology journal club is held. This is an exercise in the critical appraisal of a recent or seminal research article in nephrology. It is conducted by the Nephrology Subspecialty Residents, followed by a discussion involving the Attending Staff.
4. Nephrology Conference Attendance
The training program enthusiastically supports trainee attendance at national and international nephrology conferences. In particular, all trainees are provided with support to attend both the Canadian Society of Nephrology and American Society of Nephrology Annual Meetings in both the PGY4 and PGY5 years. In their PGY5 year, trainees are provided with support to attend one national of international nephrology course (which has typically been “Renal Biopsy in Medical Diseases of the Kidneys”, at Columbia University). In addition, trainees are provided with support to attend any other meeting at which they are giving a presentation.
II. THE ATTENDING STAFF
As of October, 2008, the Section of Nephrology at the University of Manitoba will consist of nineteen full-time members and one part-time member. Their clinical interests span the gamut of nephrology, and include all areas of general consultative nephrology, hemodialysis, peritoneal dialysis, and renal transplantation. In addition, section members are actively involved in research as well as other areas of non-clinical academic activity. Examples include research in mineral metabolism in end stage renal disease, exercise in dialysis patients, nutrition in chronic kidney disease, non-invasive monitoring of renal allografts, clinicopathologic correlations in acute and chronic allograft rejection, as well as proteomics and biomarkers; other academic pursuits include nephrology and undergraduate education, efficient care delivery systems and health economics, and access to renal care. Nephrology Subspecialty Residents participate regularly in this activity.
III. RELATIONSHIPS WITH OTHER DEPARTMENTS
Productive relationships exist between the Adult Nephrology Training Program and other Departments. Trainees may gain experience in performing certain technical procedures relevant to nephrology (such as tunneled dialysis catheter insertion or percutaneous renal biopsy) with the assistance of members of the Departments of Radiology and Surgery. Adult Nephrology trainees regularly interact with members of the Section of Pediatric Nephrology and its trainees in rounds, academic halfdays, and clinical rotations. They also interact regularly with members of the Department of Pathology. |
