By John Paoni
You have completed medical school, and you are now in your first year of nephrology fellowship. Chances are you have relocated to a new place to live and you are trying to settle in. Moving is stressful. You are in learning mode and are trying to absorb as much knowledge as you can. All you can focus on is gathering knowledge to prepare yourself for treating people with end-stage renal disease (ESRD). Once you have settled into an apartment or a home, you have to learn new geography. going to a new place always presents challenges. Every program is different and you are now the “new" kid on the block. So it is basically, back to start-over phase as you begin your first year in nephrology fellowship.
Your days are spent rounding in the dialysis clinic with another nephrologist, diagnosing and treating patients. You will be categorizing patients by the extent of their disease, i.e., hypertension, electrolyte disturbances, etc. You will recommend dialysis and renal replacement therapies for some patients. Some patients will require a renal transplant. You need to learn fluid and acid base physiology, how to manage acute and chronic renal failure, vascular disorders, pharmacology, and nutrition. Depending upon your program, you may also be trained in some procedures. You may learn to perform kidney biopsies and catheter placement. So basically, your thought process is trying to gain as much clinical knowledge as possible. You will spend long hours in the hospital and the clinic(s).
This is a pivotal point in your career. You are balancing between family, school, loans and often other financial concerns. If you are a foreign medical graduate, you may have some visa issues. The pressure is building and you need to set a plan in place. But the only thing on your mind is to learn as much as you can about nephrology. This is your fellowship and you want to make the most of it. Set a plan in motion.