Programs Aim to Train Next Generation of Nephrologists

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). Previous surveys have reported that the level of satisfaction experienced by nephrology fellows is related to their exposure to mentored clinical and scholarly activities during fellowship training (1).

With a trend toward declining interest in nephrology as a career (1), (2), the Mount Desert Island Biological Laboratory (MDIBL) in Maine aims to instill enthusiasm and thought-provoking training for medical students, residents, and nephrology fellows. It provides excellent mentoring in the basics of renal physiology and mechanistic approaches to the understanding of electrolyte disorders. The ASN TREKS (Tutored Research and Education for Kidney Scholars) includes the weeklong Origins of Renal Physiology workshop as part of its program (3).

The “Origins of Renal Physiology” course for residents, nephrology fellows, and faculty attempts to lay the groundwork for producing investigators and academic nephrologists by providing excellent hands-on experience in the basics of renal physiology and its history. Since its inception in 2008, the 1-week course has been conducted in mid-September at the MDIBL. It enrolls 30 trainees every year. From six modules—water homeostasis, salt homeostasis and secretion, collecting duct sodium balance, GFR, genetics, and proximal tubular function—each trainee registers in any three 1.5-day modules. During long workdays, each trainee performs classic experiments with the help of module-specific syllabi, collects data, and analyzes the data. Subsequently, data presentations are done by the trainees on the next afternoon in group laboratory meetings, with the intent that trainees learn from one another. Access to classic articles in nephrology, one or two guest lectures, and workshops on how to write manuscripts are provided during the week. Travel and housing are provided for the residents and fellows, who pay only a registration fee. The program is supported by an educational grant from the National Institute of Diabetes and Digestive and Kidney Diseases.

The ASN TREKS program supports medical students and graduate students pursuing a PhD to attend the course and become connected with a nephrologist mentor who will interact with the student over the course of medical school training, graduate school, or postdoctoral fellowship. TREKS participants may attend ASN Kidney Week during the 3rd or 4th year of medical school or graduate school with travel support (as part of the ASN Kidney STARS program, formerly known as the ASN Program for Students and Residents, which is designed to help medical students develop long-term mentorships and to encourage careers in nephrology).

Fellowship clinical experience and general nephrology practice are heavily focused on short-term and longterm dialysis. Electrolyte disorders, which are intellectually stimulating, provide only a minor share of the daily workload in nephrology practice. In the process, knowledge of homeostasis and abnormalities may decline. Hands-on training in renal physiology and its history stimulates nephrologists and generates an outstanding grasp of the subject. It also provides teaching tools so that fellows and nephrologists can teach medical students and residents during case discussions and inpatient rounds. With the increasing demand for nephrologists and a declining interest in this subspecialty, it is essential to train next-generation nephrologists. The courses offered at the MDIBL attempt to instill enthusiasm and learning in students, residents, and fellows. In addition, they attempt to recruit medical students to commit to nephrology as a career. More information regarding the MDIBL and the national courses can be obtained at the following URLs:


The author thanks Mark Zeidel, MD, course director, for providing information for this article and editing its content, and Ms. Judi Medlin, program coordinator at the MDIBL.


  1. Shah HH, et al. Career choice selection and satisfaction among US adult nephrology fellows. Clin J Am Soc Nephrol 2012; 7:1513–1520.
  2. Adams ND. Attracting more residents into nephrology. Clin J Am Soc Nephrol 2012; 7:1382–1384.
  3. Zeidel M, et al. A national course for renal fellows: the Origins of Renal Physiology. J Am Soc Nephrol 2008; 19:649–650.