DrNB Nephrology: Admissions, Medical Colleges, Fees, Eligibility Criteria details

DrNB Nephrology or Doctorate of National Board in Nephrology also known as DrNB in 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 study of the diagnosis and treatment of kidney diseases and also deals with renal replacement therapy (dialysis and kidney transplantation).

The course is a full-time course pursued at various accredited institutes/hospitals across the country. Some of the top accredited institutes/hospitals offering this course include Abirami Kidney Care Dr. Thangavelu Hospital, Tamil Nadu, AIG Hospital, Hyderabad, Telangana, Apollo Hospital, Guwahati, Assam, and more.

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

The fee for pursuing DrNB (Nephrology) varies from accredited institutes/hospital to hospital and may range from Rs. 70,000 to Rs.1,25,000 per annum.

After completion of their respective course, doctors can either join the job market or can pursue certificate courses and Fellowship programs recognized by NMC and NBE. Candidates can take reputed jobs at positions as Senior residents, Consultants, etc. with an approximate salary range of Rs.4,00,000 to Rs.60,00,000 per annum.

DNB is equivalent to MD/MS/DM/MCH degrees awarded respectively in medical and surgical super specialties. The list of recognized qualifications awarded by the Board in various broad and super specialties as approved by the Government of India are included in the first schedule of the Indian Medical Council Act, 1956.

The Diplomate of National Board in broad-specialty qualifications and super specialty qualifications when granted in a medical institution with the attached hospital or a hospital with the strength of five hundred or more beds, by the National Board of Examinations, shall be equivalent in all respects to the corresponding postgraduate qualification and the super-specialty qualification granted under the Act, but in all other cases, senior residency in a medical college for an additional period of one year shall be required for such qualification to be equivalent for teaching also.

What is DrNB in Nephrology?

Doctorate of National Board in Nephrology, also known as DrNB (Nephrology) or DrNB in (Nephrology) is a three-year super specialty program that candidates can pursue after completing a postgraduate degree.

Nephrology is the branch of medical science dealing with the study of the diagnosis and treatment of kidney diseases and also deals with renal replacement therapy (dialysis and kidney transplantation).

The National Board of Examinations (NBE) has released a curriculum for DrNB in Nephrology.

The curriculum governs the education and training of DrNB in Nephrology.

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

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 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 specialty.

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 DrNB in Nephrology

Eligibility Criteria

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

Note:

• The prior entry qualifications shall be strictly by Post Graduate Medical Education Regulations, 2000, and its amendments notified by the NMC and any clarification issued from NMC in this regard.
• •The candidate must have obtained permanent registration with 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 DrNB in Nephrology. Candidates can view the complete admission process for DrNB in 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. PGIMER, Chandigarh

3. JIPMER, Puducherry

4. NIMHANS, Bengaluru

• Candidates from all eligible feeder specialty subjects shall be required to appear in the question paper of the 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 for the examination, a candidate shall be eligible to exercise his/her choices in the counseling only for those super specialty subjects covered in the said group for which his/ her broad specialty is an eligible feeder qualification.

Fees Structure

The fee structure for DrNB in Nephrology varies from accredited institute/hospital to hospital. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for DrNB in Nephrology ranges from Rs. 70,000 to Rs.1,25,000 per annum.

Colleges offering DrNB in Nephrology

Various accredited institutes/hospitals across India offer courses for pursuing DrNB in Nephrology.

As per the National Board of Examinations website, the following accredited institutes/hospitals are offering DrNB (Nephrology) courses for the academic year 2022-23.

Syllabus

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

The course content for DrNB in Nephrology is given in the NBE Curriculum released by the National Board of Examinations, which can be assessed through the link mentioned below:

1. Applied basic sciences knowledge relevant to the field of nephrology including electrolyte and acid-base disorders.

2. Investigative techniques, selection, and interpretation of results

3. Pathogenesis of renal diseases and renal histopathology

4. Diseases of the urinary react (glomerular diseases urinary tract infection, tubulointerstitial diseases, inherited diseases, toxic nephropathies, systemic diseases with renal involvement, renal stone disease, urinary tract obstruction, vascular diseases of the kidney, hypertension, neoplasia etc)

5. Renal failure (diagnosis and medical management)

6. Principles and practice of dialysis

7. Renal transplantation and Transplant immunology

8. Recent advances in nephrology

9. Biostatistics and clinical epidemiology

10. Ethics, psychosocial, economics of management of renal diseases, human organ transplant act and medicolegal aspects of transplantation.

i. Assessment of Renal Disease

• History and clinical examination of patients with renal disease

• Urinalysis and microscopy

• Clinical assessment of renal function

• Renal function in the newborn infant

• The aging kidney

• Imaging in renal disease

• Renal biopsy Immunological investigation of renal disease

ii. BASICS- Embryology of the kidney

• Anatomy of the kidney

• Renal circulation

• Solute transport / Both organic and organic

• Renal Acidification Urine Concentration & Dilution

• Role of the kidney in blood pressure regulation

• Endocrine and Autocrine function of the kidney

iii. Pharmacology and Drug

• Handling of drugs in kidney disease Drug‐induced nephropathies

• Clinical use of diuretics

• Systemic cancer therapies and the kidney

iv. Fluid and Electrolyte Disorders

• Hypo/hypernatremia:

• Disorders of water balance

• Hypo/hyperkalemia

• Hypo/hypercalcemia

• Hypo/hyperphosphatemia

• Hypo/hypermagnesemia

• Clinical acid‐base disorders

v. Epidemiology and Risk Factors

• Epidemiology of kidney disease in Indian subcontinents

• Risk factors of CKD Nephron endowment

• Aging and kidney disease

• CKDu (chronic kidney disease of unknown etiology)

vi. Pediatric Nephrology

• Malformation of the kidney

• Fluid, Electrolyte,

• Acid-base disturbance

• Disease of kidney and Urinary track

• Dialysis in Children

vii. Urologic Aspects of Pediatric Nephrology

• Anomalies of the urinary tract: the trainee will understand a. Diagnosis, evaluation, treatment, and long-term outcome of anomalies of the upper and lower urinary tract such

a. Hydronephrosis,

b. Hydroureter

c. Ureterocoele

d. Posterior urethral valves, prune belly triad syndrome, ectopic or fused kidney

• The pathophysiologic consequences of urinary tract obstruction

• Special fetal and neonatal issues genitourinary (GU) issues such as

• Evaluation and management of GU abnormalities detected in utero

a. Indications for prenatal intervention for fetal urinary tract obstruction

b. Diagnosis and management of hematuria in neonates

• Urinary tract infection (UTI) in infancy, childhood, and adolescence: the trainee will know

a. The definition, epidemiology, pathogenesis, and spectrum of causative organisms

b. Appropriate diagnostic methods and pitfalls

c. Modes of therapy

d. Appropriate follow-up and imaging evaluation

e. The causes of sterile pyuria

• Vesicoureteral reflux (VUR): the trainee will understand

• The epidemiology, natural history, appropriate imaging, and VUR grading

• The clinical management and long-term follow-up of each grade of VUR reflux

• Neurogenic bladder: the trainee will understand

a. Normal physiologic phases of micturition

b. Different types of neurogenic bladder, including "nonneurogenic"

c. Etiologies, pathophysiology, and treatment options

• Enuresis in Children: the trainee will understand

a. The maturation of bladder function

b. The definition, incidence, and pathogenesis of enuresis

c. When and how to evaluate enuresis, and therapeutic modalities for the treatment

• Urinary tract trauma: the trainee will recognize

a. Predisposing factors, physical, laboratory, and imaging findings, and possible sequelae

• Renal tumors in children: the trainee will know and understand

a. The clinical features, natural history, evaluation, and diagnosis of nephroblastoma (Wilms' tumor), mesoblastic nephroma,

b. The genetic implications and associated phenotypic abnormalities

viii. Glomerular Disease

• Proteinuria and/or hematuria

• Nephrotic syndrome

• Minimal change disease Focal segmental glomerulosclerosis

• Immunoglobulin A nephropathy and Henoch‐Schönlein purpura

• Membranous nephropathy

• Mesangiocapillary glomerulonephritis

• Acute endocapillary glomerulonephritis

• Crescentic glomerulonephritis

• Anti-glomerular basement membrane (Goodpasture's) disease

• Infection‐related glomerulonephritis

• Malignancy‐associated glomerular disease

• Glomerular disease in the tropics

ix. The Kidney in Systemic Disease

• Diabetes mellitus

• Amyloid and immunotactoid glomerulopathy

• Plasma cell dyscrasias Sarcoidosis

• Systemic vasculitis

• Mixed cryoglobulinemia and hepatitis C infection

• Systemic lupus erythematosus

• Scleroderma‐systemic

• sclerosis Rheumatoid arthritis,

• connective tissue disease, and

• sjögren's syndrome

• Sickle cell nephropathy

• Cancer and the kidney

x. Tubular Disease

• Isolated defects of tubular function

• Fanconi syndrome

• Renal tubular acidosis

• Hypokalemia

• tubular disorders

• Nephrogenic diabetes insipidus

xi. Chronic Interstitial Disease

• Analgesic nephropathy

• Nonsteroidal anti‐inflammatory drugs and the kidney

• Nephrotoxic metals Balkan nephropathy

• Aristolochic acid nephropathy ('Chinese herb nephropathy') and other rare causes of chronic interstitial nephritis

xii. Urinary Tract Infection

• Lower and upper urinary tract infections in adults

• Urinary tract infection in children

• Renal tuberculosis or other mycobacterial infections Fungal infections and the kidney

• UTI in Pregnancy and Graft pyelonephritis

xiii. Renal Stone Disease

• Medical management of stone disease

• Surgical management of stone disease

• Nephrocalcinosis

• Renal stone disease in children

xiv. Acute Kidney Injury (Aki)

• Clinical approach to AKI

• Renal replacement therapies in AKI

• Dialysis and hemoperfusion treatment of acute poisoning

• Glomerulonephritis,

• vasculitis, and nephritic syndrome

• Acute tubulointerstitial nephritis

• Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura

• Hepatorenal syndrome

• Ischemic AKI

• Pigment‐induced AKI

• AKI in tropical countries

• AKI in infants and children

• AKI in pregnancy AKI in the elderly

xv. Chronic Kidney Disease (CKD)

• Assessment of CKD

• Endocrine disorders in CKD

• Sexual disorders in CKD

• Hypertension in CKD

• Cardiovascular risk factors in CKD

• Gastrointestinal disorders in CKD

• Liver disorder in CKD

• Hematological disorders in CKD

• Skeletal disorders in CKD

• β2‐Microglobulin amyloidosis in CKD

• Immune function in CKD

• Coagulation disorders in CKD

• Dermatologic disorders in CKD

• Neuropsychiatric disorders in CKD

xvi. Special Problems in CKD

• CKD in the elderly

• CKD in diabetic patients

• CKD in pregnancy

• CKD in children

• Growth and endocrine disturbances in children with CKD

xvii. Dialysis

• Dialysis strategies

• Vascular access Hemodialysis,

• hemofiltration and hemodiafiltration

• Peritoneal dialysis

• Adequacy of dialysis

• Medical management of the dialysis patient

• Psychological aspects of treatment for renal failure

xviii. Renal Transplatation

• Donor & Recipient issues

• Transplantation immunobiology

• Medical & surgical complications following transplantation

• Early management of transplant recipients

• Immunosuppression for renal transplantation

• Chronic complications in transplant recipients

• CMV, BKV, and other virus-related renal damage.

xix. Inherited Renal Disease

• Investigation of inherited renal disease

• Autosomal dominant polycystic kidney disease

• Nephronophthisis

• Alport's syndrome

• Primary hyperoxalurias

xx. Structural and Congenital Abnormalities

• Renal dysplasia

• Vesicoureteric reflux and reflux nephropathy

• Urinary tract obstruction

• Congenital abnormalities of the urinary tract

• Medullary sponge kidney

xxi. Method of Training

The training of postgraduate courses shall be on a residency pattern with assigned responsibilities of patient care. The participation of the students in all facets of the training process shall be insisted upon.

o Nephrology ward 12 months (split it into 1st yr. & 2nd yr.)

o Dialysis 12months (split it into 1st yr. & 2nd yr.)

o Transplantation 10 months (in the 3rd year)

o Radiology, Urology 1 month

o Outstation posting maximum period of 2 months

a. Nephrology ward posting - Candidate is expected to acquire the ability of case taking and healthy personal relationship with the patient, Investigate and manage the patient under the guidance of a Postgraduate Teacher.

b. Dialysis posting - Trainee is expected to do the canulations, making access for different extracorporeal treatments, peritoneal catheter insertions, and renal biopsy procedures under the guidance of a postgraduate teacher.

c. Renal Transplantation posting -Trainee is expected to do the donor, and recipient evaluation, perfusion procedures of transplantation, Brain death criteria and diagnosis, counseling for organ transplantation, ICU care of recipients and follow-up of the transplant recipients under the cover of a post-graduate teacher. During the training period, he/she is expected to participate in a public meeting where renal diseases are discussed with the common people. During the training period, he/she is expected to take classes for undergraduates, postgraduates, nursing students, and trainees of dialysis technology.

• Bedside rounds - daily

• Mortality meeting - once a week

• Seminar - once in two weeks

• Grand rounds - once a week

• Journal club - once in two weeks

• Renal histology conference - once in two weeks

• Clinical case discussion - once a week

• Transplant meeting - once a week

• Nephro-urology conference - once a month

• Nephro-radiology conference - once a month

• Outpatient nephrology care including renal transplant clinic

d. Didactic Lectures -A minimum of 15-20 lectures/year covering the recent advances in all aspects of renal diseases would be delivered by consultant faculty. In addition, candidates will be required to attend the complete, short-term basic and clinical courses on

• Bio-statistics

• Research methodology and experimental lab medicine relevant to Nephrology

• Use of Computers in Medicine

• Bio ethics, ethical issues in transplantation including "Human Organ Transplant Act"

e. Interventional Procedures-A candidate will be required to have achieved proficiency in performing and supervising hemodialysis, peritoneal dialysis, and renal biopsies. He would be expected to have performed a minimum of 50 renal biopsies (native), a minimum of 25 graft biopsies, 300 hemodialyses including CVVHD, CRRT, and 50 peritoneal dialysis- rather 5-10 intermittent peritoneal dialysis. (PD is not being practiced by most hospitals. However, residents need to be familiar with this life-saving procedure)

The candidate would be expected to involve and be trained in all aspects of the CAPD program.

The candidate would also be expected to have inserted at least 50 internal jugulars, 50 femoral catheters, and at least 5-10 AVF and 10 CAPD catheters.

The candidate would maintain a record of all the procedures/ interventions in a log book, which would be certified by the Head of the department. Investigative work-up.

The candidate is expected to perform routine urine examinations and ultrasonography. In addition, he/she must familiarize himself/herself with the following investigations:

f. Laboratory:

• Electrolyte and acid-base analysis

• Renal function tests

• Auto analyzer functioning

• Renal pathology interpretation including immuno-fluoresence and electron microscopy.

g. Radiological:

• Intravenous urography

• Micturatingcystourethrography

• Digital subtraction angiography

• Selective renal angiography and interventional angioplasty and stenting

• Selective renal venography

• Doppler studies

• Antegrade and retrograde pyelography

• CT imaging

• Magnetic resonance imaging

h. Nuclear Medicine:

• Various renal isotope imaging and functional techniques

• Urodynamic studies

i. Microbiology:

• Viral, Bacterial and funal cultures, Serological and PCR techniques

j. Immunological test:

• ANCA, ANA, anti-dsDNA, complement, anit GBM ab, cryoglobulin, immunoelectrophoresis

k. Tissue typing:

• Crossmatch, serological typing, molecular HLA typing, PRA

l. Renal function testing

• Renal plasma flow, GRF

• Renal concentrating, diluting capacity

• Microalbuminuria

• Proteinuria measurement

• Urinary acidification

• Renal sodium and potassium handling

Career Options

After completing a DrNB in Nephrology, candidates will get employment opportunities in Government and 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 (Nephrology), Junior Consultant, Senior Consultant (Nephrology), Nephrologist, etc.

Courses After DrNB in Nephrology Course

DrNB in Nephrology is a specialization course that can be pursued after finishing a Postgraduate medical course. After pursuing a specialization in DrNB in Nephrology, a candidate could also pursue certificate courses and Fellowship programs recognized by NMC and NBE, where DrNB in Nephrology is a feeder qualification.

Frequently Asked Questions (FAQs) – DrNB in Nephrology Course

Question: What is the complete form of DrNB?

Answer: The full form of DrNB is a Doctorate of National Board.

Question: What is a DrNB in Nephrology?

Answer: DrNB Nephrology or Doctorate of National Board in Nephrology also known as DrNB in 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 DrNB in Nephrology?

Answer: DrNB in Nephrology is a super specialty program of three years.

Question: What is the eligibility of a DrNB in Nephrology?

Answer: Candidates must have a postgraduate medical Degree in MD/DNB (General Medicine) or MD/DNB (Paediatrics) obtained from any college/university recognized by the MCI (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the DNB website.

Question: What is the scope of a DrNB in Nephrology?

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

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

Answer: The DrNB in Nephrology candidate's average salary is Rs.4,00,000 – Rs.60,00,000 per annum depending on the experience.

Question: Can you teach after completing DrNB Course?

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

Question: What is the difference between DrNB and DNB?

Answer: As of today, DrNB is a super-specialist qualification imparted by the NBE (SS level). Whereas DNB is a specialist qualification (PG level). Earlier DrNB used to be called DNB SS but now it is called DrNB.