Nephrology

Certification Examination Blueprint What Does the Examination Cover? The exam is designed to evaluate the extent of the candidate's knowledge and clinical judgment in the areas in which a nephrologist should demonstrate a high level of competence. Expertise in the broad domain of nephrology, and the diagnosis and treatment of both common and rare conditions that have important consequences for patients, will be assessed. The exam also will test knowledge of general internal medicine as encountered in the practice of nephrology. Exam content is consistent with a pre-established blueprint, or table of specifications. The blueprint is developed by the Subspecialty Board on Nephrology and is reviewed and revised annually to ensure that it is current. In addition, practicing nephrologists, nephrology trainees, and training program directors are surveyed periodically to provide feedback on the blueprinting process. The blueprint serves as a guide in developing the exam. The majority of questions (over 75 percent) are based on patient presentations occurring in settings that reflect current medical practice. Questions requiring simple recall of medical facts are in the minority; the majority of items require integration of information from several sources, prioritization of alternatives, and/or utilization of clinical judgment in reaching a correct conclusion. Some questions require interpretation of pictorial material such as radiographs, sonograms, photomicrographs, and radionuclide studies. The content areas covered and their relative proportions of coverage in specified areas are as follows: Medical Content Category Chronic kidney disease Glomerular/Vascular disorders Kidney transplantation Hypertension Electrolyte physiology: Sodium/Water AcidBase/Potassium Clinical pharmacology and Miscellaneous Tubular/Interstitial and cystic disorders Mineral metabolism Acute renal failure/ICU nephrology Total Relative Percentage 14 12 10 10 10 10 10 6 8 10 100%

Cross-Content Areas Adolescent Medicine Basic Science Critical Care Medicine End-of-Life/Palliative Care Clinical Epidemiology Ethics Geriatric Medicine Nutrition Preventive Medicine Medical Literature

Relative Percentage 2 2 2 2 2 2 5 2 2 2

Content Outline of the Certification Examination This content outline describes a typical Nephrology Certification Examination; actual content on a specific examination may vary. Each medical-content category from the examination blueprint is listed in boldface below, along with target blueprint percentage and total number of questions in the category. Within each category, the approximate distribution of questions in specified areas also is listed. Medical Category (Relative Percentage) Sodium/Water (10%) Hyponatremia Hypernatremia Oliguria/Polyuria Salt excess Salt depletion Other disorders AcidBase/Potassium (10%) Metabolic acidosis Metabolic alkalosis Mixed respiratory and acidbase disturbances Hyperkalemia Hypokalemia and potassium deficiency Respiratory acidbase disorders Other disorders Number of Questions 1921 as follows: 79 35 13 24 24 01 1921 as follows: 46 24 24 35 24 13 01

Medical Category (Relative Percentage) Mineral metabolism (8%) Renal osteodystrophy Nephrolithiasis Disorders of calcium metabolism Disorders of phosphate metabolism Disorders of magnesium metabolism Other disorders Chronic Kidney Disease (14%) Anemia Cardiovascular disease Hemodialysis Peritoneal dialysis Progression to ESRD Differential diagnosis Complications/Outcomes Other disorders Hypertension (10%) Essential hypertension/pathogenesis Hypertension with kidney disease Renovascular hypertension Other secondary forms of hypertension Pharmacology of hypertension therapy Complications/Target-organ damage Epidemiology/Genetics Other disorders Tubular/Interstitial & Cystic Disorders (6%) Urinary tract infections Renal tubular disorders Chronic tubulointerstitial disease Other disorders

Number of Questions 1517 as follows: 46 35 46 13 13 01 2729 as follows: 35 35 68 35 24 24 24 01 1921 as follows: 02 35 35 35 35 13 02 01 1113 as follows: 13 13 79 01

Medical Category (Relative Percentage) Glomerular/Vascular (12%) Indications/complications of kidney biopsy Nephritic glomerular disorders and vasculitis/vasculopathy Nephrotic/heavy-proteinuric glomerular disorders Diagnosis of glomerular/vascular disorders based on kidney biopsy Diagnosis/treatment of diabetic nephropathy Epidemiology/natural history of glomerular disorders Other disorders Kidney Transplantation (10%) Pharmacology of immunosuppressive drugs Long-term complications Recipient/donor outcomes (i.e., patient/graft survival rates, causes of patient death, graft loss) Immunology and clinical patterns of allograft rejection Perioperative management Recipient and donor evaluation Miscellaneous Pharmacology/Miscellaneous (10%) Nephrotoxicity Drug selection and dosing in kidney disease Drug interactions/adverse effects Evaluation of hematuria and other urological conditions Mechanisms Miscellaneous Acute Renal Failure/ICU Nephrology (10%) Differential diagnosis Management Prevention Complications/Outcomes ICU Miscellaneous

Number of Questions 2325 as follows: 02 68 57 35 24 02 01 1921 as follows: 46 35 35 13 13 24 01 1921 as follows: 810 46 24 02 02 01 1921 as follows: 35 79 02 46 13 01