Rotations

A variety of inpatient and outpatient clinical rotations and a multitude of research and scholarly activities are designed to meet career needs.

Inpatient Rotations

  • University Hospital: a 456-bed teaching hospital in San Antonio, Texas.  UT Health SA exclusively partners with University Hospital to provide comprehensive medical care to the people of Bexar County.  We are also a tertiary referral center for the 22-county region of South Texas. Our patient population is comprised of 69% Hispanic and 7% African American and 7% Caucasians.  The rotations at UH provide the best opportunity to learn renal physiology in an active clinical setting ; one gets to evaluate a patient with pH of 6.9, serum sodium of 96 meq/L and another patient with 7.6 and 175 meq/L respectively, on the same day. Inpatient nephrology services include:
    • General Nephrology Consult Service
      • 2 fellows
      • Acute and critical care nephrology consults
      • Average 20-30 patients for service
    • Transplant Nephrology Consult Service
      • 1- fellows
      • Nephrology consults for all inpatient transplant services
      • Average 10-15 patients for service
      • Attend Monday AM and Thursday AM transplant outpatient clinics (located within UH)
  • VA Consult Service: The South Texas Veterans Health Care System (STVHCS) Medical Service oversees all inpatient and subspecialty care medicine, as well as academic primary care for over 75,000 of the Nation’s Veterans enrolled at STVHCS. Medical Service clinics service over 60,000 new patients consults annually. Medical Service physicians also staff 10 ICU beds, 8 CCU, 118 ward, 6 bone marrow transplant and 7 research beds servicing over 5,000 admissions each year. Audie L. Murphy Memorial Veterans Hospital is located across the street from University Hospital and affiliated with UT Health SA.  
    • 1-2 fellows
    • Acute and chronic inpatient nephrology and dialysis consults
    • Average 10-15 patients
  • SAMMC consult service: formerly Brooke Army Medical Center, located at Fort Sam Houston and serving both active duty and retired military.  A 425-bed facility, it is the only Level I trauma center within the Department of Defense.
    • 0-1 fellows
    • Acute and chronic inpatient nephrology and dialysis consults
    • Average 10 patients

Outpatient Rotations

  • Continuity Clinics: fellows attend one mandatory continuity clinic every week alternatively at
    • University Hospital – Texas Diabetes Institute
    • VA General Nephrology Clinic
  • Dialysis Services
    • Hemodialysis: 4 University Health owned dialysis clinics located throughout San Antonio.  All of our dialysis units are 5 stars rated by Medicare.
    • Peritoneal Dialysis: Offered at our University Hospital NW dialysis clinic
    • Research: Each second-year fellow is provided with dedicated 4 months to work with research mentor who they identify during their first year. There are ample opportunities for research at the basic, translational and clinical levels. The division takes pride in its rich contribution to the research in the diabetes, acute kidney injury, aging, cardio-renal disease, fibrosis, and genetic basis of kidney disease. We are also major contributors and active in the NIH funded Kidney Precision Medicine Project- which is the future of renal medicine. We participate in multiple NIH consortia, individual and large multi-PI grants,  and industry sponsored clinical trials.

Sample year

Rotation

1st year

2nd year

UH Consult 3-4 2
UH Transplant 2 1-2
VA Consult 3-4 1-2
UH Outpatient Dialysis 2 1
SAAMC Consult 0-1 0-1
Elective 1 1
Research 0 4

POC Ultrasound Experience

Please see Point-of-care Ultrasonography hyperlink for more details.

Each fellow during their elective and outpatient dialysis month, will have opportunity to work with Dr. Koratala who has extensive experience in performing and teaching POCUS and renal ultrasound. Our POCUS curriculum is designed to provide longitudinal training spread out to facilitate long-term skill retention. Each fellow rotates 2-3 half days per week roughly amounting to a total of 8 weeks during these months. There are didactics in the form of lectures and grand rounds in addition to the above video curriculum. We have divided the learning objectives/milestones on a 6-month basis (levels I, II, and III in the order of increasing skills) for the first 18 months of fellowship. The rest is reserved for continued practice of the acquired skills. The detailed list of applications is mentioned in reference 2. We also conduct live demonstrations and practice sessions on model patients at the Long school of Medicine’s state of the art Center for Clinical Ultrasound Education. For interested fellows, opportunities exist to learn POCUS applications that are beyond the scope of nephrology practice in collaboration with other medical specialties such as critical care medicine. Fellows are strongly encouraged to participate in ultrasound-related research activities and publish their work in peer reviewed medical journals.