The United States will face a shortage of nephrologists during the next decade. This shortfall will occur despite the fact that the number of nephrology fellows nearly doubled during the past 20 years, from 460 in 1987 to 863 in 2008 (1,2). The current disparities—by ethnicity, socioeconomic status, and geographical location—among patients with kidney disease will worsen as a result of this shortage.
At least three simultaneous trends are conspiring to fuel this crisis: Nephrology is not an appealing career option for the majority of U.S. medical school graduates (USMGs), the graduates of international medical schools are facing pressures not to seek additional training or to practice in this country, and the prevalence of chronic kidney disease (CKD) and end stage renal disease (ESRD) is rising dramatically.
These are certainly interesting times for nephrology education. As the number of patients with chronic kidney disease increases, the number of trainees seeking careers in nephrology is not keeping pace. The nephrology workforce forms the ASN, so this month we examine personnel issues, including changes in the education of nephrologists-to-be and those maintaining certification. Other topics of interest include international medical graduates, women, transplant nephrologists, and pediatric nephrologists.
We started with a curse; let’s end with a wish: “May you find this an interesting section.”
—Pascale Lane, editor in chief, ASN Kidney News
Crowley AE, Etzel SI, Shaw HA: Graduate medical education in the United States. J Am Med Assoc 1987; 258:1031–1097.
Accreditation Council for Graduate Medical Education: Number of Accredited Programs for the Current Academic Year (2008–2009). http://www.acgme.org/adspublic/reports/accredited_programs.asp
Accreditation Council for Graduate Medical Education: Internal Medicine Program Requirements. http://www.acgme.org/acWebsite/downloads/RRC_progReq/140_internal_medicine_07012007.pdf
Association of American Medical Colleges Center for Workforce Studies: 2008 Physician Specialty Data. http://www.aamc.org/workforce/specialtyphysiciandatabook.pdf
Coresh J, Selvin E, Stevens, L, et al.: Prevalence of Chronic Kidney Disease in the United States. J Am Med Assoc 2007; 298:2038–2047.
United States Renal Data System 2008 Annual Data Report; Volume Two; Atlas of End-Stage Renal Disease, Incidence and Prevalence.