In 1969, Postgraduate Institute of Medical Education and Research (PGIMER) became the first center in India to start a nephrology training program.
An increasing number ofcenters are providing superspecialty training in nephrology in India.
Two types of nephrology training courses are available: university-affiliated academic institutions conduct a 3-year postdoctoral course leading to the award of a DM degree in Nephrology, and other centers not affiliated to universities (mostly private hospitals) are recognized by the National Board of Examinations for a 3-year Diplomate in National Boards (DNB) course.
Eligibility for superspecialty training requires completion of a 5½-year undergraduate (MBBS) course including one year of internship, followed by a 3-year postgraduate (MD) course in Internal Medicine or Pediatrics.
Nephrology trainees are taught procedural skills including kidney biopsies, central venous catheterization to establish temporary access for dialysis, construct AV fistula and placement of peritoneal dialysis (PD) catheter. The content varies from hospital-to-hospital.
Nephrology trainees acquire skills in differentiating functional and technical aspects of various treatment modalities including hemodialysis, CRRT (continuous venovenous hemofiltration and hemodiafiltration), plasmapheresis, and acute and chronic PD. They learn technical issues associated with different modalities, their indications, individualization of prescription, and identification and management of complications. Trainees start CRRT and acute PD procedures and write down prescriptions. Acute PD is often utilized to tide over an emergency if a slot for HD is not immediately available;
Trainees supervise the workup of potential kidney transplant recipients and donors, may assist the surgeons in organ harvesting and perfusion, and be involved in post-transplant care.
In several teaching hospitals, students pursuing the postgraduate (MD) course in Internal Medicine undertake rotations in the nephrology unit during which they learn basic principles of nephrology, assist Nephrology Residents in management and diagnosis of patients with kidney disease and participate in the teaching activities of the department.
After successful completion of the course, candidates are eligible for appointment as Lecturer or Assistant Professor in medical colleges, join private sector hospitals. A significant proportion go abroad and provide skilled nephrology services in North America, Europe, Australia and the Middle East.