Kidney TREKS: ASN’s New Initiative to Increase Interest in Nephrology Careers

In recent years much attention has been focused on medical students’ and residents’ declining interest in nephrology careers (1,2). The numbers of candidates, especially U.S. medical graduates (USMGs), applying to nephrology fellowship programs have dwindled over the past decade. In the 2012 fellowship appointment year there were only 1.1 applicants for each nephrology position in the National Residency Matching Program and only 24.2% of matched applicants were USMGs (3). This decline seems unjustified since nephrology remains an intellectually challenging and rewarding field. Some of the reasons being reported for this shift include minimal nephrology exposure during medical school and internal medicine residency, unstimulating renal pathophysiology introductory coursework, and a lack of mentorship. In addition, there is great concern that the supply of international medical graduates, who have composed a large portion of the nephrology fellowship applicant pool for many years, may dwindle because of increasing difficulties in obtaining visas to train and work in the United States or improved opportunities to return to their countries of origin.

Innovation and discovery in nephrology are also in jeopardy. Fewer students are choosing career paths as physician-scientists, especially in internal medicine and its subspecialties (4). Contraction of funding sources for young investigators, lack of mentorship and research opportunities in medical school, diminished remuneration, and an increased debt burden paired with protracted length of research training are among the cited culprits (5).

In response to these concerns, the ASN Workforce Committee has devised an innovative way to attract USMGs to nephrology and research at an early stage in their training. ASN’s new Kidney TREKS (Tutored Research and Education for Kidney Scholars) program is aimed at trainees at the medical school level. It begins with a unique laboratory experience at Mount Desert Island Biologic Laboratories (MDIBL) in Bar Harbor, Maine. This 1-week, fully funded, lab-based hands-on course will take place June 8–14, 2013. Modeled on the highly successful “Origins of Renal Physiology” course for fellows and junior faculty at MDIBL, and directed by Mark Zeidel, MD, FASN, Chair of the Department of Medicine at Beth Israel Deaconess Hospital in Boston, the week will feature renowned investigators in the field. Students will participate in modules that allow them to perform experiments and discuss and present results that help them understand key concepts in nephrology, including water and salt homeostasis, acid-base homeostasis, glomerular function, personalized medicine, and genetics. Both classical experiments and modern molecular techniques will be explored.

Participants will then enter a longitudinal mentorship component of the program and will be paired with a nephrologist at their home institution. This mentor will serve to guide them through nephrology electives and additional research opportunities, such as application to the ASN Student Scholars Grants program. Finally, participants will be invited to attend ASN Kidney Week during their third or fourth years in medical school through the ASN Program for Medical Students and Residents. This successful initiative includes guided learning pathways and exposes trainees to the full spectrum of nephrology discovery at Kidney Week.

Applications for the Kidney TREKS program can be found online at http://www.asn-online.org/education/training/students/kidney-treks.aspx. Medical students of all levels are encouraged to apply and acceptance will be on a rolling basis with a final deadline of May 15, 2013.

Notes

[1] Lauren Stern, MD, is affiliated wtih Boston Medical Center and Boston University School of Medicine, and Mark Parker, MD, is director of the division of nephrology and transplantation, Maine Medical Center, and associate clinical professor of Medicine, Tufts University School of Medicine.

References

1. Parker MG, et al. The future nephrology workforce: will there be one? Clin J Am Soc Nephrol 2011; 6:1501–1506.

2. Kohan DE. Training the next generation of nephrologists. Clin J Am Soc Nephrol 2011; 6:2564–2566.

3. National Residents Matching Program. Results and Data: Specialties Matching Service 2012 Appointment Year. Washington, DC: National Residents Matching Program; 2012.

4. Andriole DA, et al. Characteristics and career intentions of the emerging MD/PhD workforce. JAMA 2008; 300:1165–1173.

5. Borges NJ, et al. How, when, and why do physicians choose careers in academic medicine? A literature review. Acad Med 2010; 85:680–686.

February 2013 (Vol. 5, Number 2)