Sunday 21-4-2019 Latest Update : 17-04-2019 AT 14:35


Nephrology

Given the expansion of the great event in the area of ​​jurisdiction of Nephrology in the Arab world, it became necessary to find a training program for high-level to contribute to the construction of qualified doctors are able to secure the care required for the growing number of kidney patients and help maintain a good level to the level of services in the units specialized located in the Arab countries and work on the expansion of this branch of medicine and promoting it.
1 - must be on the elements involved in the people of total commitment to this training program of higher level, which aims not only to meet the urgent needs of these people, but to provide an integrated program to train doctors of internal (defined as physicians have completed training in Internal Medicine) and to equip them with knowledge and skills, and how clinical trial and take the proper positions for the exercise of nephrology.
2 - conditions that must be provided in the institution (hospital) to accept it as a training center (it is not necessary to have all the facilities available in the same hospital, but can be shared with other centers within the same city, for example).
2-1 provide the following facilities:
2.1.1 Histopathology of renal biopsies read.
2.1.2 Urinary Surgery.
2.1.3 Laboratory analyzes of clinical trial.
2.1.4 Unit kidney transplant.
2.1.5 rays.
2.1.6 Vascular Surgery.
2-2 In addition, you must have a library containing books medical books in the core internal medicine and kidney disease as well as provide access to recent publications in nephrology and related.
2.3 The hemodialysis unit in which at least thirty patients.
2.4 The existence of a center for the cultivation of the College in the same city.
2-5 provides peritoneal dialysis.
2-6 provide for a renal biopsies, all types of Qthatr hemodialysis and peritoneal dialysis, provide Angiography college, where the availability of these requirements is necessary to develop the skills and confidence breeds success of this program.
2-7 that the institution is ready and willing to do medical education and scientific research.

Director of the program:
Must have Administrator doctor holds high qualifications in internal medicine and nephrology, with practical experience of not less than five years in this area include previous experience in the rehabilitation of doctors Alduarin in the kidney, with a record of scientific research is acceptable, and preferably a full-time fully in college and able to give enough time to manage this program and close supervision on all the details to ensure a high level applied.
3-2 members of the (body) the other program:
 
In addition to the program manager must have another doctor highly qualified in internal medicine and nephrology, full time or part-time doctors, with the expertise and previous experience in rehabilitation and training of resident physicians in specific training programs.
3-3 procedures to join the program (registration):
3-4 outlines of the program:
3.4.1 the training period of two years.
3.4.2 full-time for the training program is necessary, the trainee full-time commitment to this program during the entire period.
3-4-3 is in training institutions have been recognized by the Arab Council for terms of reference for health.
3.4.4 Topics (axes) program:
3-4-4-1 outpatient clinics.
3-4-4-2 medical consultations.
3-4-4-3 patients follow-up treatment.
3-4-4-4 actions (interventions) Nephrology.
3-4-4-5 shift (under request).
3-4-4-6 cases provide clinical and theoretical lectures.
3-4-4-7 Club nephrology journals.
3-4-4-8 ... attend meetings related to renal medicine.
3-4-4-9 study (readings) self.
3-4-4-10 research project.
3-4-4-11 choice of optional subjects.
3-4-4-12 to participate in the activities of Department of Internal Medicine and scientific activities of the hospital.
3.4.5 assess the trainee:
3-4-5-1 daily basis, interact with the consultants.
3-4-5-2 every 3-6 months, a written assessment and discussion.
3-4-5-3 after the first year, my assessment testing is conducted by local members of the Council.

3-5 relationship with the Department of Internal Medicine and Medical Education:
The trainee should adhere to regulations and Department of Internal Medicine Department of Medical Education, and Director of the training program to inform the head of medical education through the Head of Internal Medicine conduct of the trainee on a regular basis, and in the event of any problems being discussed with the Committee of the hospital in the Department of Medical Education.
Departures in order to learn, and leave must be authenticated by the Department of Medical Education after the approval of Department of Internal Medicine and the Division of the kidney.
4 - Program Objectives:
4-1 The Program is designed for the competence of kidney disease are able to provide him supplies and scientific process to form a specialist kidney disease with a high efficiency.
4.1.1 Clinical Nephrology:
This program is hoped to follow the trainee to gain clinical experience in various subjects of renal diseases, and have identified below some of these topics (note that the questionnaire distributed to the trainees every eight months to see the depth of commitment to the program and to develop proposals to fill gaps).
1 - diseases of glomeruli.
2 - diabetes and diabetic nephropathy.
3 - high blood pressure.
4 - acute renal failure and kidney disease in intensive care units,
5 - chronic renal failure.
6 - DNA disorders - basis.
7 - fluid and electrolyte disorders.
8 - cystic kidney disease and kidney disease genetics.
9 - interstitial inflammation of the kidneys and urinary tract infections.
10 - Disorders of positive ions and metabolism of two-valence metals.
11 - a kidney transplant.
12 - College and pregnancy.
13 - and kidney function tests.
14 - drugs in kidney disease.
15 - Skills and Ethics.
16 - Design and carry out research.
4.1.1 hemodialysis of acute and chronic.
Peritoneal dialysis 4.1.2.
4.1.3 kidney transplantation (preparation and follow up patients).
4.1.4 diagnosis of kidney disease (histologically and radiologically).
4.1.5 research project.
4-2 of knowledge and skills that are expected to get them trained during the years of training:
4.2.1 patients and normal anatomy of the College and the ureter and renal vessels, glomeruli of the microscopic anatomy and functional anatomy and pipe it.
4.2.2 Biochemistry: knowledge of the impact of hormones on the kidney, the organization put the total ammonia, mechanisms of action of diuretics, the metabolism of hydrogen ions.
4.2.3 the organization of the overall physiology of water, sodium, potassium, calcium, Amonezim, phosphorus and uric acid.
4.2.4 Drugs: nomination and secretion of drugs, the act of different drugs such as diuretics to college, did effluent urinary pH and urine boiled the drug is the most widely used non-proliferation and the principles of ionic (non ionic)
4.2.5 Immunology and Microbiology: immune mechanisms of renal disease, immune organ transplantation, use of medications for the repressive immunity, infectious complications of renal disease and immunologically Amadafeen in general.
4.2.6 Genetics: Patterns of inheritance in renal diseases, textile cliques, and stereotypes.
4.2.7 Statistics: Analysis of knowledge of clinical data and laboratory and the rules of reform increase or decrease water and electrolytes.
4-2-8 laws and ethics: the laws and ethics of organ donation, the definition of death, the commitment to systems and policies of the hospital.
4.2.9 psychology and sociology: understanding the methods of adaptation of patients with their disease and their families and the elements of medical and non-medical care, which holds them.
 

5 - Events (activities), the trainee:
The program provides training for kidney disease system enables the trainee to develop his abilities in all aspects of clinical nephrology, and can be divided into the activities of the trainee to basic science, clinical science and research.
5-1 outpatient clinics:
The trainee must spend the afternoon for two days a week at a clinic kidney disease of Foreign Affairs, where the checks under the supervision of consultants kidney patients and works to follow, and through experience, discussion and reading can learn how to diagnose and address the most renal diseases. When you reach the trainee experience and knowledge to a certain level helps to control and education of new doctors during turnover in the Division of the kidney.
5-2 internal consulting:
When you request an internal consultancy to express an opinion or do some procedures the trainee to take the observation and physical examination (clinical) and requested the surveys and then a personal consultation and then submit the case to the consultant on duty.
 
It is also possible to be seeing the beginning of the patient by medical students during turnover in the Division of the kidneys, but these patients must see and discuss their cases with the trainees of the kidneys before being brought to consultants, and must see the patient in the hospital every day and organize follow-up on an outpatient basis.
5-3 internal kidney patients:
Problems of renal patients admitted from clinics or from the emergency department by physicians kidney should follow by the trainees under the supervision of consultants.
5-4 hemodialysis:
5.4.1 engage with doctors and kidney dieticians and social worker and surgeon vascular surgeon and a kidney transplant and the nurses in the follow-up patients with chronic renal failure and the development of educational programs to them before their arrival in renal failure the final which will help the trainee in how to prepare patients for post processing Almaadh for the post of the college.
5.4.2 learning, and discussion of the patient, under the supervision of consultants treatment options netting (Alaaadh) of the kidney transplant and hemodialysis, and peritoneal dialysis, as well as choose not to undergo treatment in some cases.
5.4.3 know the feeding system which assists in delaying the need to address Almaadh and maintain good health in patients with dialysis.
5.4.4 learn decision-making time of the start of hemodialysis or peritoneal and direct them in a timely manner to avoid complications.
5-4-5 to learn how to apply the hemodialysis and peritoneal and programs used by the clinical situation.
5.4.6 knowledge of developments in the techniques of handling patients with renal failure, the final go.
Know the 5-4-7 treatment complications such as renal failure, anemia, and bone dystrophy, high blood Daft.
5-4-8 learn how to manage the Division of dialysis in terms of effectiveness and economic cost so that it can secure the good life for patients in a positive economically.
5-4-9 to learn different ways to monitor the effectiveness of dialysis.
5-5 kidney transplantation:
  
A kidney transplant is an important part of the training program in the jurisdiction of kidney disease, and in the end of the program is hoped that the trainee should have acquired the knowledge of complete and accurate in the science of immunity, organ transplantation, as well as the indications and contraindications kidney transplant as in the preparation of patients for transplantation and evaluation of both the Muti and the introduction. and the management of patients post-transplant rejection episodes and find out how to remedy them. addition to the full knowledge of the immune suppressor drugs used in transplant programs, mechanisms of action, side-actions, its participation, Prague application.
5-6 high blood pressure:
Blood pressure is an integral element in the program of the jurisdiction of kidney disease, and the trainee to know all aspects of diagnosis and management of all forms of high blood pressure, initial and secondary education.
5-7 nephrology procedures:
5-7-2 overall biopsy (20 at least).
5-7-3 biopsy total cultivated (10 at least).
5-7-4 a Qthatr hemodialysis (20 at least)
5-7-5 peritoneal dialysis procedure Qthatr sharp (optional).
5-7-6 microscopic examination of urine (100 at least) an analysis of one week at least.
5-7-7 mastery of dialysis techniques.
5-7-8 harmony with cliques textile, mixed lymphocyte transplantation, immune suppression in renal transplantation.
5-7-9 measure increasing the dose of medication.
07/05/10 trainee competence of kidney disease should be given responsibility for overseeing the units purification and transplantation to gain management experience necessary for its future work as a doctor kidneys.
07.05.11 knowledge of techniques of vascular sockets (fistulas, grafts, ..).
Trainee of 5/7/12 hoped kidney disease participating in the training of medical personnel as well as educating people about organ donation, as well as all threads Nephrology and methods of prevention.
5-8 shifts:
The trainee to alternate during the period of his training with consultants as required to night shift which can be at home with going to the hospital whenever necessary to see the patient and communication with consultants to manage medical conditions, and are rotations necessary to develop the knowledge, skills and special cases of emergency.
5-9 cases provide clinical and medical topics:
  
Should the trainee to submit cases and topics in the seminars, morning meetings, panel discussions with patients, meetings of the City of kidney disease and transplantation.
5-10 Club nephrology journals:
Trainees must participate in the program of kidney disease meets monthly meeting in which consultants and doctors working in the renal unit to discuss important articles published in the kidney disease, and the intern to provide copies of an article or two articles for those who will attend the meeting a week before it occurs.
5-11 nephrology meetings:
Trainee to attend the meetings of nephrology following:
5-11-1 Club kidney transplant once a month.
5-11-2 Conference on Local mayor, once a year.
5-11-3 global conference and at least one during the training period.
5-12 study (reading) self:
Acquire and enhance knowledge in nephrology and medical knowledge and surgical-related require reading at least the following:
5-12-1 - a reference in modern medicine.
5-12-2 - a reference interview in kidney disease.
5-12-3 reference in modern pathology.
5-12-4 reference interview in kidney transplantation.
5-12-5 important topics related to disease and kidney transplantation in the journals International College, American Journal of kidney disease, kidney disease Sreriaat and cultivated, kidney transplant procedures ... etc..
5-12-6 index and selected topics of general medicine and surgery related.
5-12-7 articles in the medical literature, written for the purposes of patient care or medical education or research.
5-12-8 experience and knowledge in medical information technology and statistical programs.
5-13 Research Project:
It is hoped the trainee during the training period that:
5-13-1 being considered due to the files of patients and displays the results of the study for publication.
5-13-2 clinical case study of at least one and submitted for publication
5-13-3 is hoped that the trainee during the training to design and being a research on the problem of renal exist in the Arab countries determined by the trainee as one of his interests (optional).
5-14 exercises elected:
Could agree on training elected in the following circumstances:
5-14-1 must be acceptable to the performance of the trainee in general.
5-14-2 on the partition that will be the training that:
5-14-2-1 advance written consent.
5-14-2-2 provides a list of written goals and scientific activities of the trainees.
5-14-2-3 approval to undertake a formal assessment of the trainee at the end of the training period.
5-14-3 to recognize the medical training of the Committee that training contributes to the election substantially in the training of trainee Kalmaaudh in the unity of kidneys of children or radiation or a research project.
5-15 activities of the hospital and the Department of Medical Education:
Kidney trainee must attend the following tours:
5-15-1 morning reports of the Section.
5-15-2 visit patients.
5-15-3 Public tours of the Department of Internal Medicine.
5-15-4 overall round for the entire hospital.
5-15-5 meetings of the diagnosis and treatment.
5-16 - Evaluation of the trainee
The evaluation of knowledge and performance of the trainee is necessary to know the weaknesses and strengthen him, and informal assessment must be continuous while the official evaluation must be conducted in certain points of the training program where the results and discuss the works to strengthen areas of weakness,
5-16-1 after the completion of training for two years is reasonable, the trainee receives a document from the Department of competence certified by the nephrology department of medical education,
5-16-2 after the completion of the training program the trainees may progress to kidney exam course by the Arab Council for terms of reference of the fact that the health condition that had previously received a certificate of Internal Medicine.
5-16-3 at any moment of the training program, if it appears that the level of training is not up to standards established by the Department of the kidneys is a meeting of the Higher Training Committee and asks the trainee to work on upgrading and if his failure to achieve the required standards required to withdraw from the the program.

Papers and documents required for registration:

1. Registration form, can be obtained from the Department of Higher Medical Education, and are also available on the website www.arab-board.org
2. Certificate of completion of four years of training in internal medicine before starting the training program for kidney disease, you must obtain a Certificate of Internal Medicine exam before applying to the jurisdiction of kidney disease.
3. At least two letters of recommendation submitted by the members of the college or consultants working with them advanced Brōh well recognize the suitability of the training in the field of kidney disease
4. A letter signed by the applicant undertakes to train full-time under this program.
5. Acceptance testing includes a personal interview to test advanced in general and professional discovery capabilities may include a written test
6. Pledge to abide by the rules and instructions of the training programs of the Arab Council for terms of reference for health.

Final exam consists of two foundations, the written exam, and clinical and oral exam.
5.17.1 written final exam
5-17-1-1 exam will be held once a year (January, December)
5-17-1-2 exam consists of one paper containing 100 questions
5-17-1-3 for this exam and a half hours.
5-17-1-4 mark of success in this exam 60%.
5-17-1-5 opportunities for advancement for the exam four attempts not to exceed twice the last attempt the training period. The Scientific Council shall be entitled to grant an exceptional opportunity so as to leave to the President of the Scientific Council, Mr. Secretary-General the power to determine the reasons for giving this opportunity. In the event exhausting opportunities for advancement, Ergn bound him for good.

5-17-2 clinical and oral exam:
 
Require the trainee to be successful in the written exam before entering the exam which is held once to twice a year on dates determined by the system of the Arab Council for terms of reference for health.
5-71-2-1 clinical exam consists of:
A - the case of long: have allocated one hour, half to take a medical history and examination of the patient, and the other half to be discussed with the Committee of the exam, and have allocated 40% of the mark.
B - short cases: there are three cases have allocated all of 30 minutes and have 30% of the mark.
5-17-2-2 oral examination
Be in the form (OSCE) and the time allotted 30 minutes with 30% of the mark.
5-17-2-3 mark of success in clinical and oral exam is 60%.
5-17-2-4 opportunities for advancement of the clinical and oral exam
Opportunities for advancement of the clinical and oral exam four attempts Examination + an exceptional opportunity in the same condition for the granting of the previous exceptional opportunity, so that the last attempt to exceed twice the length of training. In the absence of his success, he must apply for the final written exam for two sessions only. In the absence of his success in the final written exam, separated from the program and delete his registration.
In the event of his success in the written final exam, his chances are entitled to apply for clinical and oral exam. In the absence of success, separated from the program and delete his registration.

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