Nephrology Rotation

Physical Address

Madigan Army Medical Center
Department of Nephrology
5th Floor, Hospital Tower
9040 Jackson Ave
Joint Base Lewis McChord, WA 98431

Business Hours

Monday - Friday 7:00 a.m. - 4:00 p.m.
Closed on Federal Holidays and Selected Training Holidays

Contact Information

Phone: (253) 968-1485
Fax: (253) 968-1188

Welcome to the Nephrology Service:

The Madigan Army Medical Center Nephrology Service maintains an outpatient service with ongoing continuity care of complex nephrology patients and an inpatient consultation service with 24-hour pager availability. Students rotating through the nephrology service will receive exposure to a broad range of clinical syndromes and presentations including hematuria, proteinuria, acute kidney injury, chronic kidney disease, acid-base and electrolyte abnormalities, kidney stones, and hypertension. They will also receive instruction on diagnosis and management of interstitial, glomerular, diabetic, nephritic and nephrotic kidney disease, as well as care for renal transplant patients on immunosuppression. While on service students will observe acute and chronic hemodialysis, as well common nephrology procedures such as central line placement and kidney biopsies.


Students will perform initial evaluations to include history and physicals for all patients evaluated in the outpatient clinic and referred to the inpatient consultative service. Students are expected to present a complete history with pertinent review of systems and focused physical examination, review available labs and radiographic studies and generate a differential diagnosis and basic diagnostic and therapeutic plan. The attending physician works with the student to facilitate development of appropriate clinical assessments and plans, and presents relevant case-based information to advance the student’s understanding of the nephrology disease process and management.


Informal patient specific teaching is viewed as the most important learning opportunity for students. In addition to supplement their clinical and attending teaching time, students are expected to attend morning report and core teaching conference daily. An attending physician will lead small group didactic and discussion sessions three times per week. The goal of these sessions will be to cover topics not covered by direct patient care experiences and highlight particularly important topics where repetition and a more detailed and systematic approach is key. The student will be assigned supplement reading from MKSAP 16th Edition. While this resource will be helpful for provision of care to patients, it is also intended to ensure exposure to all of the intended topics particularly for those not encountered clinically during the rotation.

Patient Characteristics:

Older adolescent, adult, and geriatric age groups. Military (active duty, retired, dependents) and VA beneficiary patients. Patients from a variety of cultures with different ethnicities and socio-economic situations. The demographics of this group are representative of the national population.

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