DM Paediatric Nephrology: Admissions, Medical Colleges, Fees, Eligibility Criteria details

Published On 2022-12-11 12:30 GMT   |   Update On 2023-12-16 09:33 GMT

DM Pediatric Nephrology or Doctorate of Medicine in Pediatric Nephrology also known as DM in Pediatric Nephrology is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course. The duration of this super specialty course is 3 years, and it focuses on the diagnosis, treatment and management of diseases affecting...

Login or Register to read the full article

DM Pediatric Nephrology or Doctorate of Medicine in Pediatric Nephrology also known as DM in Pediatric Nephrology is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course. The duration of this super specialty course is 3 years, and it focuses on the diagnosis, treatment and management of diseases affecting the kidney and urinary tract in children.

The course is a full-time course pursued at various recognized medical colleges across the country. Some of the top medical colleges offering this course include St. Johns Medical College- Bangalore and, All India Institute of Medical Sciences- Rishikesh.

Admission to this course is done through the NEET-SS Entrance exam conducted by the National Board of Examinations, followed by counselling based on the scores of the exam that is conducted by DGHS/MCC/State Authorities.

The fee for pursuing DM (Pediatric Nephrology) varies from college to college and may range from Rs.5000 to Rs. 20,00,000 per year.

After completion of their respective course, doctors can either join the job market or can pursue certificate courses and Fellowship programmes recognised by NMC and NBE. Candidates can take reputed jobs at positions as Senior residents, Consultants etc. with an approximate salary range of Rs. 5,00,000 to Rs. 30,00,000 per year.

What is DM in Pediatric Nephrology?

Doctorate of Medicine in Pediatric Nephrology, also known as DM (Pediatric Nephrology) or DM in (Pediatric Nephrology) is a three-year super specialty programme that candidates can pursue after completing postgraduate degree.

Pediatric Nephrology is the branch of medical science dealing with the diagnosis, treatment and management of diseases affecting the kidney and urinary tract in children.

National Medical Commission (NMC), the apex medical regulator, has released guidelines for a Competency-Based Postgraduate Training Programme for DM in Pediatric Nephrology.

The Competency-Based Postgraduate Training Programme governs the education and training of DMs in Pediatric Nephrology.

The postgraduate students must gain ample of knowledge and experience in the diagnosis, treatment of patients with acute, serious, and life-threatening medical and surgical diseases.

The PG education intends to create specialists who can contribute to high-quality health care and advances in science through research and training.

The required training done by a postgraduate specialist in the field of Pediatric Nephrology would help the specialist to recognize the health needs of the community. The student should be competent to handle medical problems effectively and should be aware of the recent advances in their speciality.

The candidate is also expected to know the principles of research methodology and modes of the consulting library. The candidate should regularly attend conferences, workshops and CMEs to upgrade her/ his knowledge.

Course Highlights

Here are some of the course highlights of DM in Pediatric Nephrology

Name of Course

DM in Pediatric Nephrology

Level

Doctorate

Duration of Course

Three years

Course Mode

Full Time

Minimum Academic Requirement

Postgraduate medical degree obtained from any college/university recognized by the MCI (Now NMC)/NBE

Admission Process / Entrance Process / Entrance Modalities

Entrance Exam (NEET-SS)

INI CET for various AIIMS, PGIMER Chandigarh, JIPMER Puducherry, NIMHANS Bengaluru

Counselling by DGHS/MCC/State Authorities

Course Fees

Rs.5000 to Rs. 20,00,000 per year

Average Salary

Rs. 5,00,000 to Rs. 30,00,000 per year

Eligibility Criteria

The eligibility criteria for DM in Pediatric Nephrology are defined as the set of rules or minimum prerequisites that aspirants must meet in order to be eligible for admission, which include:

  • Candidates must be in possession of a postgraduate medical Degree (MD/MS/DNB) from any college/university recognized by the MCI (Now NMC)/NBE.
  • The candidate must have obtained permanent registration of any State Medical Council to be eligible for admission.
  • The medical college's recognition cut-off dates for the Postgraduate Degree courses shall be as prescribed by the Medical Council of India (now NMC).

Admission Process

  • The admission process contains a few steps to be followed in order by the candidates for admission to DM in Pediatric Nephrology. Candidates can view the complete admission process for DM in Pediatric Nephrology mentioned below:
  • The NEET-SS or National Eligibility Entrance Test for Super specialty courses is a national-level master's level examination conducted by the NBE for admission to DM/MCh/DrNB Courses.
  • Qualifying Criteria-Candidates placed at the 50th percentile or above shall be declared as qualified in the NEET-SS in their respective specialty.
  • The following Medical institutions are not covered under centralized admissions for DM/MCh courses through NEET-SS:
  1. AIIMS, New Delhi and other AIIMS
  2. 2.PGIMER, Chandigarh
  3. 3.JIPMER, Puducherry
  4. 4.NIMHANS, Bengaluru
  • Candidates from all eligible feeder specialty subjects shall be required to appear in the question paper of respective group, if they are willing to opt for a super specialty course in any of the super specialty courses covered in that group.
  • A candidate can opt for appearing in the question papers of as many groups for which his/her Postgraduate specialty qualification is an eligible feeder qualification.
  • By appearing in the question paper of a group and on qualifying the examination, a candidate shall be eligible to exercise his/her choices in the counseling only for those superspecialty subjects covered in said group for which his/ her broad specialty is an eligible feeder qualification.

Fees Structure

The fee structure for DM in Pediatric Nephrology varies from college to college. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for DM in Pediatric Nephrology is around Rs.5000 to Rs. 20,00,000 per year.

Colleges offering DM in Pediatric Nephrology

There are various medical colleges across India that offer courses for pursuing DM in (Pediatric Nephrology).

As per National Medical Commission (NMC) website, the following medical colleges are offering DM in (Pediatric Nephrology) courses for the academic year 2022-23.

Sl.No.

Course Name

Name and Address of Medical College / Medical Institution

Annual Intake (Seats)

1

DM - Paediatric Nephrology

St. Johns Medical College, Bangalore

1

2

DM - Paediatric Nephrology

All India Institute of Medical Sciences, Rishikesh

6

Syllabus

A DM in Pediatric Nephrology is a three years specialization course that provides training in the stream of Pediatric Nephrology.

The course content for DM in Pediatric Nephrology is given in the Competency-Based Postgraduate Training Programme released by National Medical Commission, which can be assessed through the link mentioned below:

.1 SUBJECT SPECIFIC THEORETICAL COMPETENCIES

3.1.1 Cognitive domain (Knowledge domain)

3.1.2 Affective domain (Attitudes including Communication and Professionalism)

3.2 SUBJECT SPECIFIC PRACTICE-BASED OR PRACTICAL COMPETENCIES

The curriculum outlines competences that trainees must reach by the end of the programme (combining 3.1 and 3.2)

A. Investigation of the kidney

1. Renal Anatomy and Physiology

Knowledge

  • To understand the embryology and development of genito-urinary system
  • To understand the development of renal function and physiology for the assessment of:

a. GFR from height and plasma creatinine

  1. Calcium, phosphate & bone mineral metabolism

c. Urinary concentrating and diluting ability

d. Tubular handling of fluid and electrolytes

e. Acid-base balance

  • To explain the practicalities, limitations and special precautions of measurement of:

a. Creatinine clearance

b. Protein and calcium excretion

c. Tubular handling

d. Tests for urinary acidification

Skills

To appropriately request and interpret the above investigations

Multidisciplinary

aspects

Laboratory Medicine Department

Resources

Clinical Physiology of Acid-Base and Electrolyte Disorders – Burton David Rose

Principles of Renal Physiology – Chris Lote

Pediatric Renal Investigations – Chapman & Taylor

1. Imaging

Knowledge

  • To understand the role, limitations and interpretation of commonly used imaging modalities
  • To know the practicalities and safety precautions associated with each test

· To understand the role of arteriography and percutaneous

nephrostomy tube placement

Skills

· To appropriately request the different radiological investigations

· To be able to interpret scan images

Multidisciplinary aspects

  • Liaison with radiologists in deciding the most appropriate investigations

Resources

  • Nephro-urology radiology meetings/Posting in nuclear medicine unit

· Bank of typical case images

2. Renal Biopsy and nephropathology

Knowledge

· To describe the anatomy of both native and transplant kidneys

· To know the indications for renal biopsy

· To describe the procedure of renal biopsy and its complications

  • To know the type of solutions used for light (LM), immunofluorescence (IF), and electron microscopy (EM) specimens immediately post-biopsy
  • To have a basic knowledge of handling and processing of renal biopsy tissue and utility of various stains (hematoxylin and eosin, periodic acid Schiff, Trichrome (Masson), silver-stains, and Congo

red /immuno-fluroscence used in the diagnosis of renal disease.

Skills

  • To counsel families in preparation for renal biopsy, thus allowing informed consent

· To perform a native (and transplant) biopsy safely

  • To recognize the histopathologic characteristics of normal kidney on LM, IF, and EM
  • To recognize common histological appearances and consequences for diagnosis, prognosis and treatment
  • Able to interpret slides, including all the components: LM, IF and EM.

· Obtain adequate clinical background and information from the

appropriate nephrologist submitting the specimen to allow optimal

interpretation of the biopsy.

Multidisciplinary

aspects

Radiologist and pathologist

Resources

Nephropathology meetings Bank of typical case histology

Training day for processing, staining and interpreting of renal biopsy

samples

(B) Urinary Tract Infection (UTI) and Vesicoureteric Reflux

Knowledge

· To know the epidemiology of UTI

· To understand current theories about renal scarring

· To be aware of issues in diagnosis of UTI

  • To describe the role of ultrasound scan, MCU, DMSA and other investigations for UTI
  • To know the medical and surgical options in the management of UTI
  • To describe the mechanisms of action of antimicrobials and their adverse effects

· To understand the secondary progression of renal damage and its

prevention

Skills

  • To appropriately manage urinary tract infection in different age groups

· To show ability to counsel parents about relevant investigations of

UTI, and possible management of siblings of children with reflux

Multidisciplinary aspects

· To know the appropriate follow-up into adult life

· To recognize the role of microbiologists, urologists and radiologists

  • To be able to contribute to the development of strategies for management of UTI at local and regional level

Resources

· Microbiology department

· Nephro-pediatric surgery-radiology meeting

  • Structural Malformations

Knowledge

· To understand renal embryology and developmental anatomy

  • To describe the anatomy of the urinary tract and the sites and causes of urinary obstruction
  • To know the presentations of developmental variants and abnormalities, including obstruction
  • To describe the fluid and electrolyte disturbances occurring following the relief of obstruction
  • To be aware of the different reconstructive procedures performed, and their implications for future management
  • To be aware of other urological diagnoses, including genital anomalies

· To know the importance of ambiguous genitalia and intersex in

renal disease: structural as well as neoplastic

Skills

· To be able to provide medical support to urological services,

especially following relief of obstruction

Multidisciplinary aspects

  • Liaison with radiologists, obstetricians and surgeons in management decisions and antenatal counseling

· To show ability to communicate and work together with other health

professionals

Resources

· Department of Pediatric Surgery

· Radiology meeting

· Department/Division of Neonatology

(D) Disorders of Micturition

Knowledge

  • To know the common renal and non-renal diagnoses associated with enuresis

· To know the appropriate use of urodynamic studies

  • To explain the rationale for various management strategies in enuresis using behavioral and pharmacological therapies

Skills

  • To be able to interpret urodynamic studies, and instigate appropriate management

· To know the practicalities involved in enuretic alarms

Multidisciplinary aspects

· Liaison with urodynamic staff

· Role of the psychologist

Resources

Pediatric urologists/surgeons

Bank of images

(E) Neurogenic bladder

Knowledge

· To know the pathophysiology of neurogenic bladder

· To know the role of basic urodynamic investigations

  • To know the appropriate surgical management of different types of bladder dysfunction

· To understand the treatments available to regularize bowel and

bladder habit

Skills

  • To be able to appropriately asses the whole child with neurogenic bladder

· To show ability to investigate and manage the upper and lower

urinary tract

Multidisciplinary

aspects

· To know the importance of shared care with surgeons and urologists

Resources

· Pediatric urology services

(F) Hematuria

Knowledge

  • To know the pathophysiology of macroscopic and microscopic hematuria
  • To describe the methods of investigation in microscopic hematuria, including the role of renal biopsy
  • To understand the various findings of phase contrast microscopy and their meaning
  • To know the underlying causes of hematuria
  • To know the long term outcome of the underlying causes

Skills

  • To be able to perform urinalysis
  • To demonstrate appropriate investigation and management of the child with hematuria, including role of imaging,

urological assessment, and genetic and molecular studies

Multidisciplinary aspects

  • To explain the mode of inheritance of hereditary nephritis, and implications for other family members
  • To appreciate the role of the pediatric surgeon
  • To understand the need for long-term follow up

Resources

  • Nephropathology meeting
  • Pathology laboratory (microscopy of urine)

(G) Proteinuria

Knowledge

  • To know the pathophysiology of proteinuria
  • To know the physiological and pathological causes of asymptomatic proteinuria
  • To describe the methods of investigation of asymptomatic proteinuria
  • To list the indications for renal biopsy
  • To know the long-term prognosis of the various conditions causing proteinuria

Skills

  • To be able to differentiate between pathological and physiological proteinuria
  • To show ability to manage the child with proteinuria

Multidisciplinary aspects

  • To understand the requirement of long-term follow-up

(H) Glomerular disease

Knowledge

  • To describe the etiology, pathophysiology and immunological basis of glomerulonephritis
  • To know the different forms of presentation
  • To understand the clinical course and prognosis of acute and chronic glomerulonephritis
  • To know the indications for immunosuppressive agents,

cytotoxic drugs, plasmapharesis and dialysis

Skills

  • To appropriately investigate and manage the acute

nephritic syndrome, and new presentation of chronic

glomerulonephritis

  • To demonstrate the appropriate use of general and specific measures to treat glomerulonephritis

Resources

  • Pathology laboratory

(I) Nephrotic syndrome

Knowledge

  • To know the causes of nephrotic syndrome
  • To be aware of the pathophysiology of nephrotic syndrome, including latest research
  • To understand the investigation of nephrotic syndrome including indications for renal biopsy
  • To understand the complications of the nephrotic state
  • To know the pharmacology and side-effects of steroids, other immunosuppressive agents and other treatment modalities

Skills

  • To appropriately investigate and manage initial episode of nephrotic syndrome and relapses and the complications
  • To appropriately investigate and manage steroid resistant nephrotic syndrome and the complications
  • To manage adverse effects of immunosuppressive medications
  • To demonstrate the appropriate use of general and specific

measures to treat secondary causes of nephrotic syndrome

Multidisciplinary aspects

Liaison with local pediatricians in long-term management

Resources

Pediatrics, Pathology

(J) Systemic lupus erythematosus (SLE)

Knowledge

  • To describe the pathogenesis of SLE and underlying immunological mechanisms
  • To list the histological classification of lupus nephritis
  • To describe the clinical course of lupus nephritis
  • To describe the different treatment options

Skills

  • To perform a relevant clinical examination to diagnose and assess a patient with SLE
  • To plan and interpret investigations, including renal histology and immunology
  • To appropriately manage acute renal failure due to SLE, including use of plasmapharesis
  • To show ability to undertake long-term management of the

patient with lupus nephritis

Multidisciplinary aspects

  • To appreciate the role of other specialists, especially rheumatologists
  • To counsel the patient about long-term implications of SLE, including problems with renal transplantation and

impact on reproductive potential

Resources

Adult nephrology, rheumatology services

(K) Other Vasculitis

Knowledge

  • To understand the pathophysiology and immunology of vasculitis
  • To know the different causes of vasculitis
  • To know the presentation of vasculitis, patterns of multisystem involvement and spectrum of disease
  • To describe the investigation and monitoring of the patient with vasculitis
  • To list the different therapeutic options available, including

adverse effects

Skills

  • To perform a relevant multisystem clinical examination
  • To be able to appropriately investigate and treat vasculitis, including use of immunosuppression, in the short and long- term

Multidisciplinary aspects

To work with other specialists including rheumatologists

Resources

Pediatric and adult rheumatology clinics

(L) Hemolytic uremic syndrome (HUS)

Knowledge

  • To understand the pathophysiology of microangiopathic hemolytic anemia
  • To know the epidemiology of VTEC, S. dysenteriae
  • To know the presentation and clinical course of diarrhea- positive and atypical HUS
  • To be aware of non-renal manifestations of HUS
  • To understand the long-term consequences and prognosis of D+ HUS
  • To understand principles of treatment, including conservative, and the role of plasma exchange and dialysis
  • To understand the investigation of atypical HUS
  • To be aware of the long-term management of atypical HUS including implications for transplantation

Skills

  • To be able to investigate, diagnose and manage the initial presentation of HUS
  • To appropriately initiate dialysis and plasma exchange
    • Interstitial nephritis

Knowledge

To list the causes of interstitial nephritis and tubulo-

interstitial disease, and the relationship to systemic conditions

Skills

To appropriately investigate and manage the child with

interstitial nephritis, including use of corticosteroids

(N) Hypertension

Knowledge

  • To define and understand how to diagnose hypertension
  • To know the common renal and non-renal diagnoses implicated in hypertension in different age groups
  • To describe the possible mechanisms causing primary (essential) and secondary hypertension
  • To describe the investigation of hypertension including the use of arteriography and renal vein sampling ; nuclear imaging
  • To describe the mechanism of action and side-effects of

anti-hypertensive agents

  • To understand vascular interventions in renal artery stenosis

Skills

  • To show ability to appropriately investigate the child with hypertension
  • To be competent in the management of hypertensive emergencies
  • To be competent in the management of chronic hypertension, and in using the different classes of drugs
  • To be able perform and interpret ABPM read out and

modify prescription

Multidisciplinary aspects

  • Liaison with local pediatricians; interventional radiologist

Resources

  • Intensive care unit; Radiology services

(O) Nephrolithiasis

Knowledge

  • To know the etiology of renal stone formation, including underlying tubular abnormalities
  • To know the biochemical and radiological investigation of renal stones
  • To understand the acute and chronic medical (including prevention of the development of renal stones) and surgical

management of renal stones (including lithotripsy)

Skills

  • To demonstrate ability to appropriately investigate the child with renal stones
  • To show ability to manage the child with renal stones

Multidisciplinary aspects

  • To involve pediatric urologists where indicated
  • To show understanding of the significance of the family history and genetic implications in some cases

Resources

Departments of Laboratory Medicine, Pediatric Surgery,

Urology and Radiology

(P) Tubular disorders

Knowledge

  • To understand the different presentations of primary and secondary tubular disorders
  • To know the different causes
  • To understand the investigation of tubulopathies

Skills

  • To be competent in the investigation and management of

tubular disorders

Multidisciplinary aspects

  • To understand the role of other specialists (hepatologists, neurologists, biochemists, geneticists) in the diagnosis, management and treatment of these disorders
  • To be able to provide dialysis support to other specialists

Resources

Metabolic clinics, Endocrine clinic

Biochemistry department

  • Cystic disease

Knowledge

  • To list the different causes of renal cystic disease in different age groups
  • To describe the mode of inheritance and methods of screening
  • To know the clinical course and associated features of autosomal recessive and autosomal dominant polycystic

kidney disease

Skills

  • To appropriately examine and investigate the child with renal cysts in different age groups
  • To appropriately manage the child with polycystic kidney

disease

Multidisciplinary aspects

  • To appreciate the implications of a diagnosis of autosomal dominant polycystic kidney disease on other family members
  • To recognize the importance of genetic counseling

Resources

  • Radiology services

(R) Genetic disorders (Inherited diseases of the kidneys)

Knowledge

  • To know the presentation and management of commonly encountered inherited renal disease including renal involvement in syndromes, familial nephritis and polycystic kidney disease
  • To understand basic genetic principles

Skills

  • To be able to advise parents of the risks of recurrences and the need for family screening in commonly inherited

diseases

Multidisciplinary aspects

To understand the role of the geneticist in diagnosis

and counseling, including antenatal diagnosis

Resources

Geneticist

(S) Fluid and electrolyte disturbances

Knowledge

  • To understand the physiology underlying fluid and electrolyte imbalance in the child without primary renal disease
  • To know the principles of treatment of fluid and electrolyte imbalance
  • To know the endocrine diseases associated with electrolyte

imbalance and their management

Skills

To be able to manage fluid and electrolyte imbalances in

non-renal disease including overdose

Resources

  • Intensive care unit
  • Endocrine clinics

(T) Acute Kidney Injury (AKI)

Knowledge

  • To know the differential diagnosis of AKI
  • To know the investigation including role of renal biopsy
  • To describe the methods to correct fluid and biochemical abnormalities and to know the indications for dialysis
  • To describe the principles of dialysis and filtration
  • To know the treatment of reversible causes of AKI

Skills

  • To perform a reliable and accurate clinical assessment of

the patient's fluid status

  • To be able to appropriately manage the complications of AKI – conservative and dialysis
  • To be able to select and practically manage the different dialysis modalities including peritoneal dialysis, hemodialysis and hemofiltration
  • To be able to commence correct treatment of the underlying cause
  • To manage the patient with multiorgan failure or systemic

disease requiring acute renal replacement therapy

Multidisciplinary aspects

  • To recognize the role of nurses in the management of AKI
  • Liaison and share care with the intensive care unit

Resources

Intensive care and neonatal intensive care units

(U) Chronic Kidney Disease (CKD)

Knowledge

  • To know the epidemiology of CKD
  • To list the causes of CKD
  • To know the investigations required in a child with new presentation of CKD, including assessment of the degree of renal failure and reversibility of the condition
  • To understand the natural history and prognosis of common diseases causing CKD, and treatment strategies that may ameliorate the condition
  • To understand the factors involved in failure to thrive in CKD
  • To describe the pathophysiology, investigation and indications for treatment in the management of renal bone disease
  • To describe the pathophysiology of renal anemia, and its investigation and management, including use of

erythropoietin and iron therapy

Skills

  • To identify and appropriately manage the underlying cause
  • To manage the child with CKD including biochemical disturbance, bone disease and anemia
  • To appropriately counsel the family to facilitate the selection of dialysis modality and prior to referral for renal transplantation
  • To make an accurate clinical assessment of nutritional status and to use appropriate dietary advice with the assistance of dietitians
  • To prescribe and monitor treatment for hyperlipidemia
  • To show ability to prevent, diagnose and manage renal bone disease
  • To diagnose and appropriately treat renal anemia

Multidisciplinary aspects

  • To appreciate the role of the multiprofessional team including dietitian, psychologist, social worker
  • To understand the role of the dialysis nurses and transplant coordinator
  • To audit biochemical and hematological results against national guidelines
  • To appreciate the impact of CKD on cardiovascular disease

in adult life

Resources

  • Chronic kidney disease clinics
  • Multidisciplinary team meeting

(V) Transplantation

Knowledge

Pre-Transplantation

  • To understand the ethical issues surrounding organ donation/ transplant
  • To know the principles of recipient selection, indications and contraindications
  • To describe the theoretical and practical application of

blood grouping, HLA matching and donor-recipient cross

matching

  • To know what is involved in a transplant work-up
  • To know the advantages and disadvantages of deceased versus live related donor transplantation
  • To know the acceptability criteria for deceased organ donation
  • To describe the advantages and disadvantages of preemptive transplantation

Transplantation

  • To understand the unique needs of children undergoing organ transplantation
  • To know the basic surgical procedures involved
  • To know the medications used, including side-effects and recent advances and trials
  • To know the approach towards handling deceased organ transplantation

Post-Transplantation

  • To know the indications for and knowledge of the procedure of renal transplant biopsy
  • To understand the immune mechanisms of rejection
  • To know the recurrence rate of the original disease, and other complications pertaining to the original diagnosis and their management

Skills

Pre-transplantation

  • To assess the suitability of a patient for renal transplant
  • To discuss the issues of transplantation

Transplantation

  • To be able to manage the peri-operative transplant period
  • To assess renal transplant function
  • To plan and modify immunosuppressive therapy

Post-transplantation

  • To be competent in the diagnosis and management of acute rejection episodes
  • To understand the role of fine needle cytology and histopathology for diagnosing rejection
  • To be able to manage the stable transplant patient
  • To be able to advise the child, family and school
  • To be able to diagnose and manage chronic rejection
  • To be aware of the diagnosis and management of the short and long-term complications of transplantation
  • To counsel patients with a failing graft and discuss future

management on renal replacement therapy

Multidisciplinary aspects

To understand the role of the transplant coordinator

To appreciate the role of the multidisciplinary team

Resources

  • Transplant clinics
  • Tissue typing laboratory
  • Transplant surgeon

(W) DIALYSIS

1. Hemodialysis

Knowledge

  • To describe the principles of hemodialysis and compare and contrast with other methods of dialysis
  • To describe the anatomy of the neck veins, and their assessment
  • To describe the methods of vascular access and arterio venous fistulas, and their complications
  • To understand the principles of water treatment and maintaining water quality
  • To define the methods to assess adequacy of hemodialysis
  • To list the complications occurring during dialysis
  • To list the particular infections which may occur in patients on dialysis, and to define strategies to prevent

blood-borne viral infections in patients on hemodialysis

Skills

  • To be able to plan the initiation of hemodialysis
  • To manage different forms of vascular access, and their difficulties
  • To assess the functional status of AV fistula and cannulate
  • To operate hemodialysis machine and respond to alarms; disinfection of machines and circuits
  • To be able to handle dialyzers and the dialyzer tubings appropriately
  • To adjust the prescription of hemodialysis based on adequacy and monitor change
  • To manage the complications of hemodialysis
  • To diagnose, investigate and treat infection

Multidisciplinary aspects

  • To understand the role of the nurses in preparing the patient physically and psychologically for hemodialysis, and in the long term management
  • To counsel patients about blood borne infection
  • To work closely with the microbiologist in developing protocols and in audit and management of infection

Resources

Hemodialysis technician and nurses

Departments of Nephrology, Microbiology and Surgery

2. Peritoneal Dialysis

Knowledge

  • To describe the principles of acute and peritoneal dialysis, and know the advantages and disadvantages compared to hemodialysis
  • To describe methods to assess adequacy of peritoneal dialysis and ultrafiltration
  • To describe the anatomy and outline the surgical procedure of insertion of peritoneal dialysis catheters
  • To know the complications of peritoneal dialysis, both

infective and mechanical

Skills

  • To be able to prescribe peritoneal dialysis and monitor change and measure adequacy
  • To perform peritoneal equilibration test (PET)
  • To operate and troubleshoot PD cyclers
  • To manage the complications of peritoneal dialysis

Multidisciplinary aspects

Pediatric surgeon

(X) Pharmacology

Knowledge

  • To define the principles of pharmacokinetics and drug handling in renal impairment
  • To list ways in which different classes of drugs act on the nephron
  • To describe how drugs may affect renal function
  • To list the effects of hemodialysis, hemofiltration and peritoneal dialysis on drug prescribing
  • To describe the principles of drug interactions especially

immunosuppressive agents

Skills

  • To prescribe safely to patients with renal disease

Multidisciplinary aspects

  • To educate patients regarding importance of compliance

and reporting of problems with medication

Resources

Pharmacologists

  • Psychosocial and Ethical issues

Knowledge

  • To understand the impact of chronic illness on the child, adolescent, parents, siblings and extended family
  • To understand the ethics of research in children
  • To know the process of informed consent in different ages
  • To know the procedures for clinical trials

Skills

  • To demonstrate competence in communication skills at initial diagnosis and thereafter
  • Liaison with pediatricians and other health professionals
  • To show interest in ethical discussions within the department
  • To show ability to take informed consent

Multidisciplinary aspects

  • To understand the role of the psychologist, psychiatrist,

social worker, teacher and religious leaders

  • To understand the care of the dying child

Resources

Multidisciplinary team meeting

(Z) Teaching skills

Knowledge

  • To understand the principles of adult learning and different teaching techniques
  • To understand the role of clinical audit and research

Skills

  • To demonstrate formal and informal teaching skills at undergraduate and postgraduate level, and to other professionals within the multidisciplinary team
  • To demonstrate continuing self-education and self- reflection
  • To show support or active involvement in research
  • To show ability to critically evaluate literature reviews, audit and research papers
  • To demonstrate ability in oral presentation skills and

manuscript preparation

(A1) Nutrition

Knowledge

  • To develop basic knowledge of nutritional requirements of children with acute kidney injury and chronic kidney

disease including those on dialysis and transplantation

Skills

  • To be able to counsel and provide nutritional advice for

children with chronic kidney disease

Multidisciplinary aspects

  • Nutritionist

Competency in Procedural /Practical Skills:

The post graduate student should be able to perform independently the following procedures

• Renal biopsy

Satisfactory performance of percutaneous biopsy of native and transplant kidneys entail:

  • knowledge of indications for the procedure,
  • obtaining informed consent,
  • performance of the procedure itself including minimizing patient discomfort, and
  • interpretation of results of the biopsy.

• Central venous access insertion for hemodialysis

Satisfactory placement of vascular access entails:

  • knowledge of informed consent,
  • proper Seldinger technique,
  • knowledge of vascular anatomy,
  • minimizing patient discomfort, as well as
  • functional catheter placement and recognize/manage complications

• Acute peritoneal dialysis catheter insertion

Satisfactory placement of peritoneal catheter placement entails:

  • knowledge of informed consent,
  • proper technique,
  • minimizing patient discomfort, as well as
  • functional catheter placement.

In addition they should be able to perform independently the following:

To be able to write a prescription, conduct and supervise acute and chronic intermittent hemodialysis

  • Entails knowledge of proper indications for hemodialysis,
  • knowledge of first dialysis precautions,
  • writing of dialysis order which includes choosing dialysis filters,
  • estimating dry weight and modification during special circumstances (critically ill child, in-born errors of metabolism),
  • choosing dialysate composition,
  • understanding and treatment of complications, and
  • modifying dialysis prescription for inadequate clearance in chronic hemodialysis patients.

To be able to write a prescription, conduct and supervise acute and chronic peritoneal dialysis:

  • Entails knowledge of proper indications of peritoneal dialysis,
  • writing orders for peritoneal dialysis which includes dialysis prescription (volume of dialysate, frequency of exchanges, and use of different hypertonic solutions),
  • understanding and treatment of complications, and
  • modifying dialysis prescription in special situations (lactic acidosis, metabolic disorders) and inadequate clearance in chronic peritoneal dialysis patients

To be able to write a prescription, conduct and supervise continuous renal replacement therapy (CRRT)

  • Entails knowledge of proper indications of CRRT,
  • writing orders for continuous renal replacement therapy (flow rate of dialysate, choosing ultrafiltration rate,
  • choosing dialysate composition including the use of bicarbonate based solutions),
  • understanding and treatment of complications, and
  • modifying dialysis prescription for inadequate clearance in patients undergoing continuous renal replacement therapy

To be able to write a prescription, conduct and supervise slow low efficiency daily dialysis (SLED)

  • Entails knowledge of proper indications of SLED,
  • writing orders (flow rate of dialysate,
  • choosing ultrafiltration rate,
  • choosing dialysate composition,
  • understanding and treatment of complications, and
  • modifying dialysis prescription for inadequate clearance in patients undergoing SLED

To be able to write a prescription, conduct and supervise plasmapheresis

  • Entails knowledge of proper indications of plasmapheresis,
  • writing orders (volume of plasma replacement,
  • choosing rate of plasmapheresis, monitoring,
  • understanding and treatment of complications, and modifying plasmapheresis prescription based on the goal of plasmapheresis.

To be able to perform urine analysis at bedside

  • To perform correctly urinalysis and interpret findings and to know the limitations of interpretation as applied to patient care

Procedure

O

A

P

SJ

Renal biopsy

Hemodialysis catheter access

Acute peritoneal catheter insertion

Urine analysis

O- Observed; A- Assisted; P- Performed independently; SJ- Supervised junior colleague

Career Options

After completing a DM in Pediatric Nephrology, candidates will get employment opportunities in Government as well as in the Private sector.

In the Government sector, candidates have various options to choose from which include Registrar, Senior Resident, Demonstrator, Tutor, etc.

While in the Private sector the options include Resident Doctor, Consultant, Visiting Consultant (Pediatric Nephrology), Junior Consultant, Senior Consultant (Pediatric Nephrology), Pediatric Nephrology Specialist.

Courses After DM in Pediatric Nephrology Course

DM in Pediatric Nephrology is a specialisation course which can be pursued after finishing a Postgraduate medical course. After pursuing specialisation in DM in Pediatric Nephrology, a candidate could also pursue certificate courses and Fellowship programmes recognised by NMC and NBE, where DM in Pediatric Nephrology is a feeder qualification.

Frequently Asked Question (FAQs) –DM in Pediatric Nephrology Course

Question: What is the full form of DM?

Answer: The full form of DM is Doctorate of Medicine.

Question: What is a DM in Pediatric Nephrology?

Answer: DM Pediatric Nephrology or Doctorate of Medicine in Pediatric Nephrology also known as DM in Pediatric Nephrology is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course.

Question: What is the duration of a DM in Pediatric Nephrology?

Answer: DM in Pediatric Nephrology is a super specialty programme of three years.

Question: What is the eligibility of a DM in Pediatric Nephrology?

Answer: Candidates must be in possession of a postgraduate medical Degree (MD/MS/DNB) from any college/university recognized by the Medical Council of India (now NMC)/NBE.

Question: What is the scope of a DM in Pediatric Nephrology?

Answer: DM in Pediatric Nephrology offers candidates various employment opportunities and career prospects.

Question: What is the average salary for a DM in Pediatric Nephrology candidate?

Answer: The DM in Pediatric Nephrology candidate's average salary is between Rs. 5,00,000 to Rs. 30,00,000 per year depending on the experience.

Question: Can you teach after completing DM Course?

Answer: Yes, candidate can teach in a medical college/hospital after completing DM course.

Tags:    

Disclaimer: This site is primarily intended for healthcare professionals. Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement/treatment or prescription. Use of this site is subject to our terms of use, privacy policy, advertisement policy. © 2024 Minerva Medical Treatment Pvt Ltd

Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .

Similar News