• In line with CPSP recommendations, and keeping the international emphasis in view, SIH is deeply committed to the development of good professional competencies and behavior.
• The following attitudes (adopted from booklet ‘Requirements for Fellowship training’ by CPSP) are promoted at SIH.
• The educational strategies which will be used to inculcate these attributes are:
• role modeling,
• role plays,
• group discussions and
• regular, formal and informal feedback

Towards Patients

The candidates will be able to:

• establish a positive relationship with all patients in order to ease illness and suffering.
• facilitate the transfer of information important to the management and prevention of disease.
• demonstrate awareness of bio-psycho-social factors in the assessment and management of a patient.
• demonstrate sensitivity in performing internal examination. It is important to explain to the patient why an intimate examination is necessary and what the examination will involve. The patient’s permission must be obtained and, where possible, the patient should be invited to bring a relative or friend. The patient should have privacy to dress and undress. The discussion should be kept relevant and avoid unnecessary personal comments. Questions and feedback should be encouraged.
• consistently show consideration of the interests of the patient and the community as paramount with these interests never subservient to one’s own personal or professional interest.

Towards Self Development:

The candidate will be able to:

• demonstrate, consistently respect for every human being irrespective of ethnic background, culture, socioeconomic status and religion.
• deal with patients in a non-discriminatory and prejudice-free manner.
• deal with patients with honesty and compassion.
• demonstrate flexibility and willingness to adjust appropriately to changing circumstances.
• foster the habit and principle of self-education and reflection in order to constantly update and refresh knowledge and skills and as a commitment to continuing education.
• recognize stress in self and others.
• deal with stress and support medical colleagues and allied health workers.
• handle complaints including self-criticism or criticism by colleagues or patients.
• understand the importance of obtaining and valuing a second opinion.
•  

Towards Society:

The candidate will be able to:

• understand the social and governmental aspects of health care provision.
• offer professional services while keeping the cost effectiveness of individual forms of care.
• apply an understanding of hospital and community-based resources available for patients and care givers in rural areas.
• demonstrate an understanding of health service management and health economics in rural areas.
• understand the use of ‘telemedicine’ in practicing health.

FCPS training takes place at Shifa International Hospital. SIH is a 504-bedded hospital where there are 60-70 admissions in Nephrology ward alone each month and about 15 hemodialysis session monthly. This department has 7 consultants. There are also more than 80 beds that can accommodate critically ill patients.

Dialysis Chairs & Bed:

• 22 including
• 6 Hep-C
• 2 Hep-B
• 14 Nephrotic Patients
• G-3 Nephrology Wards- 10 bed
• PKI Nephrology beds- 04 beds

• Program Director
• Associate Program Director (x 2)
• Chief Resident
• Program Coordinator

A well-equipped central library is there to cater to the academic needs of the trainees. Text books, latest journals, both hard copies and online versions, are available to support learning.

Computer, printer and Internet connections are available on all floors of SIH so that the trainees do not always have to go to the central library. They are encouraged to use this facility so that they are always present on the wards for learning and for looking after their patients.

1. Nephrology Conference Room in OPD
2. D-0 Medicine Conference Room (Shared with department)

Trainees registered with RTMC will follow the following rotational program.

During the first year of training in Nephrology, the trainee will rotate through:

• Hemodialysis for four months
• Urology and urodynamic lab for two months
• Consultative Nephrology

During the second year of training in Nephrology, the trainee will rotate through:

• Radiology department for the purpose of gaining EXPERIENCE in Renal imaging, Radiology, ultrasonography and isotope studies for two months.
• Urology department for the purpose of gaining EXPERIENCE (as an observer) in Renal transplantation for the period of four months.

Objectives and schedule of daily duties will be provided by in-charges of rotations of the respective wards. Upon successful completion of the rotation, each trainee must get a signed certificate by the most senior CPSP approved supervisor of that ward.

After due registration with RTMC, every trainee must attend workshops as soon as he/ she receives the letter of invitation from CPSP.

The workshops for Nephrology trainees are:

  1. Research Methodology, Biostatistics and Medical Writing
   2. Communication Skills
   3. Basics of Computer and Internet

Assessment will be in the format of FCPS II examination. This will be held once a year towards the end of the training program year.

It will comprise of:

A.   Theory paper which will include:

1. One-Best and Extended matching questions (75 one best and 25 EMQs)
2. Short Essay Questions (4)

B.   TOACS (7 to 8 stations)
C.   Short cases (2 per resident)
D.  Long cases (1 per resident)

Result will be announced within 24 hours. These who do not clear these examinations in the first attempt will be helped in achieving the deficient competencies and re-examined after four months.

Those who do not clear in the second attempt will be asked to leave the residency program.

A supervisor will meet his / her residents at the start of the training program to apprise them of:

1. The schedule
2. Duty rotations
3. Responsibilities during the training program (including regular signing of log books.
4. Objectives of the years training
5. Facilities available at the hospital and the ward
6. Evaluation and feedback procedure
7. Assessment system

The supervisor discusses the expectations and aspirations of the residents in order to get them involved, motivated and become a part of the motivating team. The supervisor and the residents are required to spell out the expectations so that these form the basis for review and feedback. The supervisor emphasizes upon regular signing of the log books.

The supervisor and resident are strongly urged to meet to review the training program every four months. It is the responsibility of the trainee to seek an appointment from the supervisor for this purpose. In this meeting the goals and objectives set previously will be reviewed in order to see what has been achieved and what has not been achieved satisfactorily. The trainee is required to apprise the supervisor about the progress and set back he/ she is facing in the training. He/ she must also apprise the supervisor about the progress in the research work.

The supervisors are encouraged to provide informal feedback regularly in order to augment the learning process.

Hence forth such meetings are to be held in a scheduled and formal manner. They will be held throughout the training program. In case either party faces problems, he/ she may ask the Medical Education Coordinator to intervene and resolve the issues.

By the end of year one, the resident should attain competence at the following skills so that he/ she is able to function independently:

    * History taking skills
    * Physical examination skills
    * Interpretation skills
    * Plan of investigations
    * Communication skills
    * Conduction of research (i.e. synopsis writing)
    * Clinical reasoning
    * Knowledge application
    * Professional behavior (including ethical behavior)

By the end of year two, the resident should attain competence at the following skills so that he/ she is able to function independently:

    * Some of the diagnostic and therapeutic procedures (list of procedures given in table below)
    * Clinical decision making (including making differential, provisional, final diagnoses and problem identification)
    * Conduction of research (working on dissertation/ article)
    * Hemodialysis
    * Central Vein Dialysis Catheter, Placements ( Internal Jugular & Femoral)
    * Renal Biopsies (Native & Transplant)
    * Peritoneal Dialysis

Note: These competencies are in addition to the ones already attained in the previous year/s.

By the end of year three, the resident should attain competence at the following skills so that he/ she is able to function independently:

    * Some of the diagnostic and therapeutic procedures (list of procedures given in table below)
    * Clinical decision making (including making differential, provisional, final diagnoses and problem identification)
    * Conduction of research (submission of dissertation/ article)
Note: These competencies are in addition to the ones already attained in the previous year/s.

By the end of year four, the resident should attain competence at the following skills so that he/ she is able to function independently:

    * Most diagnostic and therapeutic procedures (list of procedures given below)
    * Patient management

SAMPLE MONTHLY SCHEDULE:

Each resident does an average of one night in four on-calls within the Hospital premises, although occasionally one night in three or two may be necessary.

Residents are evaluated by faculty every month, based on their rotation. Feedback is provided by the Programme Director and Coordinator, every 3 months.
Annual TOACS and Year end PGME exams are conducted. In addition, formative assessments based on assorted topics may be arranged every 2-3 months.

Candidates are required to fill on-line application form. Please follow the steps mentioned below:
1. Register yourself by defining user name and password.
2. After your account is created, you will need to login to fill the Application Form. Programs offered will be displayed after registration.
3. A candidate can apply for only one program at a time.
4. Candidate may partially fill the form and save it on-line for resuming filling out the form later using login credentials.
5. Once the on-line application form is filled and submitted, candidate would be able to take a printout.
6. The hard copy of the on-line application form along with the required documents mentioned in the Application Form must be submitted to the PGME Office, Medical Staff Affairs either personally, through friends/relatives or through reliable courier service.

7. Check your junk emails (in case of email not received).

If there is still confusion, then follow these Steps

Step 1. Register yourself
Step 2. Check your email address and click on the received link
Step 3. Login
Step 4. Fill the Profile necessary information
Step 5. Submit
Step 6. Ok
Step 7. Online Application Form
Step 8. Select Program or Medical Officer
Step 9. Select specialty
Step 10. Submit
Step 11. Print application form.

All residents are encouraged to get involved in audits and research projects, however research project as per CPSP requirements is mandatory for all.

• MBBS or equivalent
• One-year House Job
• Two years training in Internal Medicine
• Eligible to appear in Medicine Intermediate Module examination (IMM)