I spent three weeks in the Department of Nephrology at Chaim Sheba Medical Centre, Tel Hashomer, under the supervision of Prof. Eli Holtzman. During my time with the nephrology service, I was attached to the renal consult team and the peritoneal and haemodialysis team members.

The outpatient clinics I attended included general nephrology, which gave me great exposure to a wide range of renal medicine from Lupus Nephritis to Familial Mediterranean Fever to Polycystic Kidney disease. Many of the outpatients were post-transplant, and were being monitored for their immunosuppression regime and some were being investigated for transplant complications such as polyoma virus reactivation or graft rejection. I found the teaching on the interpretation of the various renal profiles and urine microscopy results to be invaluable to my understanding of basic nephrology.

I accompanied the attending consultant on the daily renal consults to the various inpatient wards, appreciating the necessity for nephrology input to patients who are oliguric or have raised creatinine. Interesting and challenging cases included a patient with Lupus Nephritis, another with suspected Churg Strauss Syndrome and a third with newly diagnosed multiple myeloma who had renal complications. The discussion of these cases with the consultant, and their proposed management and investigation was of real benefit to my approach to internal medicine patients.  The pharmacology of diuretics, ACE inhibitors and ARBs was particularly relevant on my elective, and I feel much more confident and aware of their indication and side effects on patients with renal impairment than before.

I attended the renal biopsy conference, and examined biopsies for patients with minimal change nephritic syndrome, focal segmental glomerulosclerosis and membranous nephropathy. This enabled me to appreciate the variety of investigations – from ultrasound to biopsy to renal profiles -that are indicated for various symptoms and signs in renal medicine.

I thoroughly enjoyed my elective at Sheba Medical Centre. The staff were wonderfully welcoming and educational in their efforts to include me as part of the team. I certainly learned a lot of nephrology which will be of great use to me in my clinical finals and as an Intern. My experience of Israel and Tel Aviv are extremely positive, and I am grateful to the Jewish Medical Association UK (JMA) for assisting me with the opportunity to visit such a culturally and medically enlightening place. I would strongly encourage other medical students to avail themselves of an opportunity to do elective with Tel Aviv University (TAU) – in fact I managed to convince my two best friends to come along with me and they both enjoyed their electives in general surgery and cardiology respectively.

David Mark Kelly
Trinity College Dublin