Welcome & Program Info

Description of Program

Since July of 1982, the Division of Nephrology & Transplantation Immunology has offered a Residency Program in Nephrology.  This Training Program is being revised and enhanced.  The Program will not only fulfill the requirements of the Royal College of Physicians and Surgeons for the Certificate of Special Competence in Nephrology but will be flexible so as to prepare residents for careers in either academic medicine or community practice.

The basic program is two years in length; however there is the possibility of applying for:

1.      Additional research training years for those interested in academic careers. For those applicants who anticipate that their practice will be outside an academic centre, the acquisition of a full range of clinical skills is a priority.  Trainees interested in an academic career with a significant research component may initiate their research fellowship during the second year of the program, provided the objectives of the clinical training have been met.  In all cases, the Training Program will meet the subspecialty requirements of the Royal College of Physicians and Surgeons of Canada.

2.      A one-year renal transplant clinical fellowship.

3.      A one-year home dialysis therapies clinical and research fellowship.

The Division is also willing to consider certain applicants who wish to practice internal medicine with nephrology expertise in a smaller community.  Such individuals may wish to apply for a single year in the Nephrology Training Program as their fourth year in Internal Medicine.  This training would meet the RCPSC requirements for Internal Medicine but would not satisfy the requirements for certification in Nephrology.

Philosophy

The training program’s primary goal is to provide residents with an excellent foundation in clinical nephrology, which includes ancillary training permitting strong patient advocacy and practice management, while permitting ample opportunity to explore research and quality improvement initiatives. This will include clinical rotations representing the spectrum of clinical nephrology. Basic principles of the training program include:

1. Fostering a continuity of care model of practice. This is fundamental to a specialty based in no small part on chronic care and longitudinal relationships. Trainees will participate in longitudinal clinics in general nephrology and transplant, as well as manage a rural hemodialysis unit, over the two years of training

2. A strong base in clinic nephrology. Month long rotations cover the breadth of clinical nephrology. Our training program also promotes competent procedural skills relevant to nephrology.

3. A strong core curriculum. Up to 5 hours of teaching rounds weekly, including a core resident lecture series, journal club, fluid and electrolyte rounds, renal pathology rounds and nephrology grand rounds.

4. Graded responsibility. Resident autonomy in patient care is encouraged and evaluated as training progresses.

5. Fostering professionalism and practice management. The model of training facilitates time management and prioritization skills. Residents also receive teaching specific to establishing a renal practice as well as bioethics and medico-legal issues

6. Facilitating advocacy and effective communication skills. Through care of the patient in a continuity model, as well as dedicated lectures and simulation exercises and mandatory training in quality improvement initiatives, residents will receive a strong basis for patient advocacy and effective communication.

7. Encouraging research and quality improvement initiatives. Ample elective time exists to explore research interests and a mentored QI project is a mandatory component of training. Many divisional members, with diverse research interests, are internationally renowned in their fields of study and can provide mentoring. The core training schedule can be modified to increase the research component, and additional years of research training may be added. 

Environment

The Training Program is positioned within the Alberta Health Services Northern Alberta Renal Program (NARP), through which hemodialysis, peritoneal dialysis and renal transplant patients are cared for in Edmonton and in satellite dialysis units in outlying communities.  Dr. Kailash Jindal is the Director, Division of Nephrology & Transplantation Immunology and the Regional Clinical Program Director, NARP. 

The great majority of training is provided at the Walter C. Mackenzie Health Sciences Centre.  This modern 630-bed hospital is a tertiary referral centre for approximately 1.4 million residents of the region extending from central Alberta to the Arctic, including parts of British Columbia and Saskatchewan.  The 18 bed in-patient unit is adjacent to two 18 station in-centre hemodialysis units.  Both the peritoneal dialysis unit (~150 active patients), home hemodialysis unit and the renal transplant program (including a dedicated inpatient transplant unit) are located on site.

The clinical renal program is supported by several ancillary services.  These include:

§  An active renal pathology service headed by Dr. Kim Solez, an international authority on renal transplant pathology and cybernephrology.

§  An active clinical trials program which has participated in multi-centre trials of new immunosuppressives, agents to treat acute renal failure, and innovations in peritoneal dialysis catheters.  The clinical trials staff are available to facilitate the development and processing of clinical studies initiated by trainees and may assist in data collection.  The program is supported by a statistician.

§  A tissue typing laboratory with a particular interest in molecular HLA typing and the role of alloantibody in allograft rejection.

§  Basic science research programs which emphasize mechanisms of tissue injury, the mechanism of action of immunosuppressive agents, the regulation of HLA and cytokine gene expression, endothelial biology and glomerular physiology.  Research is also conducted on the mechanisms of peritonitis.

§  A host of clinical research programs exist, headed by Divisional members with training in Clinical Epidemiology, Ethics, Health Economics and Health Administration.

§  An active ambulatory care program exists, with clinics for patients with general renal disorders, those on renal replacement therapy and recipients of renal transplants.  There is a longitudinal clinic experience organized for each trainee where he/she sees new patients and follows patients discharged from hospital.

§  An on-site pediatric nephrology service staffed by three pediatric nephrologists

§  A multidisciplinary team of surgeons, dieticians, social workers, physiotherapists and occupational therapists who participate in the care of the renal patient.

Training Objectives

As required by the Royal College of Physicians and Surgeons of Canada, the nephrology resident must acquire both clinical competence in the management of renal disorders and a sound background in relevant areas of basic science.  The resident will learn the skills necessary to become a consultant in kidney disease, renal manifestations of systemic diseases, and provision of renal replacement therapy.  The experience necessary to achieve these objectives is provided in both ambulatory and in-patient settings at the University of Alberta Hospitals.  The program utilizes a set of syndrome-specific learning objectives established on the national level to ensure that each trainee masters the core knowledge base. The Program also ensures appropriate emphasis upon CanMEDS criteria, and performance according to these criteria is assessed at the end of each rotation. For an overview of general CanMEDS objectives, the 2012 revision of the Royal College Objectives of Training is included in the trainee manual. Rotation-specific objectives, organized by CanMEDS themes also exist for each rotation. A comprehensive syllabus of required knowledge is also enclosed in the trainee manual and should be referred to by the trainee and mentors to provide a framework on rotations and self-directed learning exercises.

Revised June 2015