Renal medicine is one of the most interesting, exciting, challenging, and rewarding medical specialties in which to pursue a medical career.
The clinical experience working in renal medicine is tremendously varied and encompasses the acute management of sick patients with acute kidney injury (often overlapping with intensive care medicine), the long term management of chronic kidney disease in both pre-dialysis and dialysis settings, and renal transplantation with the chance to restore a patients health and quality of life. Renal medicine is one of the few remaining hospital based specialties that provides long term follow up and general medical care to a significant number of patients. Advances in medical therapies are enabling us to treat more complex patients with renal failure. The renal physician is uniquely placed to assimilate the diverse problems and co-morbidities that a renal patient experiences and with the help of the multi-disciplinary team can provide high quality, holistic, life-long care.
Much of the work crosses other specialty boundaries requiring close working relationships with vascular and transplant surgeons, histocompatibility and immunogenetic laboratories, haematologists, intensivists, palliative care teams, cardiologists, rheumatologists, diabetologists, urologists, obstetricians and microbiologists/infectious disease specialists.
The multi-disciplinary team includes nurse specialists, transplant coordinators, dieticians, physiotherapists, psychologists, social workers, dialysis nurses, technicians, IT specialists, secretaries and managers.
There are a host of fascinating disease processes to understand and significant developments are being made especially in the field of immunology and transplant medicine. Renal physicians also care for patients with nephrotic syndrome, vasculitis, tubular or metabolic disorders and kidney involvement in multisystem disorders such as systemic lupus and scleroderma.
Dual training in Renal Medicine and GIM takes a minimum of 5 years after entry at ST3 level. Most trainees will dual accredit. To achieve competence in renal medicine alone requires a minimum of 3 years training. Some trainees have been able to undertake intensive care training alongside training in renal medicine and GIM.
The South West Specialty Training Programme in Renal Medicine is provided by rotation between renal units at the following hospitals:
- Gloucestershire Royal Hospital, Gloucester
- Southmead Hospital, Bristol
- Royal Devon and Exeter Hospital, Exeter
- Derriford Hospital, Plymouth
- Royal Cornwall Hospital, Truro
- Dorset County Hospital, Dorchester
Each unit provides experience in all aspects of nephrology, dialysis and long term renal transplant follow up.
Experience in acute renal transplantation is provided at Southmead (Bristol) and Derriford (Plymouth) Hospitals. Therefore, all trainees will undertake some of their training in Bristol or Plymouth to ensure acute renal transplantation experience. Trainees are expected to make no more than two geographical moves during their period of training. For these purposes, Bristol/Gloucester and Plymouth/Exeter are considered as single geographical moves.
At each hospital, apart from Southmead in Bristol, there is an opportunity to train in acute GIM for those trainees seeking dual certification. Generally, wherever possible, we aim to provide a rotation in either the northern or the southern end of the region.
There are research opportunities at Exeter and Bristol and both scientific and clinical research are actively encouraged as Out of Programme Experience.
At each unit, trainees will have an educational supervisor who will, through appraisal meetings, support the trainee as they acquire competencies relevant to their stage of training. The highly-regarded Renal Training Programme consists of a full day held at one of the renal units alternating monthly with GIM. The renal training days are shared with renal trainees from South Wales. The South West Regional Renal Meeting is held once a year and provides an opportunity for trainees to present audit, clinical cases and research at a regional level.
Speciality Training Committee
Regional Specialty Advisor – Dr Chris Dudley, North Bristol NHS Trust, Southmead Hospital, Bristol
Other Specialty Training Committee members:
- Dr. Jim Moriarty, Gloucestershire Hospitals NHS Foundation Trust, Gloucester
- Dr Richard D’Souza, Royal Devon & Exeter NHS Foundation Trust, Exeter
- Dr Imran Saif, Plymouth Hospitals NHS Trust, Derriford, Plymouth
- Dr Karamadoukis, Dorset County Hospital NHS Foundation Trust, Dorchester
- Dr Paul Johnston, Royal Cornwall Hospital NHS Trust, Truro
- Dr Mark Gilchrist , Trainee Representative (Clinical Research Fellow - Bristol)
Training Programme Director – Dr Karen Anderson, Southmead Hospital, Bristol, BS10 5NB