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The Division of Nephrology at the University of Mississippi Medical Center supports a threefold mission:
The Division of Nephrology at the University of Mississippi Medical Center strives to provide state-of-the-art care to the kidney patients of the state of Mississippi. Our services include both in hospital and outpatient consultation and full-service inpatient and outpatient dialysis. In addition we are the only renal transplant center in the state of Mississippi and provide comprehensive care of transplant patients in both the inpatient and outpatient setting. Our faculty has varied areas of academic focus and expertise that collectively allow us to provide care for unusual diseases and complicated patients as only an Academic Center can. We also pride ourselves on our dedication to education on all levels of the medical curriculum, teaching medical student, residents and our own nephrology fellows. The nephrology training we provide our fellows is an intensive clinical experience that includes all facets of nephrology practice.
We have adopted the Nephrology Core Curriculum set forth by the American Society of Nephrology and The American Society of Nephrology Program Directors Committee to help us direct the training and education of trainees in Nephrology. We have designed a program intended to meet the Core Curriculum requirements, which we will outline below.
The division's commitment to education is manifest, in part, by a full menu of educational offerings. Regularly scheduled conferences include: Weekly division-wide sign-in and sign-out rounds, biweekly pathology conference, monthly morbidity and mortality conference, weekly fellow conferences including board preparation, monthly clinical case conferences, quarterly joint conferences with other division, monthly research conferences and three journal clubs per month.
During the first year, three to four months will be spent on the University Blue Service which provides consultative care to patients with Stage IV-V CKD and ESRD, three to four months on the V.A. Renal Service, two months on the transplant service and one month on an outpatient dialysis rotation called "Introduction to clinical nephrology". During the second year of the fellowship training program, fellows will spend four months on the Red Service which provides consultative care to patients with acute kidney injury, two months on the transplant service and at least two months doing research while the other four months of the year are available to do electives or continue with research. Each year the fellows have a Chronic Kidney Disease Continuity Clinic that meets weekly. During the second year, in addition to the Chronic Kidney Disease Clinic, each fellow has longitudinal outpatient experiences in in-center hemodialysis, home hemodialysis/peritoneal dialysis, and chronic transplant outpatient care.
There are two consultative services that generally follow between 10 and 20 patients and provide comprehensive care to patients with: acute renal failure, chronic kidney disease and end-stage renal disease. Some specific examples include: management of post-operative and trauma victims with acute renal failure, management of patients with acute toxic nephropathies, management of chemotherapy related nephrologic problems, as well as consultation for maintenance of chronic dialysis on ESRD patients admitted to other services. In addition, this service is frequently consulted for assistance in the management of complicated fluid, electrolyte, and acid base disturbances.
University Hospital currently has five intensive care units, including a 20-bed medical intensive care unit, a 20-bed cardiology-cardiac surgery intensive care unit, a 20-bed surgical intensive care unit, a 10-bed bone marrow transplant unit, and a 10-bed neurosurgical unit. University Hospital, as a whole, maintains approximately 750 operational beds. The nephrology services also provide consultation services to the 124-bed Mississippi Methodist Rehabilitation Center and the Wiser Hospital for Women. Although primarily a consultative service, this service may, on occasion, be assigned some ward patients at the discretion of the attending physician. Educational goals for the nephrology fellow on this service rotation include:
The renal transplant service at the University of Mississippi Medical Center is composed of a multi-disciplinary patient care team including surgeons, nephrologists, social workers, dietitians and nurses. Currently, approximately 80-100 kidney transplants are performed each year. Each nephrology fellow will spend a total of four months on the renal transplant service during his training. Patients admitted for transplant or for surgical complications post-transplantation are admitted to the Transplant Surgery Team but are followed by transplant nephrology in consultation. Patients admitted with medical issues post-transplantation are admitted to the Transplant Nephrology Team directly. The nephrology fellow is expected to be involved and familiar with patients on both sides of the service. There are usually four-12 patients in the hospital at any given time.
Renal transplant clinic is held twice weekly on Monday and Thursday from 9 a.m.-noon. The nephrology fellow on the transplant service is expected to attend their regular scheduled continuity clinic while on the service. Nephrology trainees are required to participate in at least one transplant operation as an observer and are welcome on any organ procurement procedure as well. The transplant evaluation clinic is held on Friday from 9 a.m.-noon. Educational goals to be achieved by the nephrology fellow during rotation on the renal transplant service include:
The Veterans Affairs Medical Center in Jackson, Mississippi, is an integral part of the Nephrology Fellowship Training Program at the University of Mississippi Medical Center and each fellow is required to rotate for four 1 month blocks in the first year of their nephrology training. The V.A.M.C. Nephrology Service offers a unique educational training opportunity by providing experiences with consultative nephrology, management of the acute medical problems of the chronic dialysis patient, and experience in outpatient long-term follow-up of the ambulatory chronic dialysis patient. The 16-chair dialysis unit facility at the VA provides chronic dialysis to approximately forty (40) veterans who choose to dialyze in center at the VA hospital. During rotations at the VA, nephrology fellows are actively involved in providing chronic dialysis care to the patients. This experience provides all first-year fellows an opportunity for exposure to the administrative aspects of running a dialysis unit, including working closely with the nursing personnel, understanding quality assurance monitors for dialysis units, monitoring adequacy of dialysis, and providing on-going care for a cohort of healthy dialysis patients. A renal dietitian and a renal social worker are available to assist in the management of these chronic dialysis patients and participate actively in the multi-disciplinary healthcare team. A variety of quality assurance monitors are in place for the dialysis unit including infection control, patient safety, blood pressure control, urea reduction assessment for adequacy of dialysis, and a recirculation vascular access patency assessment. The VA nephrology clinic meets on Monday mornings and Friday mornings for approximately 3 hours. Patients seen in the clinic include chronic hemodialysis patients, renal transplant patients who are veterans, patients with chronic renal insufficiency who are in conservative management protocols, and patients recently discharged from the hospital seen by the nephrology service in consultation who may require post discharge nephrologic follow-up. Our nephrology fellows have traditionally found VA clinic experience to be very rewarding. The consultative nephrology service provides care for patients throughout the 375 bed Jackson VA Medical Center Hospital with all manner of nephrologic or fluid and electrolyte problems. This service provides the nephrology trainee an opportunity to gain expertise in renal biopsy techniques, utilizing both CT as well as ultrasound guidance. Trainees also gain exposure to acute hemodialysis and peritoneal dialysis with an opportunity to develop expertise in the placement of temporary hemodialysis access.
Our outpatient hemodialysis unit at the Jackson Medical Mall currently provides chronic dialysis care for 155 patients. In the second year, the trainee will follow a shift of patients (~30) for 6 months, by rounding with an attending in the unit every week and participating in monthly lab reviews. Home dialysis experience in home hemodialysis and peritoneal dialysis is obtained at our Home Training Unit, which is connected to our outpatient clinic. This has facilitated patient consultations with dialysis nurses and the recruitment of patients to the Home Dialysis Program. We now offer CAPD, CCPD, standard 3-day/week home hemodialysis and 5-day/week dialysis with the NxStage machine. During the second year, the fellow will round in the home training unit for 6 months. Faculty supervision for this rotation includes the involvement of attending faculty of the University of Mississippi Medical Center. Both of these rotations provide a longitudinal experience of outpatient care of chronic ESRD patients and help prepare the trainee for this important aspect of nephrology.
2500 North State Street
Jackson, MS 39216
General Information: 601-984-1000
Patient Appointments: 888-815-2005