Message from the Program Director

Thank you for your interest in the LSU Nephrology Fellowship program. On behalf of the entire Renal, Electrolyte and Hypertension Division, I look forward to having an opportunity to meet you and introduce our outstanding Nephrology Fellowship educational program, our faculty, and our fellows to you. LSU Nephrology has been training outstanding nephrologists since 1988. We have an incredibly knowledgeable and dedicated teaching faculty. Fellowship is likely the most important part of your long medical journey and the decision to enroll in a program should be based on diverse clinical experiences across ambulatory and inpatient experiences. Whether you are interested in our two-year Clinical Track or One year (or more)-year Interventional Nephrology Track, I know you can find everything you could want in a Nephrology Fellowship here at LSU Health Shreveport.

All of our fellows complete training with a comprehensive experience across the full spectrum of nephrology practice: acute and chronic kidney disease, critical care nephrology, glomerulonephritis and vasculitis, hypertension, electrolyte disorders, renal complications of systemic cancer (and its treatment), renal and non-renal transplants, dialysis access, and so on. You will become competent in all dialysis modalities: continuous renal replacement therapy (CRRT), acute and chronic hemodialysis, peritoneal dialysis, and home hemodialysis. We do all our native and transplant kidney biopsies at our Interventional Nephrology suite and fellows master histopathologic interpretation of kidney biopsies. All acute and chronic hemodialysis catheters are placed by nephrology staff/trainees and all fellows feel confident at end of training to be able to pursue these procedures if needed.  

We are one of the handful of academic programs offering Interventional Nephrology training as part of fellowship. All fellows in last 15 years enrolled in our two-year fellowship had an opportunity to attain IN procedural skills and get additional certification through American Society of Diagnostic and Interventional Nephrology (ASDIN). Your education here will include simulation training (ultrasound, vein cannulation and giving bad news). One of the first things we did when I took over in 2013 as Program Director was to overhaul our curriculum with feedback and help from fellows. Outstanding didactic/journal clubs/morbidity & mortality conferences cover virtually all aspects of nephrology and dialysis as well as basic renal physiology, biostatistics, renal pathology and dialysis access, and renal imaging. Our fellows have shined in private practice, Interventional Nephrology practice and teaching at an academic medical center.

Again, all of us here at LSU look forward to meeting you.
Best regards,
Bharat Sachdeva, MD
Associate Professor of Medicine, Nephrology Fellowship Program Director; Director Interventional Nephrology

The Fellowship Experience

Schedules, Clinics, Rotations

Sample Daily Schedule

(Actual schedule may vary!)

Monday through Friday
    7:00 –  9:00 am –     Fellow/Resident Rounds
    9:00 -  12:00 noon –     Consult Rounds with Faculty
    12:00 - 1:00 pm –     Lunch/Noon Conferences (Friday Only)
    1:00 -   4:00 pm –     Consult Rounds/Clinic
    4:00 –  5:00 pm –     Consult Rounds with Faculty/Clinic
The above schedule is suggested and is subject to change upon the discretion of faculty attending.

Weekends and Holidays
The attending physician and fellow will make work rounds on Saturday, Sunday, and any other holiday.  Weekend call starts at 8:00 am Saturday morning.

Call Responsibilities
Each fellow will be on call approximately once every fifth night/weekend from 5:00 PM until 8:00 AM the next morning.

Special Conferences
Nephrology staff will post timing and venues for any special conferences and you will be notified via email.

On-call Hours
After hours fellows take call from home. Call will start at 5pm on a workday and go on till 8am the next day.

Patient Assignments
All patients on whom a consult is requested will be seen within twenty-four hours of the request. All ICU calls will be seen within (1-2) hours of origination of call unless the staff on call approves of the consult to be seen the next morning.

Sample Inpatient Schedule: Fellowship Yr. 1

•    Period 01 - Consultation (Ochsner LSU)
•    Period 02 – Elective Self Study/Ambulatory Clinic
•    Period 03 - Consultation (Ochsner LSU)
•    Period 04 – Transplant (Private)
•    Period 05 – Elective Critical Care
•    Period 06 - Consultation (Ochsner LSU)
•    Period 07 – Elective Hemodialysis Clinic Rounds
•    Period 08 – Elective Research
•    Period 09 - Consultation (Ochsner LSU)
•    Period 10 – Transplant (Private)
•    Period 11 - Consultation (Ochsner LSU)
•    Period 12 – Elective Procedural (Renal Bx and CVC Insertion)
•    Period 13 - Consultation (Ochsner LSU)

Sample Inpatient Schedule: Fellowship Yr. 2

•    Period 01 - Ambulatory Hemo Dialysis Rotation
•    Period 02 - Interventional Nephrology
•    Period 03 – Elective Nephro Pathology
•    Period 04 – Interventional Nephrology
•    Period 05 –Elective Radiology
•    Period 06 – Elective Research
•    Period 07 - Consultation (Ochsner LSU)
•    Period 08 – Elective Research
•    Period 09 – Elective Urology
•    Period 10 - Interventional Nephrology
•    Period 11 – Elective Research
•    Period 12 – Elective Ambulatory Clinic (GN/HTN/PD/Outpatient Dialysis)
•    Period 13 - Interventional Nephrology

Clinics & Rotations

Clinics
•    Tuesday – All Fellows: Continuity Clinic (10-12 patients) (Ochsner LSU)
•    Thursday – Elective/LSU Fellow: New Patient Intake Clinic (4-5 Patients)
•    Thursday (Last week)– Elective/LSU Fellow: Glomerulonephritis Clinic (4-5 Patients) (Ochsner LSU)
•    Fridays – Elective: Hypertension Clinic (10-12 patients) (Ochsner LSU)
•    PD Clinic – All Fellows: (Once a month at the fellow designated clinic)
•    HD Outpatient Shift -- Second Year fellows Once a Month

Rotations
•    Ochsner LSU Health
•    Interventional Nephrology
Elective:
•    Research
•    Pathology
•    Urology
•    Radiology
•    Interventional Radiology

Clinical Sections

AMBULATORY CLINICS

The Nephrology and Hypertension Division offers diagnostic evaluation and clinical management for patients with acute or chronic kidney diseases, hypertension, kidney transplantation, diabetic nephropathy, glomerulonephritis, nephrotic syndrome, interstitial nephritis, electrolyte and acid-based disturbances, hematuria, proteinuria, kidney stones amongst other conditions. Faculty/Residents/Fellows/Physician Extenders provide daily clinics at 1501 Kings Highway, Shreveport, LA 71103 location.

Ochsner LSU Hospital

The Ochsner LSU inpatient nephrology practice treats patients with diverse renal diseases, such as hematuria, proteinuria, acute/chronic kidney disease, kidney transplantation, diabetic nephropathy, hypertension, recurrent urinary tract infections, renovascular disease, renal tubular abnormalities, fluid and electrolyte disorders, glomerulonephritis, nephrotic syndrome, anti-GBM disease, systemic lupus erythematosus, vasculitis, and interstitial nephritis.
Renal replacement therapies including acute and chronic hemodialysis, continuous renal replacement therapy, acute and chronic peritoneal dialysis including urgent start peritoneal dialysis is offered by a qualified nephrology team at OLSU Shreveport.

Interventional Nephrology

Over the last 15 years, LSU Health Shreveport program has trained numerous interventionists in practice in academic and private setting. The IN program offers services across all aspects of dialysis access involving diagnostic and therapeutic procedures required to achieve a working dialysis access. Ultrasound exam of veins/fistulae/grafts, Venograms (radiocontrast/Carbon di Oxide), Angiograms/Angioplasty/Thrombectomy of Fistulae and Grafts, Stents in Fistulae/Grafts/Peripheral/Central Veins/Arteries, Peritoneal Dialysis catheter Insertion/Revision/Removal, Tunnelled Dialysis Catheter Insertions/Revision/Replacement/Removal, Accessory vein ligation/Coil, Fistula/Graft banding/Miller/Ligation etc.
Training in IN is available in two tracks
Nephrology Fellow Track: All fellows enrolled in 2-year nephrology fellowship are eligible for training within the 24 months of nephrology fellowship.
Interventional Nephrology Fellowship Track: Available to nephrology fellows who have completed ACGME Nephrology fellowship. This is a one-year training track as 6th/7th year fellow track.

Outpatient Dialysis Program

The Nephrology and Hypertension provides care for in-center and Home hemodialysis and peritoneal dialysis patients at several dialysis facilities that are owned and operated by DCI and Fresenius. Over 400 ESRD patients are provided care by LSU Nephrology staff.

Renal Transplant Program

Pretransplant evaluation for living-related and deceased-donor kidney transplants, post-transplant care in both ambulatory and in-patient settings, and consultation for patients with non-renal solid organ transplants with chronic kidney disease.

Conference(s)

Nephrology Didactic Conferences

1st-4th  Fridays of every month                  
12:30 noon
Topics from the curriculum will be assigned to Faculty and Fellows

Salt and Water Club

1st and 3rd Wednesday of Month            
4:00pm
Mandatory for fellows; Discuss renal physiology, electrolytes and acid base

Research Conference

5th Friday of each month, 12:30 noon 

Biopsy Conference

3rd Friday of each month,                 
1:30 PM
Review native, pediatric and transplant biopsies with pathologists

Morbidity & Mortality

1st  and 4th Friday of each month            
1:30 PM
Cases will be presented in rotation from the consult service. A Schedule for the presentation fellow will be available in the nephrology office.

Journal Club

2nd Friday of each month                 
1:30 PM
Two fellows with attending mentor will present 2-3 articles.  Article to be distributed one week prior to conference.

Nephsap Dinner Journal Club

Quarterly                        
6pm at Local Restaurants
Current topic review from Nephsap, ASN

Leave and Moonlighting

Leave

Vacation - 20 Working days of vacation.
A Leave Form should be completed by Fellow and signed by Program Director before leave is approved. No exceptions!
Leave Forms are available at Nephrology Office, Program Coordinator Office, or can be sent via email to you. Please contact Program Coordinator, Cristal Willcox, for details.

Leave period shall not exceed two weeks in a block of four-week rotation. Leave is encouraged to be taken in weekly blocks to minimize interruptions in education.

Educational Leave - Educational leave will be granted for:
    1. American Board of Internal Medicine (ABIM) Examination
    2. American Society of Nephrology Meeting
    3. National Kidney Foundation Meeting
    3. Other scientific meetings at which the fellow makes a scientific presentation.

FMLA/Maternity Leave - See the House Officer Handbook for guidelines

Sick Leave - It is the responsibility of the fellow to contact their assigned Attending Physician and the Program Director if sick leave is requested.  Failure to follow the procedure can  result in charging annual leave for any sick days.

Leave Without Pay (LWOP) - Special circumstances may warrant the fellow being granted leave without pay.  This must be arranged with the approval of the Program Director. During the period of time of LWOP, no credit for training will be given and training will be extended.

Interview leave: Fellows can avail a maximum of 5 working days in the final year of training for job interviews. Primary rotation Attending and Program Director must sign off on the leave request. Leave requests may not be made on continuity clinic (Tuesday).

Emergency Leave: Emergency leave will be approved as needed by the Program Director. FMLA leave policy will be used to sanction such leave requests.

Moonlighting

"Moonlighting” is a privilege granted to Nephrology Fellows on a case by case basis.  The direct provision of patient service for pay (moonlighting) is considered an augmentation and a privilege that should not detract from the goals and objectives of the educational program. Internal moonlighting is defined by the ACGME as moonlighting at the sponsoring institution or the non-hospital sponsor’s primary clinical site.
    Fellows are not required to engage in moonlighting.
•    If moonlighting does occur, each Resident must have a written statement of permission from the program director that is made part of the Resident’s file.
•    Resident Performance will be monitored for the effect of moonlighting activities upon performance and that adverse effects may lead to withdrawal of permission.
•    Internal and External moonlighting hours must be counted toward the 80-hour weekly limit on duty hours, and monitored by the training program.

As recommended by the Clinical Board, Fellows are encouraged to limit the number of moonlighting hours per week to 10 hrs. Fellows must notify Program Director of the average number of external moonlighting hours per month.  Fellows are reminded that the Louisiana State Malpractice Plan does not cover malpractice for moonlighting hours outside the LSU Health System.  Under no circumstances should Fellows moonlight during their regular scheduled program hours of service.
Due to Federal Guidelines, individuals with the J-1 VISA are not allowed to moonlight.
Nephrology Fellow whose attendance decreases to less than seventy five percent of conferences attended will have their approval for moonlighting suspended until their conference attendance improves to greater than seventy percent.  
Note:  Approval must first be granted by program director and “Moonlighting Approval/Evaluation” forms must be submitted and placed in fellowship file.

The Fellow-Faculty Relationship

Key Faculty

Bharat Sachdeva, MD
Program Director

Kenneth Abreo, MD
Section Chief

Adrian P. Abreo, MD

Bakhtiar Mohamad Amin, MD

 

Mary Buffington, MD

Adrian Sequeira, MD

Karina Sulaiman, MD

Support Staff

Cristal Willcox, Prorgam Coordinator

Kaleigh Stephenson, Nurse Coordinator

&

Catherine Taylor, Administrative Assistant

Mentorship

Mentorship

Specialist training is an exciting time. Long-term dreams and vivid visions are finally looking to be clearer. Years of training will finally end after this last block for most of the trainees. These 2 years in training are the final stop, before the start of a new life.

But then, there is a lot to learn and lot that seems to be coming too fast, too hard at times. Calls can be busy, patients complex, and daunting problems and complex pathology will arise. Having guidance and advice from peers who have walked that road ahead can be extremely beneficial in difficult situations.

Our Nephrology Mentoring Program is designed to facilitate and provide each fellow a supportive, nurturing, and confidential relationship with a faculty member within the division.

During fellowship, all fellows will be assigned a personal mentor to help them:

  • Acclimatize to renal pathology: Help the young fellow understand the working and principles governing care of nephrology patients.
  • Identify career plans: Discuss with fellows their long-term plans and focus on career paths.
  • Assist fellows in developing a plan for focused goals for each of the four halves of fellowship training.
  • Help build an individualized training program that connects his/her unique interests.

We are also part of a new initiative for trainees being launched by CJASN called the CJASN Trainee Peer Review Program.

The goal of the program is to provide nephrology trainees with experience in peer review during the course of their fellowship training.
A faculty mentor here at LSUHSC will designate thematic areas to review (AKI, CKD, transplant, etc.) and a total number of articles to review yearly. For select manuscripts, CJASN will invite a “trainee mentor” as a peer reviewer. Then our faculty mentor will assign the manuscript to one of our trainees to review. After the “trainee reviewer” completes the review, the faculty mentor will evaluate, edit, and provide feedback to the trainee, before submitting the  review to CJASN. CJASN will then share their decision about the review to our designated faculty mentor to share with the reviewer. To facilitate the program, CJASN is working on collating and developing resources to help trainees understand and learn how to provide meaningful peer review on research articles. These materials will be freely available through the CJASN website.

Research

Research

The Renal-Electrolyte and Hypertension Division Research Training Program here at LSU Health Shreveport is positioned to train committed individuals in clinical science and basic science research relevant to nephrology.

Mentors provide oversight and are an active part in trainees' first year. They  provide advice and  help each fellow develop and frame questions for a research project.


The Research mentor directly supervises all aspects of the trainee's research and/or scholarly work, including selection of the scientific questions to be addressed, experimental design, interpretation of results, evaluation of the work of others, writing up results for publication and presentation of work at scientific meetings.

Mentors are encouraged to meet with the fellow routinely (once a month) to review and discuss goals and progress.

Fellows are encouraged to develop a project plan by the end of the first half of fellowship and identify a Research mentor after discussions with their assigned mentor.

First Training Year
During the first year of fellowship, each trainee is dedicated to exploring research opportunities and developing his/her individual research program for year two. One elective month can be blocked for research planning and development.

Second Year Research Training
Research training begins in earnest during the second program year. Our research fellows can take one of several training directions that generally fall into two broad areas: bench science or clinical science.
Three to six elective months can be used towards protected research time in second year. The research plan must be developed and approved for the fellows or avail the research elective assignments.

Clinical Research Opportunities:
1.    Ochsner LSU Hospital Shreveport
2.    LSU Heath Shreveport
3.    VA Medical Center Shreveport

Basic Science Opportunities:
1.    Biomedical Research Facility, Shreveport
2.    LSU Health Shreveport

Active Research Projects in the Section of Nephrology at LSUHSC:

Recovery of Parathyroid Function Post Total Parathyroidectomy Auto-Transplantation
Principal Investigator: Dr. Kenneth Abreo

Drug Eluting Balloon Angioplasty in Dialysis Access
Principal Investigator: Dr. Bharat Sachdeva

Arterial Embolism after Thrombectomy Procedure
Principal Investigator: Dr. Kenneth Abreo

PHASE 3, RANDOMIZED, OPEN-LABEL, ACTIVE-CONTROLLED STUDY EVALUATING THE EFFICACY AND SAFETY OF ORAL VADADUSTAT FOR THE MAINTENANCE TREATMENT OF ANEMIA IN SUBJECTS WITH NON-DIALYSIS-DEPENDENT CHRONIC KIDNEY DISEASE (NDD-CKD) (PRO2TECT -CONVERSION)
Principal Investigator: Dr. Bharat Sachdeva

Fellow Supervision

Supervision

Each Fellow will be assigned a faculty supervisor (supervisor may also be the Program Director). The level and method of supervision will be consistent with the ACGME Program Requirements. The Fellows will be supervised by teaching staff in such a way that the Fellows assume progressively increasing responsibility according to their level of education, ability, experience and competence.

Levels of Supervision
To ensure oversight of fellow supervision and graded authority and responsibility, the program must use the following classification of supervision:

Direct Supervision
The supervising physician is physically present with the fellow and patient.

Indirect Supervision
With direct supervision immediately available – the supervising physician is physically within the hospital or other site of patient care and is immediately available to provide Direct Supervision.
With direct supervision available – the supervising physician is not physically present within the hospital or other site of patient care, but it immediately available by means of telephonic and/or electronic modalities and is available to provide Direct Supervision.

Each faculty member with direct teaching assignments will provide a written summary of the assessment of the fellow’s performance during the period that the fellow was under his direct supervision.

The Clinical Competency Committee will do a semi-annual evaluation of fellows with discussion of strengths or weaknesses that may be identified. A plan of corrective action will be provided to fellow if there is unsatisfactory performance.

All procedures will be done under direct supervision, until competency is documented and reviewed by CCC.

Well-Being

Well-Being

The well being of our fellows is of paramount importance to our program. We encourage healthy lifestyles, healthy choices, and healthy living. The LSU community and specifically the LSU Health Shreveport office of GME support fellow physician wellness with many support services for fellows. Stress management programs for house staff are available as needed for work-related stress issues that include, but are not limited to, the following: women physicians, residents cited for malpractice, minority physicians, and foreign medical graduates. Fellows are paired with mentors for the duration of the fellowship program.

The Nephrology Mentoring Program is designed to facilitate and provide each fellow a supportive, nurturing and confidential relationship with a faculty member within the division.

During fellowship, all fellows will be assigned a personal mentor to help them:

  • Acclimatize to renal pathology: Help the young fellow understand the working and principles governing care of nephrology patients.
  • Identify career plans: Discuss with fellows their long-term plans, focus on career paths.
  • Assist fellows in developing plan for focused goals for each of the four halves of fellowship training.
  • Help build an individualized training program that connects his/her unique interests.
  • Mentors are encouraged to meet with fellow routinely (once a month) to review and discuss goals, progress.

There is a long tradition of concern at LSU for the impaired professional. Physicians can become dysfunctional in a variety of ways, just like the patients they treat. Their individual problems often manifest in ways that can harm the patients whom they serve, the institutions that employ them, their families, and the colleagues with whom they work. Physicians often have difficulty admitting their problems with drugs or alcohol, and too often, do not get the help they need until a crisis is reached. Early interventions in confronting physicians who are heading for trouble are needed and if necessary, intensive treatment programs for the compromised professional can be made available. Routine social meetings with fellows are arranged to have open dialogue between faculty and residents.

Monthly dinner meetings with an informal discussion on some of the latest breakthroughs in nephrology provide a platform for faculty to discuss medicine and solidify personal bonds.  Attended by several faculty and the Program Director, the meeting is not mandatory for fellows.

Biannual department celebrations are held around major holidays providing an opportunity for the young trainees to feel comfortable and welcome into our family.

Meet the Current Fellows

Stefano Coppola-Fasick, MD 2018-2020

James Onyirimba, MD 2018-2020

Interested in Joining Us for Fellowship?

Fellowship Application Process:

The Division of Nephrology at LSU Health Shreveport uses the Electronic Residency Application Service application process exclusively and participates in the match. No positions will be offered out of match for the clinical nephrology track.

We require three letters of recommendation, personal statement, and United States Medical Licensing Exam (USMLE) transcript. It is advisable to have these materials submitted to the Electronic Residency Application Service (ERAS) by August 15th at the latest. Completion and passing of all three USMLE steps is required before the start of training.
Interviews generally occur August through the end of October.
We participate in the National Resident Matching Program (NRMP).
We do sponsor J-1 visa for selected applicants but are not giving any H1b visa.

"We have but one goal here at LSU Nephrology — to help understand each individual fellow goal and help design a flexible training to help you achieve success." -The Nephrology Team



CONTACT:
Program Director:
Nephrology/Interventional Nephrology - Bharat Sachdeva, MD
bsach@lsuhsc.edu
(318) 675-7402
Program Coordinator:
Nephrology/Interventional Nephrology - Cristal Willcox
cwillc@lsuhsc.edu
(318) 675-5943

Nephrology Fellowship