Is Nephrology a Dying Specialty?

May 17, 2011

The number of med students choosing to specialize in nephrology is decreasing every year while kidney disease is on the rise.

According to an article published in the May issue of the Clinical Journal of the American Society of Nephrology, the number of med students choosing to specialize in nephrology is decreasing every year even with the “growing rates of Americans who have kidney disease or are on dialysis.”

The article evaluated the statistics of which subspecialties in internal medicine were the most and least likely to be selected from 2002-2009. Based on the results, the researchers learned that there two subspecialties that have declined; geriatric medicine and nephrology. “Medical students reports receiving minimal exposure to nephrology in clinical rotations, and they perceive that the specialty is too complex, uninteresting, and lacks professional opportunity.”

With a projection that more than “750,000 Americans will be on dialysis or awaiting kidney transplant” by 2020, the decrease in nephrologists could become a problem. Mark G. Parker, MD, American Society of Nephrology (ASN) Workforce Committee Chair, said that “in medical school, students primarily work with hospitalized kidney patients, whose care is the most complex and daunting. And many students believe nephrologists to be overworked and underpaid.” However, nephrologists have a higher salary (median salary is $186,101) than some other specialties, and based on the results from a 2010 ASN found that “95% of nephrology fellows indicated they are happy with their career choice.”

The ASN is in the process of developing a strategy to encourage med students to specialize in nephrology. The ASN “will help provide stimulating experiences for trainees, nurture outstanding educators, and use social media to encourage the next generation of students to learn about the importance of kidney disease and the satisfaction many nephrologists derive from improving kidney care,” said Parker.