Who is teaching ‘Fluid and Electrolytes’?

The nephrology teaching legacy is extensive. Claude Bernard, Carl Ludwig, Homer Smith, William Schwartz, Arnold Relman, Karl Gottschalk, Robert Narins, Jerome Kassirer, Mitchell Halperin and many others made their mark in the area of teaching the internal environment and its regulation, a discipline commonly termed ‘fluid and electrolytes’. Other medical specialties need these skills every day: critical care medicine, anaesthesiology, surgery, paediatrics and many others. However, the duty of teaching this material to medical students and house staff physicians is the purview of nephrologists. Thus, when other doctors cannot come to grips with these problems, we should become introspective and blame ourselves. We must insist that more time be devoted in medical school to house staff training, board examination preparation for medical specialties other than our own and to continuing medical education to pass this information on to younger colleagues. A recent patient underscored the lack of skills inherent in our own university house staff training programme in this regard.