Procedures in Nephrology Fellowships: Time for Change

[摘要] In this month's issue of CJASN, Berns and O'Neill describe the results of a survey of US adult nephrology training program directors (68% responded) on procedures performed by faculty and fellows at their institutions (1). The results are not surprising: The vast majority of programs require competence in performing native and transplant renal biopsies and placement of temporary hemodialysis access, whereas approximately 15 to 20% of programs perform tunneled catheter placement, peritoneal dialysis access placement, and/or therapy of stenosed/clotted vascular access. As one might expect given the lack of nationally mandated standards, there is no uniformity among programs on the required number of a given procedure. What is surprising is that such analysis of training program practices has not been done for 18 yr (2). Even more concerning is that there has been no analysis for 17 yr on the effectiveness of procedural training in preparing fellows to be practicing nephrologists (3). What, then, should renal fellowship programs be doing, and how do we make this determination?

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome