CRITERIA FOR CREDENTIALING

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Criteria for Credentialing

A physician shall be credentialed as a nephrologist if he/she has successfully completed 3 years of training in nephrology in accredited centre/s.

For a physician who has been practicing before 1980 to 1990 and who may not fulfill the above criteria, to be credentialed as a nephrologist:

He/she should have a minimum of one year training in nephrology in a recognized centre. Spends a significant proportion of his/her time in clinical practice in nephrology

Core Procedural Skills

Core Procedural Skills of Subspecialists On Completion of Fellowship/Subspecialty Training

No Procedures Minimal training necessary for competence Maintenance of competence
Indicates procedures that a generalist can perform with the required minimum training Minimum training necessary for a generalist to perform the procedure competently
1) Percutaneous renal biopsy
1) Minimum training duration – 6 months
2) Minimum successful procedures – 30
3) Supervised by credentialed consultant who has maintained credential status
Remains in active nephrology practice    
2) Interpretation of basic renal histopathology
1) Minimum training duration – 1 year
2) Supervised by credentialed renal histopathologist
Continued interest in the field    
3) Haemodialysis
1) Minimum training duration – 6 months
2) Supervised by credentialed nephrologist
Remains in active nephrology practice *
1) Minimum training duration – 200 hours
2) Supervised by credentialed nephrologist
4) Chronic Peritoneal Dialysis
1) Minimum CRRT procedures – 10
2) Supervised by credentialed nephrologists
Remains in active nephrology practice    
5) Continuous renal replacement therapy (CRRT)
1) Minimum plasmapheresis procedures – 5
2) Supervised by credentialed nephrologist
Remains in active nephrology practice
   
6) Plasmapheresis
1) Minimum CRRT procedures – 10
2) Supervised by credentialed nephrologist
Remains in active nephrology practice    
7) Other extracorporeal therapies e.g. immunoadsorption, haemoperfusion
Trained in basic extracorporeal therapies e.g. plasmapheresis/haemodialysis Remains in active nephrology practice    
8) Basic renal ultrasounds
1) 30 ultrasound examinations
2) Supervised by credentialed nephrologists /radiologist
Remains in active nephrology practice    
9) Insertion of temporary vascular access
1) Minimum successful procedures – 10
2) Supervised by credentialed nephrologist
Remains in active nephrology practice  
1) Minimum successful procedures – 10
2) Supervised by credentialed nephrologists
  * subject to periodic review


Specialised Procedures

Specialised procedures for a subspecialist on completion of further accredited training program

No Procedures Minimal training necessary for competence Maintenance of competence
1) Insertion of permanent peritoneal dialysis catheters
1) Minimum successful procedures - 5
2 Supervised by credentialed nephrologists/ surgeon
Remains in active nephrology service
2) Insertion of permanent vascular access catheters
1) Minimum successful procedures - 5
2) Supervised by credentialed nephrologists/ surgeon
Remains in active nephrology service


Creteria for Accreditation

Criteria for Accreditation Of Institutions Involved in The Trainning Of Nephrologists

1) Accreditation for General Nephrology training
 
In-patient services – The department should have at least 12 beds for general nephrology with a mix of male and female patients.
Out-patient services – There shall be at least three clinic sessions per week.
Core nephrology procedures – As per core procedureal skills of nephrologists on completion of subspeciality training – ie. There should be at least 30 renal biopsies per year and 30 ultrasound examinations per year performed in the institution.
   
2) Accreditation for Dialysis training
  2.1. Haemodialysis

The institution should perform at least 6000 chronic haemodialysis treatments per year.
There should be an appropriate mix of new patients and patients who have been dialysed for more than 5 years.
The center should perform acute haemodialysis treatments for at least 15 patients with acute renal failure per year.
The centre should have facilities for continuous renal replacement therapy and plasmapheresis.
  2.2. Peritoneal dialysis

The centre should have facilities for initiating chronic PD treatment including insertion of Tenckhoff catheters, training for PD and measurement of dialysis adequacy and PET.
The centre should follow-up at least 40 patients on chronic PD therapy.
   
3) Accreditation for Renal Transplantation training.
 
The criteria to train general nephrology fellow is that the transplant programme should perform at least 10 renal transplants per year while the criteria to train renal transplant fellow (able to lead transplant programme) is 30 transplants per year. Hence it is recommended that those who wish to commence transplant programme, the centre should perform at least 20 renal transplants a year to maintain its accreditation status. (AST/ASN Renal Transplant Fellowship Training Certification programme June 28, 2002)
The centre performs potential donor and recipient work-up.
The centre manages transplant recipients in the early post transplant period in both in-patient and out-patient setting.
The centre has facilities for monitoring immunosuppressive drug levels.
The centre has access to tissue typing laboratory, diagnostic imaging services, radioisotope studies and renal pathology services.
The centre follows up at least 50 long term renal transplant recipients.
The centre has facilities for evaluation of impaired graft function.
The centre conducts regular meetings with urologists/transplant surgeons.

Any centre can apply to be accredited for full or part of the training programme to the Nephrology Board via the National Credentialing Committee.