The University General Nephrology Consult service is strictly a consultative service that is based at our University hospital, a 649 licensed bed, tertiary care and level 1 trauma center. The fellow will spend 3 months during the first year of clinical training and 1-1.5 months during their second year of clinical training at this site. The consult team will typically see 10-20 new consults weekly and maintain a service of 10-22 patients. A patient cap of 22 has been placed with an APP offloading service to protect teaching time for our fellows. During their tenure, the fellow will oversee the daily management and diagnostic evaluation of all patients on whom the service consults and acquire a working knowledge of how to manage acid-base and electrolyte disorders, acute and chronic kidney disease, glomerulonephritis, care of the hospitalized ESRD patient, and other renal-related diseases. The fellow will become adept at initiation of dialysis, modality selection, and prescription in patients with acute kidney injury, placement of temporary hemodialysis catheters, and principles and patient selection for urgent-start PD. In addition, this service affords an excellent opportunity to teach both resident and student trainees who rotate and are active participants on the consult service. Honing the fellow’s teaching skillset is heavily emphasized in this program and the consult services provide an outstanding venue to interact with a variety of trainees.