Clinical Training
The first year of the training program is designed to
instruct fellows in all aspects of clinical nephrology. To this end,
the clinical responsibilities are roughly divided between consultative
nephrology, dialysis, and renal transplantation: both in patient and
out-patient experiences are emphasized. The first year of the training
program involves 12 months of patient care at three separate, contrasting
institutions. The Atlanta Veterans Administration Medical Center is
a 524-bed referral center providing both ambulatory and inpatient dialysis,
consultative nephrology, and a large clinical outpatient service. Grady
Memorial Hospital is an 856-bed primary care center serving Fulton and
DeKalb Counties, offering extensive ambulatory and inpatient dialysis
programs, a CAPD program, and an active consultative nephrology service.
Emory University Hospital is a 600-bed tertiary care center which offers
training in kidney transplantation and renal ultrasonography in addition
to traditional aspects of clinical nephrology. The second year of the
clinical track currently consists of six months of clinical training
at Crawford Long Hospital (including a large peritoneal dialysis clinic),
three months of renal ultrasound training at Emory University Hospital,
and three months of clinical research. All clinical fellows staff the
weekly Grady Outpatient Renal Clinic for 2 years (for one month, each
fellow staffs a pediatric nephrology clinic at Eggleston Hospital instead)
and a weekly transplantation clinic at Emory University Hospital for
one year. All fellows are required to develop skills in all aspects
of dialysis, and to become expert in renal biopsy and the medical management
of renal allograft recipients. Renal fellows play important roles in
the teaching of medical students, interns, and residents, and they regularly
participate in clinical nephrology conferences and journal clubs.
All fellows receive extensive training and experience
in a variety of nephrology 
procedures including placement of temporary
and tunneled hemodialysis catheters into femoral and internal jugular
veins, placement of cuffed peritoneal dialysis catheters with and without
peritoneoscopy, removal of tunneled hemodialysis catheters, and percutaneous
biopsy of native and transplanted kidneys. Training in angiography,
thrombolysis, and angioplasty of arteriovenous grafts and fistulae is
also available within the Renal Division.
Comprehensive training in sonography has been part of
the fellowship training program since 1994. All fellows rotate through
the ultrasound service at Emory Hospital, and sonograms are also performed
at Crawford Long Hospital and Grady Memorial Hospital. Approximately
1000 sonograms are performed at Emory Hospital and Emory Clinic each
year, including diagnostic studies of native kidneys, transplanted kidneys,
and urinary bladder, and guidance for percutaneous biopsy. The Renal
Division has two scanners at Emory, and one each at Crawford Long and
Grady. In addition to their ultrasound rotation, all fellows attend
a two-day comprehensive training course at Emory. Fellows also participate
in ongoing clinical ultrasound research when on the ultrasound rotation.
Emory has a large renal transplantation program.
