Goals & Philsophy


The goal of the Nephrology Training Program is to provide advanced
education and experience to enable fellows to deliver compassionate,
thorough, and evidence-based care to a medically and socially diverse
population of patients. This includes inpatient and outpatient
consultation; acute and chronic dialysis, including continuous
modalities; and outpatient consultation and chronic kidney disease
care, including the care for renal allograft recipients. The fellow will be
provided with educational opportunities required for acquiring Board
Certification in the subspecialty of Nephrology. Fellow can be mentored
towards an academic clinical or basic science research career if
interested.

The philosophy of the Program is to develop a commitment and
dedication to scholarly excellence in patient care, teaching, and
research in an environment of professionalism.


What Makes Us Special

Historical Remarks of the Division

The Katz Family Division of Nephrology and Hypertension has been
training fellows and caring for patients with kidney disease in South
Florida for more than five decades. During this time we have trained
more than 180 nephrologists who have gone on to successful careers
in the private sector and academic setting throughout the United
States and around the world. This proud tradition of education,
research and patient care has been carried forward during these years
by a dedicated faculty, many of whom have committed their entire
careers to this Division and provided the stability and tradition that
defines who we are. The unique opportunity of having a public
hospital, private University Hospital and Veterans Hospital all on one
campus has provided the backdrop and synergy that has resulted in
the introduction of many cutting-edge patient care modalities to
South Florida, including our multi-organ transplant center.

As a consequence of generous philanthropic support, the Division has
matured into both a clinical center of excellence specializing in
managing the most challenging cases coupled with a powerful
research program centered around the Katz Family Drug Discovery
Center. Our unique geographic location as a gateway to the Caribbean
and Central and South America as well as Europe has enabled us to be
a magnet for the very best talent in physicians and physician-
scientists from many continents and to be a destination for patients
seeking the best medical care. The recruitment of such a diverse
faculty has been a continued strength of the program that translates
directly into the maintenance of excellence in the training program.

The Peggy and Harold Katz Family Drug Discovery Center
The generosity of the Peggy and Harold Katz Family has helped establish The Peggy and Harold Katz Family Drug Discovery
Center, which has supported many junior investigators and has
greatly advanced the research enterprise of the Division. In addition,
the Center fosters collaborations across Departments in the Miller
School of Medicine. Ongoing collaborations with more than 20 different
institutions from 5 different continents contribute to the emispheric
visibility of the Division and of the Center. Our faculty is contributing to
groundbreaking translational research that will improve the lives of
patients with kidney disease on a global basis.

Investigators in the Katz Family Division of Nephrology have
contributed to the field with high impact peer-reviewed publications
(hyperlink).

Miami Transplant Institute (MTI)
The Miami Transplant Institute was created as an affiliation between
Jackson Health System and UHealth. The first of its kind in the U.S., MTI
is comprised of a full multidisciplinary team of physicians with medical,
pediatric, and surgical sub-specialties.

As nephrology fellows you will be exposed to the pre-transplant
evaluation and immediate post-operative management of living and
deceased kidney transplant patients. Fellows also participate in the
management of acute and chronic rejection of kidney transplants and
serve as consultants to other organ transplant recipients who develop
renal or electrolyte complications.


Consultative Services

There is an average daily census of 15-25 patients on the Nephrology
Consultation teams’ services at Jackson Memorial Hospital and
UHealth Tower, and approximately 10-15 at the Veterans Administration
Hospital. At Jackson Memorial Hospital and UHealth Tower, patients are
approximately 45% Hispanic, 30% African-American, 10% Haitian, and
10-15% non-Hispanic Caucasian. Patients may be seen in the
emergency room, inpatient floors or intensive care units for consultation.
A large number of high acuity patients are seen in a diverse number of
ICU settings (MICU, SICU, Trauma ICU, Neuro ICU, CCU), many of whom
require continuous modalities of renal replacement therapy.


Schedule

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Call

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Curriculum

Nephrology Boot Camp-NEW:
We have designed a “crash-
course” for our incoming fellows that includes basic hemodialysis
and peritoneal dialysis concepts (how they work, how it is
prescribed), general transplantation concepts and common consult
topics (e.g. AKI, CKD, nephritic/nephrotic syndromes). By starting this way, the fellows will
know what is expected and how to address nephrology consultations
and make the transition from resident to fellow a whole lot smoother.
Additionally, we will review how to write a consultation note
efficiently and concisely and how to place dialysis orders.

Core curriculum conferences:
Faculty members will cover the
Nephrology Core Curriculum (AKI, CKD, Transplantation, Electrolyte
derangements, acid-base problems) over the course of a 24 month
learning cycle.

Journal Club:
Journal Club is an in-depth review of one article from
the recent literature. Fellows work in close collaboration with faculty
sponsor of journal club to develop the presentation. The goal of this
exercise is to learn how to critically read a manuscript as a reviewer
would and to learn the basic science as applied to nephrology. This
activity is organized by Dr. Contreras (Director of Clinical Research
Operations).

Clinical Discussions:

Consists of a clinical case presentation;

  • 15-20 minute presentation (by the fellow, student, attending,
    or housestaff) with lab data, ancillary tests (x-ray, scanning,
    ultrasounds, etc.) and formulation of the problem(s) to be
    discussed.
  • 10-15 minutes discussion by the fellow or faculty member. If a
    case with renal pathology is presented, the renal pathologist
    will lead biopsy review.
  • 15-20 minutes questions and general discussion with input
    from all attendees.

Renal Grand Rounds:
This conference is a formal 45 minute presentation by a fellow or
faculty member. It should be a state of the art and in depth analysis
of the topic using PowerPoint support.

Medicine Grand Rounds:
The Department of Medicine has weekly Medicine Grand Rounds every
Wednesday at 12 noon.


Tracks

CLINICAL TRACK
  • 2-year clinical pathway
    With the option of tailoring the second year to the fellow’s specific area of
    interest: Glomerulonephritis focus, Transplant focus (does not count as
    transplant fellowship), In-center and Home Dialysis focus,
  • 3-year clinical pathway
    Transplant Nephrology: 2 years general nephrology, 1 year transplantation.
    Transplant Program Director: Mariella Ortigosa-Goggins, MD
    (mariellaogoggins@med.miami.edu).
  • 4-year clinical pathway
    ICU-Nephrology: 2 years nephrology, 2 years critical care
RESEARCH TRACK
  • 6-year Physician Scientist ABIM pathway:
    2 years internal medicine, 3 years
    research, 1 year nephrology. For more details, please reach out to
    Dr. Alessia Fornoni, MD, PhD (afornoni@med.miami.edu).

Moonlighting Policy

PURPOSE:
The purpose of this policy is to establish appropriate standards for
moonlighting consistent with proper patient care, the educational
needs of the Fellowship Program, and the applicable Hospital Policies.

POLICY:
  • Moonlighting:
    Moonlighting is defined as all clinical and
    academic activities that occur outside the fellowship program.
  • Limitations on Moonlighting:
    Because the nephrology
    fellowship education is a full-time endeavor, the program director
    must approve all moonlighting activities to ensure that moonlighting
    does not interfere with the ability of the fellows to achieve the goals
    and objectives of the educational program. Usually, only internal
    moonlighting will be permitted.
  • Impact on Duty Hours:
    All internal moonlighting activities count toward the 80-hour weekly
    limit on duty hours.
  • Oversight:
    All approved moonlighting activities must be documented.
    Documentation must include the type of activity, site were activity
    was performed, as well as dates and times when activity was
    performed. All documentation must besubmitted to the training program director within 10 working days after
    the activity was performed.
  • Unapproved Moonlighting:
    Unapproved moonlighting will be reported to the sponsoring institution,
    the program director of the core program, and the Graduate Medical
    Education Council. If the unapproved activity interferes with the ability
    of the fellow to achieve the goals and objectives of the training program
    or violates Hospital Policies, administrative actions will be taken, including
    the possible termination of the fellow.