Official 2013-2014 Nephrology fellowship application cycle

[pH74]

This post is eye opening. Makes sense why there are no AMGs applying for nephrology. Either FMG from third world countries or Caribbean medical students like me.

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[LoudBark]

This post is eye opening. Makes sense why there are no AMGs applying for nephrology. Either FMG from third world countries or Caribbean medical students like me.

That is because AMG's typically go into one of three kinds of specialties:

1. good lifestyle
2. good pay
3. good lifestyle and good pay

Nephrology is not any of the above 3.

There are good programs that are worrying about not filling spots. There are top 20 IM programs that fill all their nephrology spots with IMG's while none of their own AMG residents go into nephrology.

 

[Invokana]

Has anyone interviewed at Dartmouth? I got an email from them this week. So strange to be getting an interview invitation this late in the season.... Any thoughts?

 

[Top Gun]

Has anyone interviewed at Dartmouth? I got an email from them this week. So strange to be getting an interview invitation this late in the season.... Any thoughts?

Well, I got two invites just this past week: Beth Israel in NYC and Harlem Hospital Center. So a few places are still sending out invites.

 

[pH74]

Wow those are late interviews... last interview on Wednesday and then done. ROL time

 

[Invokana]

Did anyone interview at Dartmouth? I actually thought I was done with my interviews. Happily ranked ten programs. Now i don't know if I should still go to this interview.

 

[pH74]

I was making my ROL today and noticed around 50% of programs where I interviewed had given at least 1 or 2 spots in prematch. One reputed program gave away 3 out of 5 spots in prematch

In the beginning of the interview season there were many more positions than as compared to NRMP quota. Even big competitive university programs have given away prematch. what is the reason for this trend? I was under impression in fellowship hardly any prematches are given away.

Should I email all programs where I interviewed and ask for prematch or should I take risk of going into match with 9 interviews?

 

[Docdoc123456]

@ph74

What you are telling about prematch confirm what I mentioned in this forum before that this year the number of the applicant is less than the number of spot available , so many program will be unfilled in the match that is why most of the weak program trying to get some position prematch, to avoid being unfilled .

This is unique for nephrology fellowship as nephrology for the last few years became the least competitive fellowship and together with geriatrics , nephrology sink in the bottom , program director understand that well and try to fill their program in prematch .

Taking a pre match , match or post match program is up to you , eventually everybody will match and will be a lot of post match open position , and like what happen last year , many of the matched either they will not start fellowship or leave it soon After starting it , so don't worry , in nephrology there will be always a positions and offer from program directors , may be for the next 5- 8 years.

 

[nephroPH]

Everyone done with interviews? Now time to sit down and make the ROL! Best of luck to all!

 

[Ash MD]

nephrology is in trouble...period

 

[Docdoc123456]

@Ash MD

I agree with you in 2 things , first: that if you love nephrology do it regardless and this what i told every body , the probelm many people after they start the fellowship they see nephrology fact different than what they used to think about it , that is why many people tend to leave early in fellowship , most people know about nephrology interesting things like rare GN , or TTP , believe me you may not see single case during the fellowship , nephrology is 99% dialysis business.

second , all of us dont love to do hospitalist for life , but on the other hand nephrology is not the only alternative of hospitalist, people can do primary care ,geriatrics or select easy fellowship like hospice palliative care , ID , Endocrinology , all they have same pay like nephrology may be higher but with better life style .

I disagree with many aspects , i did hospitalist for many years like you and i went to nephrology and after 2 month i discovered that hospitalist is a lot easier and nicer than nephrology , and what you mentioned about 120 hours work then they call you at home , ?? was that a hospitalist job?? , most hospitalist jobs work 7 on 7 off 10-12 hours shifts and no call after you go home ?? no body work 120 hours then being called at home too?

second , you said that take nephrology regardless money ? do you see nephrology such a fantastic romantic speciality to compromise with money for ?? very few people i met love nephrology, nephrology is full of social problems of dialysis Patients too.

third , you said forgot about money in the next 10 years ? that is a lot of time and no guranttee that nephrology will improve after that time , nephrology is well known world wide as non lucurative speciality.most of nephrologist in US are FMG from 3rd world countries , so they dont represent a pressure group on heath law makers.

 

[nephappl]

To all:
By match day please post data including
# unfilled programs
# unfilled positions (we are expecting a lot more than last year)
# applicants (expecting less)
# positions (hard to assess as looks like many pre-matches from scared programs)
% of AMGs matching
Is going to be fun seeing what happened this year after the disaster that last year match was. After that one no words from ASN which is hopeful that increasing exposure to Nephrology among Med students along with other educational initiatives is going to make nephrology a more appealing specialty for AMGs. None of the initiatives try at least to deal with the financial aspects of the matter which for me are the most relevant.
Will see

 

[sirolimus72]

Hi friends,

Please help me rank these programs (I know I went there so I should the best but still any input would be appreciated)
Wash U
Mass general
Tufts
baylor
UTH
UCLA
UAB
UTSW
U of Utah
OHSU

Thanks

 

[nephappl]

Hard to answer with so few specifics,
What you want to do Academics ? Bench research? Clinical research? regular clinical practice?? PhD?? MPH??
Only thing I can say is that if you are going for regular clinical practice I would choose a short 2 yr program (in case you find a job in Nephrology). In clinical practice were you trained is mostly irrelevant as renal services are almost the same everywhere (have not found the first pt asking me where I did my fellowship). If you have different goals then you set your list depending on them.

 

[Top Gun]

Hi friends,

Please help me rank these programs (I know I went there so I should the best but still any input would be appreciated)
Wash U
Mass general
Tufts
baylor
UTH
UCLA
UAB
UTSW
U of Utah
OHSU

Thanks

Only you can decide how to rank those programs. You interviewed at those places. You must have formed some impression of each program, favorable or non-favorable. Ranking residency/fellowship programs is a subjective process, and the applicant who interviewed at those programs is the best one to decide how to rank them.

 

[nephroPH]

A week left to ROL deadline! Best of luck to all.
@sirolimus, what's your long term plan? MGH is for sure geared towards academics.
What are everyone's top choices for the match?

 

[Top Gun]

A week left to ROL deadline! Best of luck to all.
@sirolimus, what's your long term plan? MGH is for sure geared towards academics.
What are everyone's top choices for the match?

Virginia Commonwealth University is my top choice. Seems like an excellent program with strong academics and collegial atmosphere, and nice location.

 

[angiotensin]

Mt Sinai is my top choice... I like the strong academics there...

 

[nephroPH]

Can't decide between VCU, UTSW and Chicago. Any ideas which one would be better in terms of finding a private practice job post fellowship?

 

[nephroPH]

Getting last minute jitters you see

 

[PermaCath]

.

 

[PermaCath]

.

 

[Invokana]

U penn.
Brown
Emory
Ohio state
UAB

Any of these id be very happy

 

[PermaCath]

U penn.
Brown
Emory
Ohio state
UAB

Any of these id be very happy

All these are excellent options, esp U penn, Emory and UAB.

 

[PermaCath]

.

 

[cureious]

Ucsf, stanford, ucla, UCSD, uci, mayo-az. Which order?

 

[nephroPH]

H

 

[gutonc]

Ucsf, stanford, ucla, UCSD, uci, mayo-az. Which order?

You're only 28 hours late asking the question.

 

[Invokana]

Did anyone receive a physical mail from UAB prior to the ROL deadline?

 

[Top Gun]

Well, its official. I matched! Ochsner Clinic.

 

[nephappl]

Can anybody share statistics for this year's match in nephrology?
Thank you
N/A

 

[Docdoc123456]

There is around 100 unfilled position in about 62 program, even very big names have unfilled position !!! Woow

 

[nephappl]

Are you kidding?
We know that might happen.
Thank you

 

[Top Gun]

There is around 100 unfilled position in about 62 program, even very big names have unfilled position !!! Woow

Where did you find that out? I looked at the NRMP site, and didn't find any data with regard to this year.

 

[LoudBark]

Are you kidding?
We know that might happen.
Thank you

No joke. Essentially everyone who applies to nephrology can be guaranteed a spot.
Even top programs have matched foreign grads from small community programs. This never happened even 10 years ago. Some program directors were saying out of fear of not matching, they had to offer many more interviews to applicants this year than ever before.

 

[mrcmedman]

Deleted

 

[HFHnephrofellow]

I am a recent grad from Henry Ford's Nephrology fellowship program. The only reason I joined this forum was the dramatic amount of misleading and twisted facts mentioned about the program in this thread. It is really upsetting that someone who is considered professional enough to become a physician would trash a fellowship program this way, attack the program director and hints that he lies to the applicants during the interviews, call staff abusive and the fellows slaves. This comment made me feel that I graduated from hell and not from a hospital. Maybe I shloud investigate the division's unwritten policy to hire only malignant staff specialized in torturing fellows !! what a joke. One thing that the person giving the negative comments above mentioned multiple times is the salary of a hospitalist compared to a nephrologist. That tells half of the story. I you are after money then don't waste your time reading my reply. Find a hospitalist job, do extra shifts, and make the money you want. If you are trying to find a way out of your hospitalist job by getting into nephrology without a real interest in the specialty, then again you are wasting your time here. About every 2 years, someone like this gets into the program. Someone who is tired of his hospitalist job and "working as a resident". These applicants are looking for a quick and easy way out due to their lack of interest in any particular specialty, or their inabiliy to get into their other undeclared choice 1 specialty (like cards or GI). Those applicants are not "fooled during the nephro interview by the PD" at Henry Ford but actually they themselves are not sincere enough. They would falsely impress their interviewees with a dramatic interest in nephrology, only to quit after a month once they realize their is really no easy fellowship, nowhere. Eventually, they leave the program and come up with a hundred excuse to cover up their act, and many would come up with a self-fulfilling prophecy that in truth is the product of their own action and wrong plans. I believe that if you don't like a specialty, you won't be able to go through a fellowship, and even if you do, you will end up as a less-than-average attending who will make everyone around him miserable. So if you are looking for quick money, easy fellowship, a way out of your hospitalist job, and you have the "any fellowship is fine" attitude then stay away from nephrology.

FELLOWSHIP PROGRAM: The fellowship program at Henry Ford is not even close to what was mentioned here. It's considered average to less-than-average busy compared to the other programs. 4 years ago, the program had less number of fellows per year and many quit due to high work load. They used to see 25-30 patients per day on the consult months. Keep in mind that such a patient load is very common for a nephrology fellowship anywhere in the US. Ask the programs you interview at and you will see. I have many friends who are doing nephrology fellowships in different places and I feel my fellowship is among the least busy. I met many fellows during the ASN and most had a heavier load of patients. The advantage Henry Ford has is the large ICU, contrary what the review above said. Because we have MICU, SICU, neuroICU, neurosurgicalICU, and CVICU, we see all types of pathology and have a more balanced and rich census. While my list would be about 60% ICU and 40% floors, other hospitals would have 30% ICU and 70% floors. Floors are basically simple ESRD cases (you wouldn't basically learn much from these case after you get used to dialysis) and floor-grade AKI cases. Those are stuff like vanco-induced AKI, over-diuresis and simple hyponatremias,..etc...Anyone with sound logic would prefer to see multisystem organ failure patients in the ICUs with AKI and CRRT, horrible acid-base disorders (i saw a bicarb level undetectable) and electrolyte anomalies (like a sodium of 200 !), rather than seeing the floor patient. I actually have learned nephrology in the ICU. Quality over quantity here ! A fellow I met from North Carolina mentioned they have 32 patients on their list (!), about 26 of them are established ESRD and floor patients and only about 6 in the ICU. That guy used to work 6 am to 7 pm while on consults, and because that rotation is basically unhumane, they would do only 2 weeks back to back of consults !! anyway, 3 years ago, the division increased dramatically the number of fellows they take. Currently there are about 12 nephro fellows and 1 transplant fellow. They increased the consult teams from 2 to 3, and cancelled the inpatient nephro rotation (although that rotation was a piece of cake. One staff, one fellow, and 2 NPs on 16 patients ! the fellow doesn't write a single note ! once the rounds are over at 11 am, the day is done). Anyway, the census became 10-17 patients a day on the consult service. After 4 pm, you don't take consults anymore, so if you are done by 4 pm you can do home. Most of the time we used to leave 4-6 pm depending on the load. The only exception is when you have to place a dialysis catheter. Over my 2 years of fellowship, I stayed past 6 pm very few times. So for a typical day, you would come at 7 am and leave by 4-5 pm. The majority of times you will have 1-2 IM residents with you (sometimes medical student too). On the busiest (and rarest) days, you may get 6 consults. With 3 persons on the team, it's embarrassing to mention how many new consults you will have to do as a fellow. That being said, out of the whole 24 months fellowship, you only do 6 or 7 consult month. Inpatient transplant rotations (2 per fellowship) are lighter with a census of 5-15 patients (around 12 usually). The rest of the fellowship is spent doing research and electives. Honestly speaking, that is decent amount of time dedicated to relaxing and doing your research. Anyone who is still in doubt can simply ask the nephro fellows during the tour to show you their census. They will pull out a list from their pocket or login to the EHR and show you the census. Fair enough I guess. Finally, the staff are really extremely friendly. This is the most infuriating part of that unfair comment about Henry Ford because it affects great and extremely nice staff whom I spent with 2 whole years. Not even a single time I felt even close to being abused. You are welcome to call them anytime day or night, step into their office, and make any relevant comment about your training. The PD cares a lot about the well being of his fellows. Throughout my 2 years there he asked me about my satisfaction with the training and about my well-being like 20 times, even when I was 1 month away from graduation !! It's not true that he always sides with the staff against the fellows. Only once, I brought up to him one minor issue. We met in the lobby and instantaneously the issue was straightened up (to my benefit). I do feel sometimes he pampers his fellows to the degree of spoiling them. The division head is the same. His office is always open and everyone gets invited randomly while passing by to get in, take a seat, and have a friendly short conversation about a random topic that could be anything. Both the PD and the Div head stayed with me till 8 pm on my 1st call (when we used to do paid inpatient calls-home calls now). I randomly met them in the inpatient dialysis unit around 5 pm and they noticed I was a little confused about some dialysis stuff. On my second call, I called the Div head for a dialysis catheter ! He drove from his home for a dialysis catheter ! the patient was a DIC who was bleeding and clotting. The line was a medical impossibility. Within half an hour, the interventional nephrologist was there too ! this is the kind of support you get at the division, not to mention all the other staff who are always welcoming and ready to teach and help with research. I used to exhaust my PD clinic staff with like 5 questions between each consecutive patient and he would always clearly teach and explain without even showing signs of annoyance. I used to email my research mentor with questions and he would reply with a long detailed explanation late at night. Please go and research other programs where fellows would barely see their division head and if lucky might see him once a month, or where the PD is so inflexible that he wouldn't allow you a switch the schedule in case you need or have some emergency. The program in general is very strong academically. You can go practice anywhere when you graduate, whether you choose to stay in academics or join a private practice. Some staff here a world renown and national. The div head is the editor in chief of one of the NKF's journals (ACKD), some NephSAP issues, ASN weekends, NKF education, etc...Henry Ford has one of the most (not to say the most) technologically advanced CRRTs programs in the whole country. You can ask about those things and more if you come here for an interview. Finally, the program has one CCM/nephro spot. Unlike what the review said, it is not exclusive to inside applicants. We had both inner and outside applicants. Anyone is welcome to call the division and ask to speak to the nephro/CCM fellows. They will tell you where they graduated from. BTW, piece of advise: anyone who is interested in nephro/CCM can also do a straight nephro fellowship then apply for a separate one year CCM. Henry Ford, like other programs (like Mayo for example), do offer a separate 1 year CCM fellowship. Many graduates in the past went to Mayo for 1 year after they finished here. Perhaps the gentleman who wrote the review was seeking that spot and was not granted to him. I have no idea. I would advise anyone who is academically motivated enough to apply to this spot, or do nephrology followed by critical care, whether at HFH or anywhere else. The job market is very flexible and unlike what was said above, you can practice any combination you want. Again, if you are only interested in CCM and hate nephro, then just do 2 straight years of CCM right after IM residency. This would save one extra year and would spare you from going through the pain of a fellowship you don't like.

HOSPITAL/CITY: definitely Detroit is a bankrupt city and that's not an ultimate discovery which was made here. Henry Ford is an inner city hospital. Well guess what, that's where you learn the most. Most big academic centers in the US are inner city hospital that provides care to underserved populations. If you are looking for a 5 stars hospital in a 5 stars city then definitely this is not the place. I would rather train in a hospital like this and see all kinds of pathology than go somewhere else. As for detroit, you don't have to live around the hospital. There is the option of on-campus housing which is literally 50 feet door-to-door, or the nearby suburbs. Those are 10-15 minutes away and maybe double the time during traffic. Using the crime rate in Detroit as a way to undermine the hospital ? please...just stay away from the drug business and you will be fine ...Chicago, Cleveland, NY, and NY are not much different..
One of the reason the match positions gets unfilled at Henry Ford is the fact that the nb of spots is getting more than the nb of applicants. Since the match was moved to 3rd residency year, many applicants went after their green card and postponed their fellowship plans due to the narrow window of time between the match result date and the deadline for job applications specially for people on visas. Most programs are suffering from such an issue, and many programs are filling from outside the match. I am not discussing here the pros and cons of nephrology, which is a major factor impacting the nb of applicants and the filled/unfilled ratio. This is your homework to do before applying to any nephrology fellowship. Maybe later I would talk about those issues.

 

[nephappl]

Completely agree,
Henry Ford is a top program in Nephrology with a great reputation.
I indeed wish I would have trained over there but they did not take me. As I said before the PD is a very nice person and the Division Chief is very well known.
The fact nephrology job market is bad (and residents know it; just see the match results) is not an excuse to trash any program / person reputation.
I agree with you, if you go for a renal fellowship do it only if you really like it not because you expect a better quality of life, better income or plenty of job opportunities of which nephrology has none compared to hospital medicine.
N/A

 

[HFHnephrofellow]

Thanks for the honest feedback nephappl. I agree with what you said regarding the job market. The visa issue is another obstacle that complicates things. Fellows who are perm residents were more able to find the jobs they want and at their preferred locations. You can't blame the specialty if most of those who practice it have visa restrictions.
As for HFH fellows, they did not end up all going to hospitalist jobs like that comment above mentioned. 8 fellows graduated last year: one got trained in Interventional Nephrology during his fellowship at HFH and got certified (!) without any extra time or money spent after graduation, 2 went to transplant nephrology (both at top notch universities ), one went for an extra year of critical care training, one went for private practice, 2 went to academics (with the direct help of the Div head), and one, only one, took a hospitalist job, mainly because he started looking for jobs a little late...

 

[HelpPleaseMD]

was told Downstate had zero positions filled for nephro.

 

[IM2GI]

was told Downstate had zero positions filled for nephro.

Brutal

 

[pH74]

its absolutely Brutal. Even Big programs like Vanderbilt, OHSU, U of Wash , Loma Linda went unfilled in Match

Currently I am in a program with 3 fellowship spots and only my spot was filled through match. I hope they fill other 2 spots - I would hate to be the only person working as first year fellow.

With further 12% medicare cut on dialysis bundle (especially IV medications) it seems future of nephrology is bleak. Some of the smaller dialysis center have plans to shut down as they are making loss with medicare payment cuts.

I hope ASN and other nephrology organizations work to reduce number of nephrology spots for next year so that graduating fellows can have better chance at securing a job.
In my region (NE) there are virtual NO nephrology jobs in major cities. It makes sense to cut nephrology fellowship spots into half because anyways 175 spots went unfilled this year. What is the point in graduating 400 + fellows each year when there are barely 70 jobs in market

I love nephrology. Its sad to see demise of this interesting field

 

[nephappl]

It does not really matter; free market wins and residents have shown they do not want to spend more years of training for nothing.
Nephrology is a dead field from the financial and work standpoint and it will be for years to come.
Arguably nowadays the only reason to spend 2-4 years in a Nephrology fellowship is that you are really in love with this and do not even care not finding a decent job in the US after you finish.
The profession is past due for a contraction and that should start with the training programs which control the supply of new grads.
We do not need more nephrologists at least in medium sized to big cities; from the practice management standpoint many of the things a doctor does can easily be replaced by a mid level provider (my training program has been doing that for years however it has been calling for a shortage of nephrologist in national meetings).
Ideally part of the solution involves:
-A honest assessment on the nephrology job market including not only how many jobs are available but how many good jobs are within them (good job means a decent practice with benefits and a serious partnership track) as many job offers are only for underemployment and exploitation of new grads.
-To recognize the private practice's responses to financial pressure (senior partners not retiring, no new hires, hiring more NPs or PAs or freezing hiring at all) which undermine the "shortage of nephrologists" theory ASN and others are promulgating. Private practices are the main source of nephrology jobs not academia.
-In a free market economy (like this is supposed to be) only reducing the supply will increase the price of the service offered; everything else (ASN initiatives to increase interest in Nephrology in students and residents .... etc) is BS. And that is particularly true given the burden of educational debt for AMGs
Unfortunately this matter is ruled by "academics" that have no clue or are in denial on how the real world works or maybe they need a lot of fellows so they can have their "academic lifestyles" assured.
I have no optimism about this, hopefully less people will be fooled on getting into this fellowship; more residents need to read SDN forums.

 

[pH74]

@nephappl

what is your advise to a fellow who will start next July? I am coming straight out of my residency. I decided not to take hospitalist job in my desired city which was paying 250,000 $ for working 14 days a month, so that I can join nephrology fellowship.

Majority of the people in academia advised - go for interest , they are plenty of jobs out there. But seems like reality is way different. I like this field but I need a good job too. I have 200,000 student loan and am planning to start a family next year. Living in Topeka, KS and making 130,000 as nephrologist with no partnership doesn't seem fair after all this effort.

 

[nephappl]

Hi pH74
Do not listen to anyone in particular people in academics. They need you to be there working for the next 2 years ; after that you are not their problem anymore
You should do what you think is best for you and the family you will be starting.
Unless you absolutely love this and do not see yourself doing anything else and you are pretty sure you are lucky enough (like me) to be working with a well established practice stay in nephrology
If you see alternatives that might be better for your future just go for them. People do not understand $200K in debt is a lot of money growing with every year of extra training.
It is true, starting salaries here are around 140-150 k (when you find a job) and at least in our practice which is a big one we are not hiring anybody for 2014 and do not expect it for 2015 either.
We are bracing for additional cuts in reimbursement and are in survival mode now.
Good luck

 

[LoudBark]

It does not really matter; free market wins and residents have shown they do not want to spend more years of training for nothing.
Nephrology is a dead field from the financial and work standpoint and it will be for years to come.
Arguably nowadays the only reason to spend 2-4 years in a Nephrology fellowship is that you are really in love with this and do not even care not finding a decent job in the US after you finish.
The profession is past due for a contraction and that should start with the training programs which control the supply of new grads.
We do not need more nephrologists at least in medium sized to big cities; from the practice management standpoint many of the things a doctor does can easily be replaced by a mid level provider (my training program has been doing that for years however it has been calling for a shortage of nephrologist in national meetings).
Ideally part of the solution involves:
-A honest assessment on the nephrology job market including not only how many jobs are available but how many good jobs are within them (good job means a decent practice with benefits and a serious partnership track) as many job offers are only for underemployment and exploitation of new grads.
-To recognize the private practice's responses to financial pressure (senior partners not retiring, no new hires, hiring more NPs or PAs or freezing hiring at all) which undermine the "shortage of nephrologists" theory ASN and others are promulgating. Private practices are the main source of nephrology jobs not academia.
-In a free market economy (like this is supposed to be) only reducing the supply will increase the price of the service offered; everything else (ASN initiatives to increase interest in Nephrology in students and residents .... etc) is BS. And that is particularly true given the burden of educational debt for AMGs
Unfortunately this matter is ruled by "academics" that have no clue or are in denial on how the real world works or maybe they need a lot of fellows so they can have their "academic lifestyles" assured.
I have no optimism about this, hopefully less people will be fooled on getting into this fellowship; more residents need to read SDN forums.

Well said! In addition, a lot of people don't realize that a lot of the few jobs that are offered are not exactly glamorous jobs in less than glamorous locations.
Recently saw a few jobs that recruiters were looking to fill where the night call was every 3rd night and every 3rd weekend. On weekends you would cover 4 different hospitals and some of the hospitals were many miles from each other. The weekend rounder would usually round until 10 or 11 pm. You were only off maybe 4 days a month. All of this for a starting salary of $175K. Sure they say within 3-4 years you can partner and potentially make over $200K but get real......you bust your behind like that and get abused first. This is all the while hospitalists in the same town are making $250K doing their 7 on and 7 off gig.

All of this of course is in the little hillbilly town that the recruiter likes to say is ONLY 3 and a half hours from a major city with an international airport!

These are the realities that academic nephrologists will never tell you about because they are not a part of the real world or they want to hide reality from you not to scare you away from their program.

But if you truly love kidney diseases and electrolyte and acid-base disorders......then knock yourself out!

 

[LoudBark]

@nephappl

what is your advise to a fellow who will start next July? I am coming straight out of my residency. I decided not to take hospitalist job in my desired city which was paying 250,000 $ for working 14 days a month, so that I can join nephrology fellowship.

Majority of the people in academia advised - go for interest , they are plenty of jobs out there. But seems like reality is way different. I like this field but I need a good job too. I have 200,000 student loan and am planning to start a family next year. Living in Topeka, KS and making 130,000 as nephrologist with no partnership doesn't seem fair after all this effort.

Look at it this way.......your difference in lifetime earnings from doing fellowship for 2 years and then doing nephrology.....compared to just doing a hospitalist gig right out of residency can be in the $ millions of dollars. The difference in number of days off in your career if you were to do hospitalist instead of nephrology fellowship and career can be in the hundreds if not over a thousand.

Now ask yourself this question: Do I LOVE kidney diseases and electrolyte and acid-base disorders SO MUCH that I would be willing to put over a $ million on the table and a thousand days of more work in order to do what I love??????? People always say idealistic things on this board and say "just do what you love", but sometimes you just have to think practically and realistically.

 

[Boyka]

I totally agree, I am a 2nd year fellow and currently looking for a job, it is quite depressing, the only jobs available are in small cities Hours away from a decent place, I can not find a reason to justify working as a nephrologists over a hospitalist, you will have to accept a lower pay, worse life style and a crapy location, all for the sake of beloved nephrology, I don't believe I love it that much.

 

[pH74]

@Boyka

I have heard similar stories from other fellows too. I was at dialysis conference at Las vegas and heard from dialysis company recruiters that indeed there were sparse jobs . In fact one of the recruiter looked at my CV and said why did you apply for nephrology?

well I hope residents next year read this forum before applying. I just applied for nephrology because I liked it without giving much thought to career after fellowship which seems dark at this point of time

 

[pH74]

I totally agree, I am a 2nd year fellow and currently looking for a job, it is quite depressing, the only jobs available are in small cities Hours away from a decent place, I can not find a reason to justify working as a nephrologists over a hospitalist, you will have to accept a lower pay, worse life style and a crapy location, all for the sake of beloved nephrology, I don't believe I love it that much.

@ boyka

do you mind giving me more details about kind of jobs you are being offered?