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OUTPATIENT EXPERIENCES:
1. Continuity Clinic
Fellows will maintain a continuity clinic one half day per week on Wednesdays for the
duration of the two-year fellowship. Fellows will on average be responsible for four to
eight patients per !-day clinic. The continuity clinic will provide the fellow with the
opportunity to gain experience in the outpatient management of a wide variety of renal
diseases. Fellows will have the opportunity of observing the natural history of many
diseases over this two-year period. Specifically, the fellow should expect to gain
significant clinical experience in the outpatient management of:

Hypertension (both primary and secondary)
Diabetic nephropathy
Chronic kidney disease and its complications
Renal disorders of pregnancy
Urinary tract infections
Tubulointerstitial renal diseases including artheroembolic disease
Disorders of mineral metabolism including nephrolithiasis, hypercalcemia, and
magnesium disorders
Disorders of water, sodium and potassium
Evaluation of hematuria and proteinuria

Fellows will have a unique opportunity to impact on patient outcomes with patient
education directed at cessation of smoking, salt restricted diets, adequate glycemic
control in diabetes, good control of blood pressure and life style modification.

Fellows will follow at least 25% of patients from each gender. The continuity clinics will
not be interrupted by more than 1 month, excluding a fellows vacation time.

Fellows will keep a healthspan patient log of all continuity clinic encounters and this will
be submitted to the program on a quarterly basis.

The continuity clinic templates according to level of training and type of rotation are
outlined below.











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Fellow Clinic Templates



1 2 3 4 5
N 8:00 9:00 N 1:30 2:30 Recip 8:00 9:00 R 8:00 8:30 R 1:30 2:00
R 9:00 - 9:30 R 2:30 3:00 R 9:00 9:30 R 8:30 9:00 R 2:00 2:30
R 9:30 10:00 N 3:00 4:00 R 9:30 10:00 R 9:00 9:30 R 2:30 3:00
N 10:00 11:00 R 4:00 4:30 N 10:00 11:00 R 9:30 10:00 R 3:00 3:30
R 11:00 11:30 N 4:30 5:00 R 11:00 11:30 R 10:00 10:30 R 3:30 4:00
R 10:30 11:00 R 4:00 4:30
R 11:00 - 11:30





Revised 11/26/12


1 = nonhospital months
2 = hospital fellow (consults and service)
3 = fellow on transplant or outpatient who
will be doing recip evals
4 = nonhospital fellow from March 15
th
of
their 2
nd
year to end of training if they are
not staying with ECU Nephrology and
maintaining a clinic
5= hospital fellow (consults and service)
from March 15
th
of 2
nd
year to end of
training if they are not staying with ECU
Nephrology and maintaining a clinic

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OUTPATIENT EXPERIENCES (continued):
2. Acute Transplant Clinic
Fellows will see an average of 6 (range of 3-8) acute transplant patients (< 4 months out)
once a week on Thursday mornings in the Moye Medical II clinic on the 1
st
floor. These
patients will be shared between 2 fellows. Fellows will only see these patients when they
are on a non-hospital rotation. Fellows on inpatient rotations such as consults or service
will not see these patients. Fellows will follow acute transplant patients for 4-6 months
during the 2013-14 academic year with anticipation of each fellow following acute
transplant patients for 4 months during each academic year thereafter. 2 teaching
attendings (Dr. Bolin and Lai) will be in the clinic each session.

The acute transplant clinic is a combined medical-surgical clinic and therefore the fellow
will have the opportunity to interact with the transplant coordinators and transplant
surgeons. The fellows will learn how to administer immunosuppressive medications
including side-effect profile and drug-drug interactions, manage medical complications of
transplantation, treat infections and diagnose/treat acute rejection.

3. Outpatient Hemodialysis Shift
Fellows will round on an afternoon hemodialysis cohort at ECU Dialysis for 4 months
over the course of their 2 year fellowship. Rotations will be divided into 2 back-to-back
months in each academic year. Fellows will select their teaching attending/dialysis shift
for each month and must do so 2 and preferably 4 weeks prior to the beginning of the
rotation. Fellows will see up to 5 patients in their 1
st
year of training, increasing the
number upwards at the end of the 1
st
year so that they see up to 10 patients during their
2
nd
year of training. The fellow is expected to round a minimum of 1 time by the 15
th
of
the months and be prepared to present the patients in a comprehensive manner to the
supervising attending. Rounds include a limited exam (heart, lungs, access, edema). The
teaching attending will either provide the fellows monthly notes or tell them how to
obtain the notes. These should be completed by the 15
th
of the month to aid in the
comprehensive presentation.

4. Peritoneal Dialysis Clinic
Fellows will see 1-3 peritoneal dialysis clinic patients per month in their own PD clinic.
It may take up to 6 months to acquire a PD patient. During outpatient rotations in the 1
st

year, fellows must attend (shadow) as many faculty clinics as possible. During the 2
nd

year, fellows may attend (shadow) faculty clinics based on the individual fellows
interests or wish to gain additional experience.

A supervising attending will be assigned to each of the fellows monthly PD clinics.




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5. Chronic Transplant Clinic
Fellows will see an average of 8-12 patients per session for 12 months over the course of
their 2 year fellowship on an alternating month basis. These patients will be shared
between 2 fellows. Fellows will see these patients at the ECU Nephrology Clinic on
Tuesday mornings when they are on non-hospital rotations. Fellows on inpatient
rotations such as consults or service will not see these patients. Fellows will follow
chronic transplant patients for 4-6 months during the 2013-14 academic year with
anticipation of each fellow following chronic transplant patients for 4 months during each
academic year thereafter. Dr. Bolin (and Jawa-TBA) are the attending supervisors in this
clinic.