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Nephrology

I About The Programme
II Assessment and Evaluation
III Target Audience and Eligibility Requirements
IV Other Information


I About The Programme

Name of Programme

Paediatric Nephrology Fellowship Programme

Overview

The aim of the Paediatric Nephrology Training and Fellowship Programme is to provide broad-based clinical training in a children's hospital/referral centre, in which the Fellow will develop into an independent and competent paediatric nephrologist with expertise in patient care, teaching and research.

This sub-specialty fellowship programme provides:
  • training for one year, which includes all aspects of paediatric nephrology including renal biopsy and histological interpretation;
  • exposure to other procedures including acute peritoneal dialysis and prescription and continuous veno-venous haemodialysis (CVVH). Part of the training may also include exposure in a dialysis/transplant centre.

For more information on Nephrology, click here.

Aim of Programme

After completing the programme, Fellows will be able to:

  • diagnose and manage renal diseases in children;
  • gain exposure to diagnostic and therapeutic procedures in nephrology (e.g. renal biopsy and renal replacement therapy);
  • take the first step to become a clinically competent nephrologist providing independent renal consultation.

Duration of Programme

12 months

Number of Training Places

1 per year

Learning Outcomes

At the end of the programme, Fellows will:

  • acquire competency skill sets to diagnose and manage spectrum of renal diseases in children;
  • acquire exposure and experience to specialise nephrology therapeutic practices, eg. renal biopsy and renal replacement therapy.

Content Areas

Nephrology Fellows will be given formal instructions, clinical experience and opportunities to acquire knowledge in the prevention, evaluation and management of a comprehensive range of childhood renal diseases covering the period from newborn to 16 years of age.

Fellows will be given opportunities to care for patients in the neonatal and paediatric intensive care setting, as well as provide continuity of care in the outpatient setting.

The broad groups of renal problems include the following:

  • perinatal and neonatal urinary tract infections, vesicoureteric reflux and reflux nephropathy;
  • voiding dysfunction and urological disorders;
  • acute and chronic glomerulonephritis – including lupus nephritis;
  • hypertension;
  • fluid and electrolyte, acid base disorders;
  • acute kidney injury from various causes including referrals from cardiology and cardiothoracic surgery, paediatric surgery and oncology;
  • inherited renal disorders including cystic diseases, tubulopathies and genetic syndromes;
  • evaluation and management of chronic renal failure;
  • dialytic management of acute renal failure including continuous renal replacement therapy and peritoneal dialysis.

Fellows will also have clinical exposure and experience in the following areas:

  • renal biopsy;
  • learn to interpret and evaluate renal pathology specimens;
  • learn to interpret renal imaging studies.

Training Methods

Tentative monthly rotation schedule:

  • Daily clinical exposure in inpatient and outpatient setting with supervision and guidance, including:
    • Daily morning nephrology ward rounds
    • Consultant supervised outpatient clinic
  • Regular interactive teaching sessions including journal clubs and seminars
  • Participation in research projects and clinical studies
  • Hands-on procedure training: renal biopsies

Team of Experts

The Paediatric Nephrology Fellowship Programme is managed by the following experts.

​Name
​Designation
​Qualification
Dr Ng Yong HongHead and Senior Consultant, Nephrology Service; Head, Department of PaediatricsMBBS, MRCPCH (UK)
​A/Prof Chao Sing MingSenior Consultant
MBBS, M Med (Paeds), MRCP (Paeds) (UK), FAMS
​Dr Indra GanesanSenior Consultant
​MD, MMed, MRCPCH (UK)
​Dr Chong Siew LeConsultant
​MD, MRCPCH (Paed) (UK)
​Prof Yap Hui KimVisiting Consultant
​MBBS, M Med (Paeds), MD (Doctor of Medicine), FAMS, FRCP (Edin), FRCPCH

II Assessment and Evaluation

Aims of Assessment

Fellows will need to demonstrate their proficiencies based on the following competencies:

(A) Patient Care

  • Fellows must provide patient care that is compassionate, appropriate and effective including the treatment of health problems and the promotion of health for children and all stages of illness.
  • Fellows must demonstrate their competence on the following elements to diagnose, treat health problems and evaluate patient care when carrying out inpatient ward rounds, in outpatient clinics and renal procedures.

    Inpatient Ward Rounds
    Renal rounds in medical wards and other subspecialty wards with renal referrals which include Paediatric ICU, Neonatal ICU and wards, Oncology/Cardiology and Paediatric Surgery.

    Present and discuss information effectively during ward rounds, sensible in ordering laboratory tests, accurately interpret laboratory results and outline subsequent management plans.

    Be familiar and have a good understanding of various management protocols and principles of therapeutics in renal diseases.

    Outpatient Clinics
    Fellows are expected to run weekly General Renal Clinics under the supervision of senior staff. Fellows will also attend to monthly Voiding Problem Clinics.

    Renal procedures
    Assist and perform (under supervision) procedures like renal biopsy and renal dialysis for a more comprehensive exposure and understanding of the whole spectrum of renal problems.    

(B) Medical Knowledge

  • Fellows must demonstrate medical knowledge of established and evolving clinical, epidemiological, social-behavioral sciences and the application of medical knowledge to patient care
  • Fellows must demonstrate and apply their medical knowledge on the following elements:
    • o scientific method of problem-solving and evidence-based decision-making skills;
    • diagnosing and managing common nephrology and nephrology related conditions;
    • data collection and interpretation of results on procedures central to nephrology including appropriate indication for and use of screening tests/procedures for patients;
    • anatomy, physiology, pharmacology, pathology and molecular biology related to the urogenital system;
    • surgical procedures employed in relation to urogenital system disorders and its complications

(C) Practice-Based Learning and Improvement

  • Fellows must demonstrate their ability to investigate and evaluate evidence, both in appraisal and assimilation of scientific evidence required for patient care in current and evolving practice settings, including diagnosing and treating health problems and promotion of health.
  • Fellows must demonstrate life-long learning skills and continuous self-assessment based on reflection and feedback required for patient care in current and evolving health care settings.
  • Fellows should demonstrate teaching and learning skills, and perform research to contribute to medical education of health professionals

(D) Interpersonal and Communication Skills

  • Fellows must demonstrate interpersonal and communication skills necessary for effective exchange of information and demonstrate the ability to collaborate with patients, their families and health professionals to provide quality patient care

(E) Professionalism

  • Fellows must demonstrate commitment and professional attributes adhering to ethical principles.

(F) Systems-Based Practice

  • Fellows must demonstrate an awareness and responsiveness to the larger context and system of health care and demonstrate effective use of resources in the system to provide optimal health care for patients.

Assessment Approaches

Assessment mode for the programme:

​Type ​Quantity
​mini-CEX
2
​Case-based Discussion (CBD)
2
​Practice Based Learning in the form of Journal Club Presentations
2
Teaching of Nephrology Residents
1


Fellows are required to attain a 75% percentage pass for this programme.

Evaluation Process

General overall grading system

The general overall grading system evaluates the Fellow’s performance upon completion of the fellowship programme. All Fellows will be given a general overall grading status at the end of the fellowship programme based on the grading criteria requirements incorporating the six competencies based knowledge, skills and performance that Fellows must demonstrate throughout the programme.

Grading Status ​Description ​Grading Criteria Requirements
​CMP
​Completes the programme
  • 100% attendance for all lectures and training skills courses
  • Active participation observed in all lectures and training skills courses
  • Completes all modes of examination achieving 75% of the passing rate
  • Completes all training skills courses
USP*
Unsatisfactory performance
  • Poor attendance rate for all lectures and training skills courses
  • Unsuccessful attempt of training deliverables as stated in modes of assessment
  • Achieves less than 50% the passing rate
  • Consistently demonstrates a poor level of meeting the six competencies
  • Consistently demonstrates poor training skills and patient care
  • Consistently demonstrates a poor professional attitude throughout the programme
  • Demonstrates low level of respect towards advisors and other health professionals
  • Demonstrates a lack of responsibility throughout the programme
​DCP
​Did not complete the programme
  • Did not attend any lecture or training skills courses
  • Fails to provide supporting documents as a valid reason for not completing the programme (e.g. medical /hospitalisation leave)
  • Demonstrates a poor professional attitude throughout the programme
​WDN
​Withdrawn from the programme
  • Did not complete or attend any part of the programme within two months


*Fellows who have attained a USP grade are given options to extend their fellowship programme. This will depend on the faculty’s evaluation on the Fellow’s clinical skills and professional attitude.

III Target Audience and Eligibility Requirements

Target Audience

Post-graduate doctors with special interest in paediatric nephrology

Pre-requisite/Eligibility Requirement(s)

Candidates must:

  • have a Master of Medicine (Paeds), MRCPCH or approved equivalent;
  • be registered with the Singapore Medical Council and currently practicing as a medical practitioner;
  • be certified to be of good standing by the Medical Council or the relevant national authority.

IV Other Information

Course Fees

Course fee will be determined upon application.

Funding

Candidates should be self-funded or have funding from external sources/institutions.

Certification

Certificate of fellowship will be awarded upon completion of the programme.