DM Nephrology: Admissions, medical colleges, fees, eligibility criteria details

Written by Dr Nitisha Kalia Published On 2023-02-10T18:15:25+05:30 | Updated On 16 Dec 2023 2:55 PM IST

DM Nephrology: Admissions, medical colleges, fees, eligibility criteria details

DM Nephrology or Doctorate of Medicine in Nephrology also known as DM 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 speciality course is 3 years, and it focuses on the diagnosis, treatment and management of diseases affecting kidney and urinary tract.

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 All India Institute of Medical Sciences, New Delhi, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry (JIPMER), Postgraduate Institute of Medical Education & Research, Chandigarh and more.

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 (Nephrology) varies from college to college and may range from Rs. 5000 to Rs. 20 lakhs 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 lakhs to Rs. 25 lakhs per year depending upon their expertise.

What is DM in Nephrology?

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

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

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 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 Nephrology

Name of Course	DM in Nephrology
Level	Doctorate
Duration of Course	Three years
Course Mode	Full Time
Minimum Academic Requirement	Candidates must have a postgraduate medical Degree in MD/DNB (General Medicine) or MD/DNB (Paediatrics) obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.
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 lakhs per year
Average Salary	Rs.5 lakhs to Rs. 25 lakhs per year

Eligibility Criteria

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

Name of DM course	Course Type	Prior Eligibility Requirement
Nephrology	DM	MD/DNB (General Medicine)
Nephrology	DM	MD/DNB (Paediatrics)

Note:

· The feeder qualification for DM in Nephrology is defined by the NBE and is subject to changes by the NBE.

· The feeder qualification mentioned here is as of 2022.

· For any changes, please refer to the NBE website.

· 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 DM in Nephrology. Candidates can view the complete admission process for DM in Nephrology mentioned below:

The NEET-SS or National Eligibility Entrance Test for Super speciality 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 speciality.

The following Medical institutions are not covered under centralized admissions for DM/ MCh courses through NEET-SS:

AIIMS, New Delhi and other AIIMS
PGIMER, Chandigarh
JIPMER, Puducherry

NIMHANS, Bengaluru

Candidates from all eligible feeder speciality subjects shall be required to appear in the question paper of the respective group if they are willing to opt for a super speciality course in any of the super speciality courses covered in that group.

A candidate can opt for appearing in the question papers of as many groups for which his/her Postgraduate speciality 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 counselling only for those super speciality subjects covered in the said group for which his/ her broad speciality is an eligible feeder qualification.

Fees Structure

The fee structure for DM in 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 Nephrology is around Rs.5000 to Rs. 20 lakhs per year.

Colleges offering DM in Nephrology

Various medical colleges across India offer courses for pursuing DM in (Nephrology).

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

Sl.No.	Course Name	State	Name and Address of Medical College / Medical Institution	Management of College
1	DM - Nephrology	Andhra Pradesh	Andhra Medical College, Visakhapatnam	Govt.
2	DM - Nephrology	Andhra Pradesh	Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati	Govt.
3	DM - Nephrology	Andhra Pradesh	NRI Medical College, Guntur	Trust
4	DM - Nephrology	Andhra Pradesh	Kurnool Medical College, Kurnool	Govt.
5	DM - Nephrology	Andhra Pradesh	Narayana Medical College, Nellore	Trust
6	DM - Nephrology	Assam	Gauhati Medical College, Guwahati	Govt.
7	DM - Nephrology	Bihar	Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna	Govt.
8	DM - Nephrology	Chandigarh	Postgraduate Institute of Medical Education & Research, Chandigarh	Govt.
9	DM - Nephrology	Chattisgarh	All India Institute of Medical Sciences, Raipur	Govt.
10	DM - Nephrology	Delhi	Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi	Govt.
11	DM - Nephrology	Delhi	All India Institute of Medical Sciences, New Delhi	Govt.
12	DM - Nephrology	Goa	Goa Medical College, Panaji	Govt.
13	DM - Nephrology	Gujarat	Smt. G.R. Doshi and Smt. K.M. Mehta Institute of Kidney Diseases and Research Centre, Dr H.L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat	Govt.
14	DM - Nephrology	Jammu & Kashmir	Sher-I-Kashmir Instt. Of Medical Sciences, Srinagar	Govt.
15	DM - Nephrology	Karnataka	Rajarajeswari Medical College & Hospital, Bangalore	Trust
16	DM - Nephrology	Karnataka	Karnataka Institute of Medical Sciences, Hubballi	Govt.
17	DM - Nephrology	Karnataka	Jawaharlal Nehru Medical College, Belgaum	Trust
18	DM - Nephrology	Karnataka	Father Mullers Medical College, Mangalore	Trust
19	DM - Nephrology	Karnataka	JSS Medical College, Mysore	Trust
20	DM - Nephrology	Karnataka	Kasturba Medical College, Manipal	Trust
21	DM - Nephrology	Karnataka	M S Ramaiah Medical College, Bangalore	Trust
22	DM - Nephrology	Karnataka	St. Johns Medical College, Bangalore	Trust
23	DM - Nephrology	Karnataka	Institute of Nephro-Urology, Bangalore	Govt.
24	DM - Nephrology	Kerala	Medical College, Thiruvananthapuram	Govt.
25	DM - Nephrology	Kerala	Government Medical College, Kozhikode, Calicut	Govt.
26	DM - Nephrology	Kerala	Government Medical College, Kottayam	Govt.
27	DM - Nephrology	Kerala	Pushpagiri Institute Of Medical Sciences and Research Centre, Tiruvalla	Trust
28	DM - Nephrology	Kerala	T D Medical College, Alleppey (Allappuzha)	Govt.
29	DM - Nephrology	Kerala	Amrita School of Medicine, Elamkara, Kochi	Trust
30	DM - Nephrology	Madhya Pradesh	All India Institute of Medical Sciences, Bhopal	Govt.
31	DM - Nephrology	Madhya Pradesh	Sri Aurobindo Medical College and Post Graduate Institute, Indore	Trust
32	DM - Nephrology	Maharashtra	Mahatma Gandhi Missions Medical College, Aurangabad	Trust
33	DM - Nephrology	Maharashtra	Seth GS Medical College, and KEM Hospital, Mumbai	Govt.
34	DM - Nephrology	Maharashtra	Bombay Hospital Institute of Medical Sciences, Mumbai	Govt.
35	DM - Nephrology	Maharashtra	Padmashree Dr D.Y.Patil Medical College, Navi Mumbai	Trust
36	DM - Nephrology	Maharashtra	Grant Medical College, Mumbai	Govt.
37	DM - Nephrology	Maharashtra	Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha	Trust
38	DM - Nephrology	Maharashtra	Topiwala National Medical College, Mumbai	Govt.
39	DM - Nephrology	Maharashtra	Dr D Y Patil Medical College, Hospital and Research Centre, Pimpri, Pune	Trust
40	DM - Nephrology	Manipur	Regional Institute of Medical Sciences, Imphal	Govt.
41	DM - Nephrology	Orissa	SCB Medical College, Cuttack	Govt.
42	DM - Nephrology	Orissa	Kalinga Institute of Medical Sciences, Bhubaneswar	Trust
43	DM - Nephrology	Orissa	Instt. Of Medical Sciences & SUM Hospital, Bhubaneswar	Trust
44	DM - Nephrology	Pondicherry	Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry	Govt.
45	DM - Nephrology	Punjab	Dayanand Medical College & Hospital, Ludhiana	Trust
46	DM - Nephrology	Punjab	Christian Medical College, Ludhiana	Trust
47	DM - Nephrology	Rajasthan	All India Institute of Medical Sciences, Jodhpur	Govt.
48	DM - Nephrology	Rajasthan	SMS Medical College, Jaipur	Govt.
49	DM - Nephrology	Rajasthan	Government Medical College, Kota	Govt.
50	DM - Nephrology	Rajasthan	Geetanjali Medical College & Hospital, Udaipur	Trust
51	DM - Nephrology	Rajasthan	National Institute of Medical Science & Research, Jaipur	Trust
52	DM - Nephrology	Rajasthan	Mahatma Gandhi Medical College and Hospital, Sitapur, Jaipur	Trust
53	DM - Nephrology	Tamil Nadu	Kilpauk Medical College, Chennai	Govt.
54	DM - Nephrology	Tamil Nadu	Saveetha Medical College and Hospital, Kanchipuram	Trust
55	DM - Nephrology	Tamil Nadu	Sri Ramachandra Medical College & Research Institute, Chennai	Trust
56	DM - Nephrology	Tamil Nadu	Christian Medical College, Vellore	Trust
57	DM - Nephrology	Tamil Nadu	Madras Medical College, Chennai	Govt.
58	DM - Nephrology	Tamil Nadu	SRM Medical College Hospital & Research Centre, Chengalpattu	Trust
59	DM - Nephrology	Tamil Nadu	Stanley Medical College, Chennai	Govt.
60	DM - Nephrology	Tamil Nadu	Madurai Medical College, Madurai	Govt.
61	DM - Nephrology	Tamil Nadu	Govt. Mohan Kumaramangalam Medical College, Salem- 30	Govt.
62	DM - Nephrology	Tamil Nadu	Tirunelveli Medical College,Tirunelveli	Govt.
63	DM - Nephrology	Tamil Nadu	PSG Institute of Medical Sciences, Coimbatore	Trust
64	DM - Nephrology	Telangana	Osmania Medical College, Hyderabad	Govt.
65	DM - Nephrology	Telangana	Gandhi Medical College, Secunderabad	Govt.
66	DM - Nephrology	Telangana	Nizams Institute of Medical Sciences, Hyderabad	Govt.
67	DM - Nephrology	Uttarakhand	All India Institute of Medical Sciences, Rishikesh	Govt.
68	DM - Nephrology	Uttar Pradesh	Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow	Govt.
69	DM - Nephrology	Uttar Pradesh	Institute of Medical Sciences, BHU, Varanasi	Govt.
70	DM - Nephrology	Uttar Pradesh	Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow	Govt.
71	DM - Nephrology	West Bengal	Institute of Postgraduate Medical Education & Research, Kolkata	Govt.
72	DM - Nephrology	West Bengal	Nilratan Sircar Medical College, Kolkata	Govt.

Syllabus

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

NMC as of 8/02/23 has not defined a Competency-based curriculum for DM Nephrology. The syllabus of AIIMS below provides a basic outline on what a DM Nephrology candidate has to undergo while training:

.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 competencies 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 the genito-urinary system To understand the development of renal function and physiology for the assessment of: a. GFR from height and plasma creatinine 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 the diagnosis of UTI To describe the role of ultrasound scans, 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 infections in different age groups · To show the 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 the relief of obstruction
Multidisciplinary aspects	Liaison with radiologists, obstetricians and surgeons in management decisions and antenatal counselling · To show the 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 behavioural 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 assess the whole child with neurogenic bladder · To show the 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 a 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 the ability to manage the child with proteinuria
Multidisciplinary aspects	To understand the requirement for long-term follow-up

(H) Glomerular disease

Knowledge	To describe the aetiology, 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, plasmapheresis 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 the 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 the initial episode of nephrotic syndrome and relapses and the complications To appropriately investigate and manage steroid-resistant nephrotic syndrome and the complications To manage the 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 paediatricians 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 the use of plasmapheresis
To show the 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 the 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 the 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 anaemia
To know the epidemiology of VTEC, S. dysenteriae
To know the presentation and clinical course of diarrhoea-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 their relationship to systemic conditions
Skills	To appropriately investigate and manage the child with interstitial nephritis, including the 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 the 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 to perform and interpret ABPM read-out and modify prescription
Multidisciplinary aspects	Liaison with local paediatricians; the interventional radiologist
Resources	Intensive care unit; Radiology services

(O) Nephrolithiasis

Knowledge	To know the aetiology 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 the ability to appropriately investigate the child with renal stones To show the ability to manage a child with renal stones
Multidisciplinary aspects	To involve pediatric urologists where indicated To show an 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 a 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 counselling
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 counselling, including antenatal diagnosis
Resources	Geneticist

(S) Fluid and electrolyte disturbances

Knowledge	To understand the physiology underlying fluid and electrolyte imbalance in a 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 the 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 the 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 a 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 the 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 anaemia, and its investigation and management, including the 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 anaemia To appropriately counsel the family to facilitate the selection of dialysis modality before 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 the ability to prevent, diagnose and manage the renal bone disease To diagnose and appropriately treat renal anaemia
Multidisciplinary aspects	To appreciate the role of the multi-professional team including a dietitian, psychologist, social worker To understand the role of the dialysis nurses and transplant coordinator To audit biochemical and haematological 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 about the original diagnosis and their management

Skills

Pre-transplantation

To assess the suitability of a patient for a 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 in 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 of 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 them with other methods of dialysis To describe the anatomy of the neck veins and their assessment To describe the methods of vascular access and arteriovenous fistulas and their complications To understand the principles of water treatment and maintaining water quality To define the methods to assess the 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; disinfect 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 the 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 technicians 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 the 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 a 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 the importance of compliance and reporting 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 paediatricians and other health professionals To show interest in ethical discussions within the department To show the 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 levels, 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 the ability to critically evaluate literature reviews, audits and research papers
To demonstrate ability in oral presentation skills and manuscript preparation

(A1) Nutrition

Knowledge	To develop basic knowledge of the 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 postgraduate student should be able to perform independently the following procedures

• Renal biopsy

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

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 orders which includes choosing dialysis filters,
estimating dry weight and modification during special circumstances (critically ill child, inborn 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 and 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 prescriptions for inadequate clearance in patients undergoing continuous renal replacement therapy

To be able to write a prescription, conduct and supervise slow low efficient 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 prescriptions 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 the 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 the 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 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 (Nephrology), Junior Consultant, Senior Consultant (Nephrology), and Nephrology Specialist.

Courses After DM in Nephrology Course

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

Frequently Asked Questions (FAQs) –DM in Nephrology Course

Question: What is the full form of DM?

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

Question: What is a DM in Nephrology?

Answer: DM Nephrology or Doctorate of Medicine in Nephrology also known as DM in Nephrology is a super speciality 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 Nephrology?

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

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

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

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

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

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

Answer: The DM in Nephrology candidate's average salary is between Rs. 5 lakhs to Rs. 25 lakhs per year depending on the experience.

Question: Can you teach after completing DM Course?

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

DM in NephrologyNephrologyDM in Nephrology feesDM in Nephrology syllabusnmcdm

Dr Nitisha Kalia

Fact checking Lead

Nitisha graduated with an MD in Medicine from O.O. Bogomolets National Medical University in Kyiv, Ukraine, in 2024. She joined Medical Dialogues in 2022. Her interests lie in healthcare management, medical writing, and fact-checking to combat the widespread medical misinformation in society.