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Policies and Procedures

7. Non-Teaching Patients
I. Introduction
At the teaching sites for the nephrology fellowship program, fellows may encounter
patients who are not affiliated with ECU Nephrology. As a general rule, regardless of the
rotation, nephrology fellows are responsible for patients followed by ECU Nephrology only.
Outlined below are the circumstances in which fellows may encounter non-teaching patients at
the various teaching sites.

II. Vidant Medical Center
Patients on the hospital wards, in the intensive care units, at the hospital based outpatient
clinics, and in the inpatient dialysis facility are the responsibility of the nephrology fellow only if
they are followed by the ECU nephrology consult, service or transplant teams. Patients followed
by private practice nephrologists or physicians not associated with ECU nephrology are seen by
the fellow only if formal consultation is requested. In the transplant clinic, fellows will see
patients shared between ECU transplant surgery and ECU nephrology. Limitations on patient
numbers for this site are outlined under the policy on this topic for each of the clinical rotations.
Patients followed by ECU nephrology that exceed the patient number limitations outlined are
considered non-teaching patients and the fellow is not responsible for the care of these patients.

III. ECU Physicians Nephrology and Hypertension
Patients seen at the ECU Nephrology and Hypertension facility are seen by nephrology
fellows on their outpatient rotation and in their continuity clinics. During the outpatient rotation,
the fellow is responsible for all patients on the afternoon dialysis teaching shift assigned to that
fellow. Since the ECU Physicians Nephrology and Hypertension dialysis facility is an open
dialysis unit patients not followed by ECU nephrology may be dialyzed during the fellows
shift. These patients are considered non-teaching patients.
In the acute care clinic, patients are the responsibility of the nephrology fellow assigned
to that clinic. Exceptions include days when the fellow has continuity clinic and months when
no fellow is assigned to this rotation. All patients in the fellows assigned continuity clinic are the
responsibility of the nephrology fellow.
Fellows bear no responsibility for non-teaching patients at the ECU Nephrology and
Hypertension facility. Limitations on patient numbers for the acute care clinic and the continuity
clinic are outlined elsewhere.

IV. Offsite Eastern Nephrology Associates Vascular Access Center Interventional
Nephrology Rotation (elective)
The nephrology fellow is one-on-one at all times with the Eastern Nephrology Associates
attending responsible for the procedures to be performed. The nephrology fellow would not be
in a position of providing patient care in the absence of the supervising physician, given the
procedural nature of this rotation. A fellow is not expected to provide care to any patient other
than those receiving procedural care by the fellow and the supervising attending.