Fellows Corner

 

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Bloodstream infections (BSI) among hemodialysis patients are among the most challenging problems in dialysis units, and are associated with significant morbidity and mortality (1).

Daniel Edmonston, MD

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Despite initiatives to improve access and delivery of preventive care, much of medicine is still reactionary. We wait behind brick-and-mortar walls for our patients to come to us with a list of problems in hand.

Medical students and residents are often intimidated by renal physiology and struggle to understand the many aspects of the kidney’s role in medical disease. If trainees have trouble grasping the complexities of the kidney, it should come as no surprise that our patients feel the same way.

Millions of lives have been successfully prolonged through dialysis. However, the world of dialysis has changed since its inception. With time, our patient population has evolved from young and fit to old and sick. Belding Scribner, the father of chronic dialysis in the US, noted the need for a “deselection committee” just five years after the Medicare payment benefit for ESRD was established in response to his perception of the loosening of dialysis criteria (1).

The US nephrology community has been concerned about lower numbers of trainees in Nephrology in recent years. A trend of fewer applicants to nephrology has been noted since 2011. Between 2013 and 2014, there were a slightly higher number of Nephrology Programs and fellowship positions opening. This led to a higher number of available positions than the number of applicants available to fill those positions in 2014 and 2015.

My grandmother’s struggle with chronic kidney disease (CKD) motivated me to consider, and ultimately choose, medicine as a career. During medical school, I had the opportunity to work with a nephrologist and attend renal clinics with him. I was intrigued by the complexity of patients with kidney disease and felt pulled toward a career in internal medicine and nephrology, which brought me to the University at Buffalo for my internal medicine residency.

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As the new academic year begins, nephrology fellows beginning their adult nephrology training can look back at the application process with a unique perspective compared with previous years’ fellows. They are the first class to enter the fellowship through the National Resident Match Program. The match has been considered a success in the fellowship community (Kohan and Rosenberg, 2009).

Attending the American Society of Nephrology (ASN) conference in November 2005 as a second year resident inspired me to pursue nephrology training upon finishing my residency in internal medicine-pediatrics.

There are several reasons why medical students and residents choose a career in nephrology. They include interest in physiology, interest in practicing a non–procedure-based subspecialty, and others (1). A key factor in their decisions is related to positive experiences during their nephrology rotations that can be accomplished only by enthusiastic and satisfied fellows and practicing nephrologists (1).

There are several reasons why medical students and residents choose a career in nephrology. They include interest in physiology, interest in practicing a non–procedure-based subspecialty, and others (1). A key factor in their decisions is related to positive experiences during their nephrology rotations that can be accomplished only by enthusiastic and satisfied fellows and practicing nephrologists (1).

Fellows Corner

Millions of lives have been successfully prolonged through dialysis. However, the world of dialysis has changed since its inception. With time, our patient population has evolved from young and fit to old and sick.

Detective Nephron

Detective Nephron, world renowned for expert analytic skills, trains budding physician-detectives on the diagnosis and treatment of kidney diseases. Wildly waving a stack of paper records, budding nephrologist L.O. Henle and medical student Ms.