EDUCATION & TRAINING
| The Nephrology Fellowship Experience

Monday through Friday
7:00 –  9:00 am – Fellow/Resident Rounds
9:00 -  12:00 noon – Consult Rounds with Faculty
12:00 - 1:00 pm – Lunch/Noon Conferences (Friday Only)
1:00 -   4:00 pm – Consult Rounds/Clinic
4:00 –  5:00 pm – Consult Rounds with Faculty/Clinic
The above schedule is suggested and is subject to change upon the discretion of faculty attending.

Weekends and Holidays
The attending physician and fellow will make work rounds on Saturday, Sunday, and any other holiday.  Weekend call starts at 8:00 am Saturday morning.

Call Responsibilities
Each fellow will be on call approximately once every fifth night/weekend from 5:00 PM until 8:00 AM the next morning.

Special Conferences
Nephrology staff will post timing and venues for any special conferences and you will be notified via email.

On-call Hours
After hours fellows take call from home. Call will start at 5pm on a workday and go on till 8am the next day.

Patient Assignments
All patients on whom a consult is requested will be seen within twenty-four hours of the request. All ICU calls will be seen within (1-2) hours of origination of call unless the staff on call approves of the consult to be seen the next morning.

Sample Inpatient Schedule: Fellowship Year One

• Period 01 - Consultation (Ochsner LSU)
• Period 02 – Elective Self Study/Ambulatory Clinic
• Period 03 - Consultation (Ochsner LSU)
• Period 04 – Transplant (Private)
• Period 05 – Elective Critical Care
• Period 06 - Consultation (Ochsner LSU)
• Period 07 – Elective Hemodialysis Clinic Rounds
• Period 08 – Elective Research
• Period 09 - Consultation (Ochsner LSU)
• Period 10 – Transplant (Private)
• Period 11 - Consultation (Ochsner LSU)
• Period 12 – Elective Procedural (Renal Bx and CVC Insertion)
• Period 13 - Consultation (Ochsner LSU)

Sample Inpatient Schedule: Fellowship Year Two

• Period 01 - Ambulatory Hemo Dialysis Rotation
• Period 02 - Interventional Nephrology
• Period 03 – Elective Nephro Pathology
• Period 04 – Interventional Nephrology
• Period 05 –Elective Radiology
• Period 06 – Elective Research
• Period 07 - Consultation (Ochsner LSU)
• Period 08 – Elective Research
• Period 09 – Elective Urology
• Period 10 - Interventional Nephrology
• Period 11 – Elective Research
• Period 12 – Elective Ambulatory Clinic (GN/HTN/PD/Outpatient Dialysis)
• Period 13 - Interventional Nephrology

Clinics

• Tuesday – All Fellows: Continuity Clinic (10-12 patients) (Ochsner LSU)
• Thursday – Elective/LSU Fellow: New Patient Intake Clinic (4-5 Patients)
• Thursday (Last week)– Elective/LSU Fellow: Glomerulonephritis Clinic (4-5 Patients) (Ochsner LSU)
• Fridays – Elective: Hypertension Clinic (10-12 patients) (Ochsner LSU)
• PD Clinic – All Fellows: (Once a month at the fellow designated clinic)
• HD Outpatient Shift -- Second Year fellows Once a Month

Rotations

• Ochsner LSU Health Shreveport
• Interventional Nephrology

Elective:

• Research
• Pathology
• Urology
• Radiology
• Interventional Radiology

The Nephrology and Hypertension Division offers diagnostic evaluation and clinical management for patients with acute or chronic kidney diseases, hypertension, kidney transplantation, diabetic nephropathy, glomerulonephritis, nephrotic syndrome, interstitial nephritis, electrolyte and acid-based disturbances, hematuria, proteinuria, kidney stones amongst other conditions. Faculty/Residents/Fellows/Physician Extenders provide daily clinics at 1501 Kings Highway, Shreveport, LA 71103 location.

The Ochsner LSU Health Shreveport Academic Medical Center inpatient nephrology practice treats patients with diverse renal diseases, such as hematuria, proteinuria, acute/chronic kidney disease, kidney transplantation, diabetic nephropathy, hypertension, recurrent urinary tract infections, renovascular disease, renal tubular abnormalities, fluid and electrolyte disorders, glomerulonephritis, nephrotic syndrome, anti-GBM disease, systemic lupus erythematosus, vasculitis, and interstitial nephritis.

Renal replacement therapies including acute and chronic hemodialysis, continuous renal replacement therapy, acute and chronic peritoneal dialysis including urgent start peritoneal dialysis is offered by a qualified nephrology team at Ochsner LSU Health Shreveport.

Over the last 15 years, LSU Health Shreveport program has trained numerous interventionists in practice in academic and private setting. The IN program offers services across all aspects of dialysis access involving diagnostic and therapeutic procedures required to achieve a working dialysis access. Ultrasound exam of veins/fistulae/grafts, Venograms (radiocontrast/Carbon di Oxide), Angiograms/Angioplasty/Thrombectomy of Fistulae and Grafts, Stents in Fistulae/Grafts/Peripheral/Central Veins/Arteries, Peritoneal Dialysis catheter Insertion/Revision/Removal, Tunnelled Dialysis Catheter Insertions/Revision/Replacement/Removal, Accessory vein ligation/Coil, Fistula/Graft banding/Miller/Ligation etc.

Training in IN is available in two tracks:

• Nephrology Fellow Track: All fellows enrolled in 2-year nephrology fellowship are eligible for training within the 24 months of nephrology fellowship.
• Interventional Nephrology Fellowship Track: Available to nephrology fellows who have completed ACGME Nephrology fellowship. This is a one-year training track as 6th/7th year fellow track.

The Nephrology and Hypertension provides care for in-center and Home hemodialysis and peritoneal dialysis patients at several dialysis facilities that are owned and operated by DCI and Fresenius. Over 400 ESRD patients are provided care by LSU Nephrology staff.

Pretransplant evaluation for living-related and deceased-donor kidney transplants, post-transplant care in both ambulatory and in-patient settings, and consultation for patients with non-renal solid organ transplants with chronic kidney disease.

1st - 4th Fridays of every month, 12:30 pm
Topics from the curriculum will be assigned to Faculty and Fellows

1st and 3rd Wednesday of Month, 4:00 pm
Mandatory for fellows; Discuss renal physiology, electrolytes and acid base

5th Friday of each month, 12:30 noon 

3rd Friday of each month, 1:30 PM
Review native, pediatric and transplant biopsies with pathologists

1st  and 4th Friday of each month, 1:30 PM
Cases will be presented in rotation from the consult service. A Schedule for the presentation fellow will be available in the nephrology office.

2nd Friday of each month, 1:30 PM
Two fellows with attending mentor will present 2-3 articles.  Article to be distributed one week prior to conference.

Quarterly, 6pm at Local Restaurants
Current topic review from Nephsap, ASN

Vacation - 20 Working days of vacation.
A Leave Form should be completed by Fellow and signed by Program Director before leave is approved. No exceptions!
Leave Forms are available at Nephrology Office, Program Coordinator Office, or can be sent via email to you. Please contact Program Coordinator, Cristal Willcox, for details.

Leave period shall not exceed two weeks in a block of four-week rotation. Leave is encouraged to be taken in weekly blocks to minimize interruptions in education.

Educational Leave - Educational leave will be granted for:

1. American Board of Internal Medicine (ABIM) Examination
2. American Society of Nephrology Meeting
3. National Kidney Foundation Meeting
4. Other scientific meetings at which the fellow makes a scientific presentation.

FMLA/Maternity Leave - See the House Officer Handbook for guidelines

Sick Leave - It is the responsibility of the fellow to contact their assigned Attending Physician and the Program Director if sick leave is requested.  Failure to follow the procedure can  result in charging annual leave for any sick days.

Leave Without Pay (LWOP) - Special circumstances may warrant the fellow being granted leave without pay.  This must be arranged with the approval of the Program Director. During the period of time of LWOP, no credit for training will be given and training will be extended.

Interview leave: Fellows can avail a maximum of 5 working days in the final year of training for job interviews. Primary rotation Attending and Program Director must sign off on the leave request. Leave requests may not be made on continuity clinic (Tuesday).

Emergency Leave: Emergency leave will be approved as needed by the Program Director. FMLA leave policy will be used to sanction such leave requests.

"Moonlighting” is a privilege granted to Nephrology Fellows on a case by case basis.  The direct provision of patient service for pay (moonlighting) is considered an augmentation and a privilege that should not detract from the goals and objectives of the educational program. Internal moonlighting is defined by the ACGME as moonlighting at the sponsoring institution or the non-hospital sponsor’s primary clinical site.

• Fellows are not required to engage in moonlighting.
• If moonlighting does occur, each Resident must have a written statement of permission from the program director that is made part of the Resident’s file.
• Resident Performance will be monitored for the effect of moonlighting activities upon performance and that adverse effects may lead to withdrawal of permission.
• Internal and External moonlighting hours must be counted toward the 80-hour weekly limit on duty hours, and monitored by the training program.

As recommended by the Clinical Board, Fellows are encouraged to limit the number of moonlighting hours per week to 10 hrs. Fellows must notify Program Director of the average number of external moonlighting hours per month.  Fellows are reminded that the Louisiana State Malpractice Plan does not cover malpractice for moonlighting hours outside the LSU Health System.  Under no circumstances should Fellows moonlight during their regular scheduled program hours of service.

Due to Federal Guidelines, individuals with the J-1 VISA are not allowed to moonlight.

Nephrology Fellow whose attendance decreases to less than seventy five percent of conferences attended will have their approval for moonlighting suspended until their conference attendance improves to greater than seventy percent.  

Note:  Approval must first be granted by program director and “Moonlighting Approval/Evaluation” forms must be submitted and placed in fellowship file.