The clinical portion of the fellowship is divided into serial 3 week rotations over 18 months. Rotations begin on Tuesdays, so as to optimize continuity of care while faculty, residents, and fellows change services. Each fellow is expected to attend or find coverage for their respective clinics during each of their rotations through the year. 

Inpatient Renal Consults -VUMC 

Composed of two fellows and up to two medical students/residents, the general consult service evaluates and helps manage all care not otherwise covered by the ESRD service. This includes diagnosing and managing causes of AKI, electrolyte and acid/base disorders, initiation of dialysis, continuous renal replacement therapies, and management of plasmapheresis. 

Inpatient ESRD Consults -VUMC 

This service is composed of an attending, a fellow, a nurse practitioner, and at times a medical student. It is primarily responsible for management of care for ESRD patients on dialysis admitted to the hospital. On this service, trainees learn how to tailor dialysis needs in effort to coordinate ongoing inpatient care. This includes continuation of dialysis in anticipation of a scheduled procedure, transition to alternative modalities, or adjustment of dialysis to meet the needs of patients with complex medical issues. Fellows are responsible for mastering management of dialysis, both hemo and peritoneal, in the inpatient setting. 

Afternoon Consults -VUMC 

The afternoon fellow covers the General consult and ESRD services from noon until 6pm, taking all new consults and covering the needs of those already on service. The overall responsibilities are the same for the general and ESRD services. The General consult fellows and the ESRD fellows are not responsible for taking new consults after 1pm.

Inpatient Renal Consults -Tennessee Valley Veterans Affairs Hospital

(The VA is located across from VUMC.)

One fellow and one attending comprise the VA consult service and help with the management of both acute consults and the management of ESRD patients, already on dialysis. Additionally, the fellow is responsible for assisting in the management of the outpatient dialysis unit at the VA and helping to coordinate care plans for outpatient ESRD patients. The VA fellow is available to perform biopsies if needed. The fellow on service is responsible for taking call until 6pm and has 1 or 2 weekends off during the three week rotation. 

Inpatient Transplant Rogers service -VA and VUMC 

The Nephrology fellow works alongside the Transplant Nephrology fellow(s) at VUMC and VA. The shared responsibilities include evaluation of new transplant recipients admitted preoperatively and through the remainder of their hospital course. Additionally, the fellows are responsible for any consultations on previous transplant recipients admitted to other services. The fellows share in the responsibility of performing transplant biopsies as well. The entire service comprises of a Transplant Attending, Transplant fellow, general Neprology fellow, Resident, Intern, Pharmacist, and medical student. The entire service comprises a Transplant Nephrology attending, Transplant fellow(s), general nephrology fellow, resident, intern, pharmacist, and transplant nurse practitioner