New members of the Department are required to participate in healthcare not only as specialists in nephrology but also as internists. In this Department, patient-oriented healthcare is achieved because we have many opportunities for working together with other departments. Experience can be gained in general internal medicine and practical techniques such as ultrasonography. New members look after patients on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) to treat chronic renal failure.
We also collaborate with the department of nutrition in holding courses on nutrition in renal diseases, diabetic nephropathy and maintenance renal failure to provide training in nutritional guidance that is indispensable in prevention of the progression of renal failure and achieves results in patient education.
New medical staff members do rounds in the dialysis rooms and wards, receive training in the management of all types of renal diseases and participate in healthcare. Not only knowledge concerning internal medicine but also surgical techniques and knowledge are required. Histopathological diagnosis is performed by light microscopy, fluorescent staining and electron microscopy of biopsy specimens. In dialysis therapy, the advantages and disadvantages of blood access in hemodialysis and catheters in CAPD are important in deciding the long-term prognosis and quality of life of patients.
In this Department, surgical procedures such as blood access (internal shunt procedures for hemodialysis and insertion of catheters for hemodialysis) and insertion of CAPD catheters are performed and maintenance hemodialysis and peritoneal dialysis is conducted after assuring appropriate and convenient access.
First year in the Department
For 6 months each, the new members work in the hemodialysis unit and wards. In the hemodialysis unit, the new member obtains basic knowledge concerning maintenance hemodialysis and participates in routine dialysis management, and treatment and management of dialysis-related complications, as well as surgical techniques for securing blood access required for introduction of hemodialysis. The new member also acquires basic knowledge of peritoneal dialysis and experience in maintenance and management including emergency measures.
* First year, the new members work in the hemodialysis unit for at least three months to gain basic experience in dialysis.
Second and third years
Experience is gained in the wards in not only nephritis but also renal failure (management and treatment of acute renal failure and introduction of dialysis) in the care of patients by a group system with top-level nephrologists as training for specialists in renal disease.
Fourth to fifth years
More practical training as a specialist in renal diseases is provided in related facilities and training as an internist for systemic management is also provided from the standpoint of guidance.
Sixth to seventh years
New members move away from the clinical setting and undertake research to obtain an academic degree and acquire the ethnical concepts and thinking in the field. The results are compiled in a paper under the guidance of a top-level physician.
Eighth years onward
The level of specialty is raised further through administrative duties in the Department and participation in education and training of residents and young physicians as a physician instructor.
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