Nephrology

Nephrology is one of the most demanding, yet incredibly interesting blocks of second year. The teaching team is enthusiastic about the content and have high expectations of students. The course is focused on conceptual understanding in addition to memorization of minute details. The concepts are intertwined and thus it is critical to pay attention during daily small group lectures, as the following day tends to build on the previous day’s complexities. Additionally, there are assigned lecture videos in Brightspace that can provide foundational information that is critical to fundamental understanding of concepts, especially renal anatomy and physiology. In the first two weeks, there is a heavy emphasis on renal physiology, and the third week focuses more on diseases. There is no big lecture, but instead there are mandatory daily small group sessions that have built-in lectures and clinical cases. Each day, multiple teams are assigned to present cases related to that day’s small group. You will also take an ungraded quiz at the beginning of each small group, followed by a brief review of answers prior to that day’s small group session. Additionally, you will be required to participate in several clinical sessions and a group “reflection” presentation based on a Nephrology topic of your choosing. Finally, there is also a dialysis discussion that you will partake in. You will view two short videos about dialysis and a patient’s experience, followed by a small group virtual morning session (led by Dr. Keddis) to reflect with peers.

You will take a multiple-choice Brightspace exam at the end of week 1 and another at the end of week 2. They are graded and course-specific, thus it is imperative to review the actual small group lecture content and pay close attention to concepts covered in the cases. You will also take an oral final exam in addition to a NBME final exam. All assessments are graded, closed-book, and proctored.

• Small Groups (10% of final grade) – A lot of content is condensed into each day’s small group lecture. You will begin class with a written, ungraded quiz and follow that by going through the self-assessment answers. You will then go through course-specific slides for about 80% of the session, with the remaining time being spent on student case presentations. Small groups will take the full 4 hours and will sometimes run late. The bright light in all this is that the nephrology team brings in snacks every day. 

• Clinical Experience Activities (10% of final grade) – You will participate in two SIM sessions with standardized patients followed by review sessions with faculty. You will rotate in groups of ~4 through three different OSCE rooms, spending about 30 minutes in the OSCE rooms and 30 minutes reviewing the case. Additionally, each student will have one Outpatient Clinic session, either in General Nephrology or Transplant. The session is preceptor specific so sometimes you simply are there to observe and other times you will be expected to perform a H&P and present. This takes roughly an hour. Carefully read the schedules! The main schedule lists the team assignment, then an outpatient schedule lists the specific student's assigned location, date, and time. 

• Reflection Presentations (10% of final grade) – Each group of about 3 students will create a PPT presentation on a student-selected Nephrology topic. You are expected to present your slides to peers and an assigned faculty member in a zoom breakout room. A rubric of expectations is provided. This can be a more simple task to complete, as each member only needs to curate roughly 2-3 slides each. Grading is mostly based on completion and being present for the session itself. It may be helpful to create the presentation in week 1 since week 2 is the most dense.  

• Daily Quizzes (20% of final grade) - The quizzes are short answer format and typically about 6 questions long. They are graded on completion and only open for 30 minutes prior to small group sessions. They are used as a self-assessment of the previous day’s material.

• Exam 1 and 2 (20% of final grade) – Each exam is roughly 50 multiple-choice questions and is based solely on the course-specific content. Exam 1 covers content from week 1, while exam 2 covers both weeks 1 and 2 (emphasis on week 2, though). The small group objectives should be used as a guide for content expected to be covered on each exam. Clinical cases are also included with several questions related to a single case. Dr. Keddis leads an interactive review session in the 30 minutes prior to each exam. The review is incredibly high-yield, and students begin the exam right after it ends. Therefore, you will need to prepare on your own and cannot rely solely on the review to perform well. They are not too difficult if you go through the lecture slides.

• Final Exams – Oral Exam & NBME (30% of final grade) – The oral exam is 10% of your final grade and is based on two clinical cases, one outpatient and one inpatient. You meet one-on-one with a faculty member over zoom who will ask questions about the cases and will guide you through them if you struggle. The grades are completely subjective and grades are based on the faculty you are assigned to. Review the course-specific content and you will be successful. Small group learning objectives lay out what you should know for the final exams.

The NBME exam has roughly 80 questions and is aligned well with course content from all 3 weeks. Dr. Keddis will do a 60-minute review right before the exam begins. It is incredibly high-yield for the actual exam, but again the test will begin as soon as the review ends (with just enough time for a quick bathroom break).

• Boards & Beyond – Use the video breakdowns provided. Watch as many of them as you can by the end of the block, as they tend to really break down key concepts into more digestible content than the course materials themselves.

  • Ryan Tatton (2022 TA) schedule

  • Jay Vasilev's schedule 

  • Joocer's 3rd Party Schedule

• UWorld – UWorld questions are high yield for the NBME and are a great preparation tool. Go through at least 10-15 Nephrology-specific questions daily and you will see key concepts that will aid you in being successful on assessments, while solidifying key concepts that will help with small groups and daily quizzes. However, UWorld is not necessary to succeed. 

• First Aid & Anki – First Aid provides a useful condensed review of core concepts and contains minute details that are applicable to assessments and small group cases. It can be used to review concepts daily and as a last review before exams. Anki cards can be unsuspended based on B&B or First Aid tags. If you love Anki, use it. But if it is not for you, you can be successful in this course without it.

• Student-Made Resources – There are several useful study guides made my students. Additionally, you might want to create a shared document of answers to the learning objectives with peers.

• Youtube Videos – Ninja nerd, osmosis, Armando Hasudungan, and Dr Matt & Dr Mike all have excellent videos that break down renal physiology and pathology concepts.

Note: there is a separate morning clinical schedule that you will be provided.