Nephro-Urology Curriculum

Nephro-urology Curriculum

This version of the curriculum has been modified by the London Specialty School of Paediatrics for use by local trainers. It identifies which competencies will be provided on regional training days, on simulation courses and compulsory training courses as part of the training package. All competencies in black font have been identified as competencies trainees are expected to obtain in their local trusts, by clinical experience or by local teaching programmes.

Red – regional training Blue – simulation Green – external courses Black – local learning

Level of Training Knowledge Skills Generic Level 1 have the knowledge and be able to assess and understanding of fluid and initiate management of electrolyte imbalance and patients presenting with blood pressure in children nephro-urology problems with kidney problems in acute and outpatient settings have the knowledge and understanding of fluid and be able to perform a electrolyte imbalance and reliable and accurate blood pressure in children assessment of fluid status with kidney problems and initiate appropriate initial fluid management understand the role of different renal imaging techniques including ultrasound, static and dynamic isotope scans in the investigation of urinary tract disorders

have an understanding of the implications for families of children with chronic kidney problems

understand the principles of prescribing in children with renal disease Level 2 continuing development of be able to recognise level 1 competencies common abnormalities on different renal imaging techniques including ultrasound, static and dynamic isotope scans in the investigation of urinary tract disorders Haematuria Level 1 know the causes of recognise features in the haematuria and proteinuria presentation which suggest and Proteinuria serious or significant pathology understand the investigations that will differentiate between the causes

know the indications for renal biopsy Level 2 continuing development of level 1 competencies Nephrotic Level 1 understand the complications be able to advise parents of the nephrotic state on the complications of syndrome steroid therapy understand the principles of the pharmacological, dietary recognise features in the and fluid management presentation which suggest serious or significant understand the investigations pathology including the indication for renal biopsy Level 2 continuing development of assess features in the level 1 competencies presentation which suggest serious or significant pathology Acute nephritis Level 1 know the aetiology, recognise features in the pathophysiology and presentation which suggest immunological basis of serious or significant glomerulonephritides and pathology vasculitides

understand the investigations that will differentiate between the causes

be aware of the range of immunosuppressive therapies that may be used in these conditions Level 2 know the features that are continuing development of prognostically significant level 1 competencies

know the range of immunosuppressive therapies that may be used in these conditions Acute renal Level 1 know the causes of acute failure renal failure understand the investigations that may differentiate between these causes

know the features of haemolytic uraemic syndrome

understand the methods to correct fluid and biochemical abnormalities seen in renal failure know the indications for dialysis Level 2 continuing development of be able to assess and level 1 competencies initiate management of life-threatening events eg hyperkalaemia Chronic renal Level 1 know the causes and natural appreciate the impact of history of conditions causing chronic renal failure in failure chronic renal failure childhood and later adult life understand the pathophysiology of bone disease, anaemia and growth failure

Know about dialysis and transplantation Level 2 continuing development of identify growth and level 1 competencies nutritional problems and use dietetic support effectively Hypertension Level 1 know the techniques of blood be able to interpret blood pressure measurement pressure measurements

know the causes of hypertension and the principles of treatment Level 2 continuing development of be able to identify level 1 competencies complications

be able to initiate management under supervision

be able to liaise with specialists effectively Acute scrotal Level 1 know the differential be able to recognise the diagnosis of this symptom important causes of acute pain scrotal pain

be able to identify children who require urgent surgical referral Level 2 continuing development of level 1 competencies Neonate with Level 1 understand the causes and be able to recognise when management of antenatal to refer to a nephrologist history of hydronephrosis or urologist abnormal antenatal know about the causes of ultrasound of echogenic or cystic kidneys the renal tract know about the inheritance patterns of renal abnormalities detected in fetal life Level 2 continuing development of be able to give basic level 1 competencies explanation of the problem, management and prognosis to parents ante- or post-natally Stones Level 1 know the causes of stone be able to recognise formation presenting features

be able to initiate management under supervision Level 2 continuing development of level 1 competencies Voiding Level 1 know both the physical and be able to take a detailed psychological causes of voiding history disorders, voiding disorders including be able to interpret enuresis, understand the principles of common urine microsopic dysuria, investigation of urinary tract and culture findings infection, and the frequency and management of vesico- recognise features in the polyuria ureteric reflux. presentation which suggest serious or significant understand the principles of pathology managing enuresis Level 2 be aware of the association be able to identify relevant of genito-urinary symptoms neurological problems with child sexual abuse be able to investigate and manage within guidelines Urogenital Level 1 know when surgical referral is be able to examine the required for circumcision, genitalia appropriately and abnormalities impalpable testes, with sensitivity hypospadias or suspected urinary tract obstruction Level 2 continuing development of recognise inflammatory or level 1 competencies traumatic lesions Tubular Level 1 know the range of be able to recognise presentations suggestive of electrolyte abnormalities disorders an underlying renal tubular disorder

know about the inheritance patterns of different tubular disorders Level 2 continuing development of level 1 competencies