Program Structure

A. Fellows

1. Formative Evaluation
Evaluation procedures are in place to assess and document theclinical and technical competence of the renal fellows. Trainees are evaluated after eachrotation by the attending physician or immediate elective supervisor for theircomprehensive and specialized medical knowledge and provision of medical care as itrelates to the field of Nephrology, including advanced skills in history-taking, physicalexamination, clinical judgment, management, and their ability to critically analyzeclinical situations, make medical decisions and provide consultative advice. Trainees arealso evaluated for technical proficiency, communication, humanistic qualities,professional attitudes and behavior, and commitment to scholarship as demonstrated withinthe clinical setting. This process is accompanied by regular, thorough and meaningfulfeedback to the trainees about their performance as this is essential to their continuinggrowth and development as nephrologists. In addition to the evaluation process describedbelow, the Program Director meets with each trainee on a quarterly basis to providestructured feedback on performance, including appropriate counseling and other necessaryremedial effort. The formative evaluation process is performed and documented by thefollowing methods:

1. Rotation/Elective Evaluations: All fellows areevaluated at the end of each rotation by the attending physician providing immediatesupervision. This evaluation is confidential and documented in the ABIM-approvedevaluation forms for subspecialties of Internal Medicine. All evaluations are discussedwith the trainee and the evaluation forms forwarded to the Program Director for review andfiling in the fellows' record.
    

2. Procedure Logbooks: All fellows must keep a procedureslogbook in which they document all procedures performed during their training. Proceduresto be entered in the logbook include placement of temporary vascular access forhemodialysis, continuous renal replacement and related procedures, and percutaneous biopsyof both autologous and transplanted kidneys. Records should state the name and medicalrecord number of the patient, date and type of procedure, indications and complications,and the name of the supervising physician. Each procedure entered should be verified andsigned by the supervising physician. The procedures logbook should be kept up-to-date andforwarded to the Program Director at the end of each year for its review and filing in thefellows' record.

2. Summative Evaluation - Annual Performance Evaluation
At the end of each academic year the Program Director will reviewall evaluations for that year with the fellow and prepare a detailed, written evaluationof his/her clinical competence. This evaluation will stipulate the degree to which theresident has mastered each component of clinical competence and has acquired proficiencyin each of the various procedural skills identified in the program's curriculum. Thisevaluation is aimed also at identifying and discussing with the trainee career goals andpotential areas of interest for research training.

B. Faculty and Program

The trainees are given opportunities to evaluate in a systematicmanner the educational effectiveness of the program by assessing the quality of thecurriculum and the extent to which the educational goals have been met by the fellows. Thetrainees are provided with a form to evaluate confidentially the faculty and the trainingprogram formally in writing annually. The form asks for input on the general knowledge,clinical and/or bedside teaching, professional enthusiasm, knowledge of scientific andmedical literature, role as mentor and research knowledge of the faculty member, togetherwith an overall assessment and requests for additional comments relating to how theprogram could be improved or modified. Additionally, the faculty are evaluated annually byMedical Students, Interns and Residents for their teaching ability. All of theseevaluations are received in confidence by the Chief of Nephrology who presents a synopsisof the main findings to the faculty. Divisional faculty meetings are held on a monthlybasis. There is regular discussion of the training program at these meetings. The resultsof such evaluations are used for faculty counseling and for selecting faculty members forspecific teaching assignments. The faculty provide input to program planning anddevelopment, and their response to the evaluations by the trainees, at the facultymeetings. Additionally, a divisional subcommittee is charged with responsibility forplanning the didactic components of the teaching program of the Division and providesinput to the faculty at the faculty meetings.

C. Mechanisms for Remediation

Any serious deficiencies or weaknesses identified duringthe annualperformance evaluation or at any time during the fellowship will require remediation.Specific remediation will be determined by the Program Director and faculty.

D. Open Door Policy

Fellows are welcome to discuss personal problems, grievances, orrequest career counseling at any time.