Bringing medical education "home": the university health network and St. Michael's hospital home dialysis fellowship.

PURPOSE OF REVIEW: Home dialysis remains variable and underused globally despite clinical and quality of life benefits for patients. Due to low patient volumes in many centers, it is challenging for nephrology trainees to gain adequate clinical exposure to achieve competency and comfort in patient management. In this review, we highlight the University of Toronto-affiliated University Health Network (UHN) and St. Michael's Hospital (SMH) Home Dialysis Fellowship as an educational model to improve competency and comfort in home dialysis.

RECENT FINDINGS: The UHN/SMH Home Dialysis Fellowship offers diverse clinical exposure with over 300 patients on peritoneal dialysis and home hemodialysis. Trainees achieve competency through repetitive exposure to a large volume of patients. The fellowship leverages continuity and longitudinal follow-up across all stages of a patient's chronic kidney disease journey. The program fosters interprofessional collaboration to develop comprehensive patient management plans. The attending physicians are leading world experts and support the varied trainee academic and career goals through mentorship and sponsorship.

SUMMARY: The UHN/SMH Home Dialysis Fellowship program combines evidence-based medical education principles with high volume, diverse, and complex patient populations to offer trainees an exceptional learning experience and the foundations to become the next generation of home dialysis experts.