During the residency training program, there are many opportunities to gain experience in ambulatory care. Once a week, a general nephrology clinic is attended by the resident. This clinic is supervised by an attending, but the resident is responsible for the patients' care. The resident will initiate the appropriate investigations and provide a treatment plan for the patients under the supervision of the attending physician. This clinic runs once a week, so the resident is able, during their rotation, to follow the patients long term and manage any complications that may occur. The residents are expected to review all lab reports and be responsible for initiating treatment changes if necessary. The also attend a weekly mentored transplant clinic following up to ten recently-transplanted patients.
In addition to the mentored longitudinal clinics, the resident has the opportunity to attend a number of clinics during other rotations. The transplant rotation has a Wednesday a.m. and Thursday a.m. clinic. During this rotation the residents are expected to be involved in the work-up of a living donor, the medical and surgical work-up of transplant recipients, and the follow-up of a number of transplant recipients at various time points post-transplant.
Ambulatory care clinics play a large role in the peritoneal dialysis rotation. During these clinics the residents will have an opportunity to review the monthly blood work and adjust the dialysis prescription as necessary. The new dialysis starts will be seen in the outpatient setting.
The nephrology resident also has the choice of attending a number of other clinics during a second-year ambulatory care rotation. These include: pediatric nephrology clinics, urology clinics, hypertension, glomerulonephritis, and general nephrology clinics.