Looking Ahead at the Nephrology Workforce

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Nephrology workforce research conducted last year by George Washington University–Health Workforce Institute (GWU-HWI) investigators and others revealed some interesting facets of the nephrology workforce that will inform ongoing research activities in 2017. Here’s a brief look back at nephrology workforce research in 2016 and trends to watch for in the year ahead.

2016 GWU-HWI report

The most recent report from GWU-HWI investigators led by Edward Salsberg, MPA, uncovered some interesting data points:

  • The number of nephrology fellows in training has remained steady, despite a large number of positions going unfilled in the Match.

  • University of North Carolina Sheps Center researchers working in collaboration with GWU project the number of adult nephrologists per 10,000 population will grow by 58% between 2016 and 2030.

Overall, the report details a mixed picture for the specialty. The job market for US medical graduates is improving although it remains challenging for international medical graduates. However, the inflow of new nephrologists is outpacing the rate of retirement for older physicians.

“Our third annual report on the nephrology workforce finds both positive and negative signs,” said Salsberg. “For example, while the job market for new nephrologists is still challenging, there were some bright spots especially for US medical school graduates as job prospects improved along with incomes. And a new survey of nephrologists over 55 found that most were satisfied with their specialty, practice, and income.”

In addition to surveying nephrologists 55 and older, GWU conducted the annual Nephrology Fellows Survey and outlined the potential of recently introduced ESRD Seamless Care Organization (ESCO) demonstration projects to influence nephrologist demand, which they determined may make the specialty more fulfilling and economically rewarding.

Appointment year (AY) 2017 Match

Results of the AY 2017 nephrology Match released on December 7, 2016, were essentially flat to the previous year. An ASN Data Brief (http://asn.kdny.info/dyo6307Gh2r) highlighted several key points:

  • Despite a 4.4% increase in the number of training tracks compared with AY 2016, the number of slots offered was flat, suggesting nephrology training positions may be contracting slightly.

  • Only 64 US MDs matched in nephrology in AY 2017, down 21% from last year and 52% from AY 2009.

2017 Workforce research portfolio

Nephrology workforce research is one part of ASN’s commitment to empower current and future members of the nephrology workforce and advance their professional goals and success. This year’s portfolio includes:

GWU-HWI Workforce Surveys

Researchers from GWU-HWI will focus on administering three surveys assessing nephrology fellows and early career nephrologists:

  • 2017 Nephrology Fellows Survey

    4th iteration of the annual fellows survey will capture longitudinal data on job market experiences

  • Survey of Nephrologists One Year Out of Training

    Assessment of nephrologists’ practice and employment settings and experiences 1 year after graduation, conducted in concert with/fulfilling ACGME-required 1-year postgraduate program assessments

  • Survey of Nephrologists Five Years Out of Training

    Detailed investigation of early career nephrologists, including the first graduating class who completed the ASN Nephrology Fellows Survey assessments of training

Best Practices Project: Internal Medicine Residencies

The Best Practices Project is one of several initiatives designed by the ASN Workforce Committee to assess best practices of institutions that successfully attract trainees, in order to increase interest in nephrology careers among the brightest medical students and residents. The project identified top internal medicine residency producing physicians who subsequently specialize in nephrology and will isolate potentially translatable practices that could be disseminated and implemented at other institutions. Results of the first phase—focusing on medical schools—were presented at ASN Kidney Week 2016.

ASN Data Analytics Program

The Data Analytics Program was created in April 2016 to advance the goals of ASN’s new strategic plan. ASN is conducting in-house research and analysis projects, building on collaborations with GWU-HWI and expanding into new areas. The Data Analytics Program will support informed, strategic decision-making and implementation of ASN initiatives and programs by collecting, managing, analyzing, and synthesizing data relevant to nephrology and nephrology professionals.

Data Analytics Program activities in 2016 included:

In 2017, the Program will focus on development of

  • ASN GME Database

    Allows monitoring of trends among training programs and nephrology fellows

  • Data Collection Efforts

    Assessing and enumerating knowledge and data resource gaps, as well as potential approaches to address them

  • ASN Data Resource Center

    A central repository for ASN’s ongoing nephrology workforce research and data collection

Workforce, Training, and Career Advancement Department

In April 2016, ASN coalesced its workforce-centered programs into a new Workforce, Training, and Career Advancement Department to foster career development for all kidney health professionals. Among the department’s portfolio are Kidney STARS, Kidney TREKS, and the ASN Foundation for Kidney Research grants programs to which ASN commits more than $3 million each year. More than 40 physician volunteers serving on the newly created Career Advancement, Diversity and Inclusion, and Workforce and Training Committees will inform the department’s strategic initiatives. Expanding the range of resources available to kidney professionals across the entire career trajectory, from student to senior clinicians and investigators, will advance their professional lives and improve treatment of kidney diseases.

Trends to watch

Among the trends to watch in 2017 are:

  • Shifts in nephrology GME

    The AY 2017 Match was flat year over year, yet positions have continued to fill. Growing anecdotal evidence demonstrates a shift in reducing the number of fellowship positions.

  • Evolution of the Specialty

    New training offerings, such as critical care nephrology, could kindle interest in the specialty.

  • A new Congress and administration

    A new healthcare landscape could result in changing regulations and practice patterns and may influence specialty choice among trainees and future physician demand.

Workforce research reports and other resources are available at http://www.asn-online.org/workforce. If you have questions, concerns, or suggestions for future workforce research, data or knowledge gaps, please contact workforce@asn-online.org.