nephrology fellowship - hemodialysis, initial prescription* 2. chronic hemodialysis, ongoing...

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    Nephrology Fellowship logbook

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    CONTENTS Instruction for the use of the logbook ..

    Cases & conditions..

    Renal replacement competencies...

    Procedures.. ..

    First year logbook ..

    Clinical nephrology I ....

    Academic activities ..

    Procedures log 1... ..

    Dialysis logbook 1..

    Transplantation log 1 ..

    Second year logbook..

    Clinical nephrology 2 ....

    Academic activities 2..

    Renal ICU..

    Procedures log 2... ..

    Dialysis logbook 2..

    Transplantation log 2 ..

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    Instructions for the use of logbook

    Aim of the logbook

    The purpose of the logbook is to provide one source of evidence for the ne-

    phrology scientific council that you attained the desired level of competency

    required for licensure. It is the place where you are going to document experi-

    ences and skills you attained during your training.

    The logbook is divided into several sections. These instructions will help you

    completing those sections correctly.

    Personnel information

    Please fill in all your personnel information required. This will help the Egyp-

    tian Fellowship Administrators to process your logbook during scientific coun-

    cil evaluation yearly and finally before sitting for the final exam. Your person-

    nel photo should be attached to the logbook and you should sign the personnel

    information page

    Clinical nephrology , dialysis and transplantation case log

    1. You will find lists with all required cases in the curriculum. Your level of

    participation in each case and expected activities are also determined

    2. You need to mention the patient data, management provided and case pro-

    visional & final diagnosis

    3. For each case write the date of the interview

    4. Make a check mark at the appropriate column indicating your level of par-

    ticipation in case management (observer, supervised management of the

    case or independent management of the case)

    5. Each case should be counter signed by your trainer. His signature is the

    proof of your actual participation. The trainer signature should be very

    clear

    Procedures log

    1. The logbook contains tables for required procedures during different stages

    of training and the level of desired performance at each stage.

    2. You will also find empty tables to write down the procedures, your level of

    participation and the date.

    3. Your trainer should countersign each procedure to document the event

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    Academic activities

    1. Academic activities that must be documented are lectures, journal clubs,

    morbidity and mortality meetings and workshops or conferences at-

    tended.

    2. Any attended activity must be signed by the workshop or conference organ-

    izer/coordinator. At least two national conferences in the field of nephrol-

    ogy must be attended

    Rotation Proof

    Your scientific council has determined specific rotations in subspecialties

    that you must go through during the training period (see your curriculum for

    details). After you finish each rotation sign its block by the Hospital/training

    center manager and stamp officially.

    Assessment of logbook activities

    1. Your trainer will assess your logbook weekly for completion and provide

    feedback

    2. Your educational supervisor will assess your logbook monthly or every two

    months, provide verbal or written feedback and counter sign important ac-

    tivities

    3. The examination committee of the scientific council will revise your log-

    book:

    A) Annually before you progress from one year of training to another

    B) At the end of training before the final exam

    To be noted that unsatisfactory completion of the logbook would lead to delay

    of training progression.

    Unsatisfactory logbook at the end of training will prevent you from entering the

    final exam

    Important Notice:

    It is your responsibility to maintain accurate and completed logbook and to regu-

    larly update your records. Shall you meet any difficulty; you must contact your

    trainer or your specialty administrator at the Egyptian Fellowship Board.

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    Core Conditions and procedures that must be Managed Competently

    by Nephrology Trainees

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    Clinical condition Clinical condition

    Renovascular diseases Arterial and venous thrombosis

    Thrombotic microangiopathies Renal vasculitis

    Clinical condition Clinical condition

    Gross Hematuria Microscopic hematuria

    Asymptomatic proteinuria Nephrotic syndrome

    Nephritic Syndrome Rapidly progressive glomeru-

    lonephritis

    Chronic glomerulonephritis

    2. Vascular Disease

    1. Glomerular Diseases

    Clinical condition Clinical condition

    Renal tubular acidosis Renal tubular rickets

    Bartter syndrome Nephrogenic diabetes insipidus

    Interstitial nephritis Hyperoxaluria

    3. Tubulo-interstitial disorders

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    Clinical condition Clinical condition

    Acute and recurrent urinary tract infections

    Stones diseases and obstructive uropathy

    Neurogenic bladder and voiding disorders

    Vesicoureteric reflux

    4. Urinary tract

    Clinical condition Clinical condition

    Pregnancy with preexisting renal

    disease Liver disease

    Pregnancy with new renal in-

    volvement Specific infections

    Essential hypertension Congestive heart failure

    Secondary hypertension Sickle cell nephropathy

    Hyperlipidemia Dysproteinemias

    Diabetic nephropathy Amyloidosis

    SLE Metabolic errors

    Other collagen disorders

    5. Systemic conditions with renal involvement

    6. Renal patients with electrolyte and acid base disturbances

    7. Cystic renal diseases

    8. Renal and urinary tract neoplasia

    9. Acute renal injury of various causes

    10. Chronic kidney disease due to various causes and stages

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    Clinical condition Clinical condition

    Acute coronary syndrome Hypertensive emergencies

    Pulmonary edema Sepsis and severe acute infections

    Cerebrovascular stroke Status epilepticus

    Hepatorenal syndrome

    11. Medical emergencies associated with renal problems

    Clinical condition Clinical condition

    Nephrotic syndrome Cystic renal diseases

    Congenital/ infantile nephrosis Acute and recurrent urinary tract

    infections

    Nephritic syndrome Congenital obstructive uropathies

    Hemolytic-Uremic syndrome Neurogenic bladder and voiding

    disorders

    Renal tubular acidosis Vesico-ureteric reflux and reflux

    nephropathy

    Renal tubular rickets Fluid, electrolyte and acid-base

    disturbances

    Bartter syndrome Acute Kidney Injury of various

    causes

    Nephrogenic Diabetes Insipidus Chronic Kidney Disease of various

    causes and stages

    12. Pediatric renal diseases

    The trainees level of participation in the management of pediat-

    ric nephrology cases is either observation or assistance in man-

    agement only

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    RENAL REPLACEMENT THERAPY COMPETENCIES

    1. Chronic hemodialysis, initial prescription*

    2. Chronic hemodialysis, ongoing management*

    3. Acute hemodialysis

    4. Slow continuous HD

    5. Hemodialysis, session complications*

    6. Hemodialysis, access complications*

    7. Plasmapheresis

    8. Acute peritoneal dialysis*

    9. Chronic peritoneal dialysis, initial prescription

    10. Chronic peritoneal dialysis, ongoing management

    11. Peritoneal dialysis, complications

    12. Pretransplant evaluation

    13. Transplantation day management

    14. Transplantation, postoperative hospital stay management

    15. Post transplant follow up

    16. Transplantation, acute stage complications

    17. Transplantation, long term complications

    Cases marked * are specifically required in both adult and pediatric pa-

    tients

    The logbook must contain evidence of competent performance of the

    above mentioned procedures at the level of

    1. observation and assistance during the first year of training

    2. Independent performance under supervision at the second year of

    training

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    LIST OF PROCEDURES

    1. Renal and urinary tract ultrasonography

    2. Native kidney ultrasound guided kidney biopsy

    3. Graft ultrasound guided kidney biopsy

    4. Insertion of femoral catheters

    5. Insertion of double lumen central venous dialysis catheters

    6. Insertion of acute peritoneal catheters

    7. Renal graft perfusion

    Trainees must observe and assist in the above mentioned procedures

    during the first year of training

    They must perform the above mentioned procedures under supervision

    during the second year of training and they may require assistance

    Trainees are assumed to have developed competency in routine medical

    procedures and advanced life support as part of their training in Inter-

    nal Medicine prior to starting the nephrolog

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