St. John Hospital and Medical Center offers a fully accredited two-year fellowship in the subspecialty of Nephrology. This program also offers an optional third year to be spent in special study in the area of Transplantation (Kidney and Pancreas) Clinical Nephrology Research, or Interventional Nephrology.
- Inpatient Nephrology 3 months
- Transplantation 2 months
- Dialysis Theories* 1 month
- Inpatient Consultative Service 4 months
- Pediatric Nephrology 1 month
- Scholarly Activity 1 month
- Inpatient Nephrology 2 months
- Consultative Nephrology 3 months
- Transplantation 2 months
- Pathology 1 month
- Scholarly Activity 2 months
- Vascular Surgery 1 month
- Hypertension 1 month
*All fellows are assigned 25-30 hemodialysis patients and 5-10 CAPD patients to follow during the entire 24-month fellowship.
The Nephrology program is housed on the campus of St. John Hospital & Medical Center. Outpatient chronic kidney disease (CKD) clinics are located immediately adjacent to the hospital, steps from the department offices and supervising faculty. The outpatient hemodialysis facility is conveniently located in the same building. St. John Dialysis Corporation provides acute dialysis services to nine hospitals totaling 1,500 beds spanning from Detroit to Port Huron. Only the latest in extracorporeal technology is utilized to provide care in the hospital setting, including plasmapheresis, continuous renal replacement therapy, and conventional dialysis.
A 36-bed inpatient unit, with a 10-station dialysis unit, is dedicated exclusively for the care of kidney disease patients. Staffed with experienced nurses along with arterial, central venous and telemetry monitoring; this state-of-the-art facility provides comprehensive care to dialysis and transplant patients alike. Our fellow has the opportunity to manage an appropriate workload with the assistance of a multi-disciplinary team of residents, interns, medical students, and ancillary professionals under the direct supervision of our academic staff.
Fellows provide primary evaluation and management of all nephrology cases on this unit while educating the residents who rotate through the service. This service is consistently highly rated by residents and fellows as an outstanding learning environment.
The Interventional Nephrology Suite is an 8,000 sq. ft. modern surgical/radiological suite, with two fully equipped operating/radiology theaters. It is physically contiguous with the Division of Nephrology and fellows' offices. The suite is fully staffed with registered nurses and accredited radiologic technicians. It offers fellows the opportunity to gain accreditation in all nephrologic interventional procedures as indicated under the supervision of an ASDIN certified interventional nephrologist or board-certified vascular surgeons.
Nephrology Consult Service
Fellows have the opportunity for extensive inpatient consultation experience both of an acute and chronic nature. They are primarily responsible for patient evaluations, assessing immediate patient needs, and initiating treatment plans (under the guidance of the nephrology staff). Should dialysis be required, the fellows have the responsibility for determining the dialysis modality best suited for the patient and initiating this treatment. A great deal of independence is offered to fellows based on their medical maturation.
SJH&MC has a fully accredited pancreatic and renal transplantation service. Approximately 50-60 renal transplants and 5-10 pancreas transplants are performed each year. Fellows have the opportunity to perform outpatient pre-transplant work-ups in the Transplant Clinic and to gain exposure in acute inpatient transplant care, including but not limited to immunosuppressive therapy and the infectious disease complications of transplant patients. Fellows continue to follow these patients post-transplant in the clinic to gain exposure to immediate post-transplant complications and develop skills in management of emerging transplant protocols.
Acute and chronic hemodialysis in addition to continuous cyclic peritoneal dialysis, continuous venovenous hemodialysis, and plasmapheresis are available at SJH&MC. Fellows gain exposure to each of these modalities and learn the technical and physiologic aspects of each. Each fellow is assigned a group of patients to be managed throughout the duration of fellowship training in nearby dialysis clinics featuring all modern modalities, including nocturnal, home hemodialysis, and CAPD.
Pathology monthly biopsy conference is led by a board certified renal pathologist to educate in the evaluation of renal biopsies using standard histologic staining, electromicroscopy and immunofluorescent studies. Fellows have full opportunity to develop the manual dexterity necessary for performing both native and transplant renal biopsies and achieve competency in these procedures.
Elective time is spent both in inpatient and outpatient pediatric rotations where exposure to acute pediatric nephrologic diseases is made available.
Fellows are expected to initiate and complete at least one clinical or bench research project during their fellowship. Research is directed by a staff nephrology mentor and by the Director of Nephrology Research. All aspects of clinical, statistical and bench research are made available at the fellows' request. A research nurse and statistician are available to the department.
The fellow will have the opportunity to become proficient in the following procedures:
- Renal biopsy (native and transplant)*
- Placement of temporary hemodialysis catheters (Femoral & Internal jugular)*
- Placement of cuffed venous hemodialysis catheters.
- Placement of permanent Tenckoff catheters.
- Angiography, angioplasty, thrombolysis and stenting of arteriovenous grafts and fistula.