The Future Nephrology Workforce

Parker, Mark G.; Ibrahim, Tod; Shaffer, Rachel; Rosner, Mitchell H.; Molitoris, Bruce A.

doi:10.2215/cjn.01290211

Cited by 112 publications

(150 citation statements)

References 16 publications

(21 reference statements)

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“…The population of patients with CKD is expanding and the current growth in the number of nephrologists is not sufficient (1,2). One key concern is the documented declining interest in nephrology among US medical graduates (5), with the proportion of international medical graduates in nephrology fellowship positions increasing from 41% to 56% in the past 5 years (3,4).…”

Section: Discussionmentioning

confidence: 99%

“…In 2008, the American Society of Nephrology (ASN) founded the Task Force on Increasing Interest in Nephrology Careers to try to find ways to strengthen interest in a nephrology career among internal medicine residents (2). These efforts, however, would be strengthened and focused with additional information regarding the underlying reasons why trainees chose a career in nephrology, especially an academic nephrology track.…”

Section: Introductionmentioning

confidence: 99%

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Factors in Career Choice among US Nephrologists

McMahon

Thomas

Tucker

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives There is a projected shortage of kidney specialists, and retention of trainees in nephrology is important. Determining factors that result in choosing a nephrology career could inform future strategies to attract nephrology fellows. Results Of the 3399 members, 913 (23%) returned the survey. Mean age was 51.1610.5 years, and 46.1% were academic nephrologists. In addition, 38.4% of respondents graduated between 2000 and 2009. Interest in nephrology began early in training, with the intellectual aspects of nephrology, early mentoring, and participation in nephrology electives named as the most common reasons in choosing nephrology. Academic nephrologists were more likely to have participated in research in medical school, have a master's degree or PhD, and successfully obtained research funding during training. Academic debt was higher among nonacademic nephrologists. Research opportunities and intellectual stimulation were the main factors for academic nephrologists when choosing their first postfellowship positions, whereas geographic location and work-life balance were foremost for nonacademic nephrologists.Conclusions These findings highlight the importance of exposing medical students and residents to nephrology early in their careers through involvement in research, electives, and positive mentoring. Further work is needed to develop and implement effective strategies, including increasing early exposure to nephrology in preclinical and clinical years, as well as encouraging participation in research, in order to attract future nephrology trainees.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors in Career Choice among US Nephrologists

McMahon

Thomas

Tucker

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…Many of these young physicians have a poor view of nephrology as a specialty [9] for the reasons mentioned above. Certainly nephrology is a challenging specialty with a sick patient cohort but it is important that we publicize the positive elements to the career of a nephrologist.…”

Section: Publicizing Nephrologymentioning

confidence: 99%

“…Interest in nephrology as a career choice for physicians in the United States continues to decline, particularly among US medical graduates (USMGs) [1,2]. In the most recent match, a staggering 32% of fellowship positions and over half of all programs did not fill [3].…”

Section: Introductionmentioning

confidence: 99%

US Nephrology Workforce Crisis: Our Specialty Must Stay Modern and Relevant

Phelan¹

2015

TOUNJ

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Interest in nephrology as a career choice for physicians in the United States continues to decline, particularly among US medical graduates. Reasons for this are multi-factorial and include nephrology being perceived as difficult, arduous and un-inspiring with poor career prospects. This short paper discusses some aspects of Nephrology that need to be adjusted to attract bright enthusiastic physicians who can move the specialty forward.

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“…These include declining interest in nephrology as a career, lower salaries compared with many other subspecialties, difficulty attracting outstanding residents who are passionate about nephrology into fellowship programs, and high rates of burnout and career dissatisfaction among practicing nephrologists (1,2). There is no doubt that the work of a nephrologist can be hard.…”

mentioning

confidence: 99%

Transforming Nephrology

Rosner

Berns

2017

CJASN

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Much has been written about the troubles facing nephrologists and the specialty of nephrology. These include declining interest in nephrology as a career, lower salaries compared with many other subspecialties, difficulty attracting outstanding residents who are passionate about nephrology into fellowship programs, and high rates of burnout and career dissatisfaction among practicing nephrologists (1,2). There is no doubt that the work of a nephrologist can be hard. Many of us, whether in academia or private practice, work long hours caring for challenging patients. Some work within health systems where our efforts are perhaps not as appreciated as we would like. Similar to other areas in the practice of medicine, nephrologists spend substantial time during their workdays, evenings, and weekend on tasks that have little meaning, such as completing forms, ticking boxes in the electronic medical record (EMR), and other tasks that do not effectively use our clinical training. For instance, a study focusing on four specialties (nephrology was not included) determined that clinicians spend only 27% of their total time on direct clinical care and 49.2% of their time on EMR and clerical work, with much of this time occurring after hours during personal time (3). This issue may be worse for nephrologists, who typically have to use several different EMRs at multiple clinical practice sites, including chronic dialysis facilities. Furthermore, many nephrologists spend hours traveling between multiple dialysis units, seeing patients in facilities owned by large for-profit dialysis companies where our contributions to patient care may not be highly valued. Compounding this are reforms on payment models that emphasize data reporting and increase the burden of documentation rather than encouraging patient-centered care. There is no wonder that many of us feel discouraged and burned out. A consequence of these feelings is that nephrologists have developed a cynicism regarding our profession and a feeling that things are only going to get worse. This cynicism leads to a destructive self-fulfilling prophesy that engenders a sense of helplessness. Our professional dissatisfaction is transparent to medical students and residents who are deciding on career choices and likely acts as a deterrent to choosing careers in nephrology. It is against these feelings that we believe it is critical for us to take a step back, ask why we chose nephrology as our specialty, and consider how we can recapture joy and excitement in our practice of nephrology. Perhaps most importantly, we need to take the necessary actions that will be required to accomplish this. This article focuses on these critical issues and offers a starting point to engage further discussion on the future of nephrology.Many of us chose nephrology out of fascination with the complex physiology underlying our specialty and an enthusiasm for improving the lives of patients with serious medical problems (4,5). In recent years, this enthusiasm has been tempered by factors that have...

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The Future Nephrology Workforce

Cited by 112 publications

References 16 publications

Factors in Career Choice among US Nephrologists

Factors in Career Choice among US Nephrologists

US Nephrology Workforce Crisis: Our Specialty Must Stay Modern and Relevant

Transforming Nephrology

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