This past month, I spent time on the acute care renal services as an elective. I have to say, this was the craziest rotation I’ve had so far! And I mostly mean that in a good way. Essentially, acute care renal services is a service that is consulted in the hospital for acute renal issues such as: AKI, needs for acute dialysis, and other acute renal problems. As you can imagine, we got consulted endlessly. Unfortunately, the service had one fellow, one attending and two medical students. There were times where we had nearly 30 patients to see. This was overwhelming for everyone.
However, despite the volume of patients, I felt that I learned a TON during this elective. Since there were so many patients, I was basically functioning as an intern. I carried 5 patients at a time, and I was coming up with plans to help manage their issues. This required a decent amount of reading (who remembers all those renal tubular acidoses?). I found myself learning about the diagnosis and management of hyponatremia, the management of contrast-induced nephropathy, the management of lupus flares, the indications for emergent dialysis, and the different ways diuretics worked. This was a jam-packed month.
We also had weekly pathology conference where the renal pathologist would go over biopsies of patients and talk about the relevant histology. Often, these biopsies were from patients I was following, so it was awesome to be a part of the continuity of care. Though I felt chronically tired, I truly enjoyed the rotation!