Core curriculum in nephrology

Abstract

IN THIS ISSUE of the American Journal of Kidney Diseases (AJKD), we initiate a new series entitled “Core Curriculum in Nephrology.” Nephrology is a rapidly evolving and expanding subspecialty. The editors felt it timely to provide nephrology training programs and trainees with a core of knowledge required for the practice of nephrology. Several reasons led to this decision: (1)Within the subspecialty of nephrology, special areas of expertise are increasing. Some (not inclusive) are transplantation, nephrology in the intensive care unit, interventional nephrology, dialysis, and pediatric nephrology. Although most nephrology training programs have expertise in many areas, it was felt that some may not have strengths in each and that a core curriculum would provide program directors and trainees with the central components of knowledge in each special aspect of nephrology.(2)Programs are required to meet standards set by the Accreditation Counsel for Graduate Medical Education (ACGME). One of the standards set by the ACGME is a requirement for a core curriculum.(3)Most trainees choose to become certified by the American Board of Internal Medicine (ABIM). It was felt that a core curriculum with relevant information and references would direct training program directors and trainees to the areas that might be considered relevant by the ABIM. The AJKD core curriculum outlines knowledge with which trainees should be familiar at the end of a renal fellowship in adult medicine. We chose to present this information as an expanded outline with key references. The curriculum is not meant to replace standard texts of nephrology (of which there are many outstanding examples). The outlines do not replace ACGME requirements. The latter are modified periodically, and new guidelines are to appear in the next several months. The curriculum should be utilized as an adjunct to the ACGME requirements, and each program should individualize the curriculum to meet its own aims, needs, and goals. Furthermore, programs will need to decide which instructional strategies will best accomplish the knowledge objective. Most important, if the curriculum is used by training program directors, it should be evaluated on a routine basis to be certain that educational objectives are being met. The curriculum will contain about 24 topics in most aspects of adult nephrology. The AJKD editors selected the topics. Most are in “traditional” areas of nephrology such as glomerular disease, hypertension, dialysis, electrolytes, etc. Some have not usually been included in a formal curriculum but were felt to be essential for nephrology trainees in the year 2003 (eg, end-of-life issues, interventional nephrology, finances of nephrology). After selecting topics, the editors developed a list of potential authors based on recommendations by experts in the various areas. An outside expert will review each outline,as will the Education Editor of the AJKD (who will question others as well). The editors realize that any curriculum is dynamic and that there will be evolution in the knowledge base required to practice nephrology. The AJKD plans to publish these outlines over approximately 2 years and to update each outline every 2 to 3 years. We also anticipate that this series may be helpful to nephrologists in clinical practice who completed training sometime in the past. The outline could be used by practicing nephrologists to review current topics felt to be of importance in the education of trainees.