How much Renal Disease is encountered in Urology?

[lilPhysician]

Hello Everyone,

A big reason that I became interested in entering medicine is because my mother had been on dialysis and received a successful renal transplant for an autoimmune disease. With that said, I'm really interested in entering a field of medicine that deals with renal pathology.

since diabetes, hypertension, and other conditions (renal cell carcinoma) make kidney disease a common and treatable problem, I thought it would be fairly mainstream in urology.

I'm currently doing some research in urologic oncology and the fellow who I'm working with told me that working with kidneys is fairly uncommon in urology unless I have the good fortune of working at a high volume academic center like Cleveland Clinic, etc...pretty unlikely and a reach in likelihood at best

1) How common are renal procedures in mainstream urology? By that I mean PP or at a hospital on a regular basis

2) How unlikely is it to be a urologist that specializes in renal pathology/disease/ surgery/ procedures?

3) I know that I could do a renal transplant fellowship. As interesting as it is, I do value seeing my family and I appreciate daylight, so is it possible to do renal transplant for a few years and then switch to a more accomodative lifestyle?

I don't have an interest in doing nephrology because I enjoy procedures and a mix of surgery/clinic. Interventional nephrology also seems to have a terrible call schedule.

I'd appreciate any clarifications on this. Thanks in advance.

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[pntgrd]

If you're interest in the kidney and it's diseases, you really should become a nephrologist. Yea, you might not be doing procedures (although many do do renal biopsies), but if it satisfies your main interest, you should do that. There are also academic pathologists that specialize in the renal path, if you're interested in research.

 

[gudog]

Hello Everyone,

A big reason that I became interested in entering medicine is because my mother had been on dialysis and received a successful renal transplant for an autoimmune disease. With that said, I'm really interested in entering a field of medicine that deals with renal pathology.

since diabetes, hypertension, and other conditions (renal cell carcinoma) make kidney disease a common and treatable problem, I thought it would be fairly mainstream in urology.

I'm currently doing some research in urologic oncology and the fellow who I'm working with told me that working with kidneys is fairly uncommon in urology unless I have the good fortune of working at a high volume academic center like Cleveland Clinic, etc...pretty unlikely and a reach in likelihood at best

1) How common are renal procedures in mainstream urology? By that I mean PP or at a hospital on a regular basis

2) How unlikely is it to be a urologist that specializes in renal pathology/disease/ surgery/ procedures?

3) I know that I could do a renal transplant fellowship. As interesting as it is, I do value seeing my family and I appreciate daylight, so is it possible to do renal transplant for a few years and then switch to a more accomodative lifestyle?

I don't have an interest in doing nephrology because I enjoy procedures and a mix of surgery/clinic. Interventional nephrology also seems to have a terrible call schedule.

I'd appreciate any clarifications on this. Thanks in advance.

Just my $0.02

1 - By renal procedures, I suspect you mean operating on the kidney as opposed to stone work, which involves kidneys routinely. As a urologist in private practice, I probably average one nephrectomy/partial nephrectomy a month.

2 - There are no fellowships for "renal disease" in urology. The stone guys do what they do, and oncology types do what they do. I guess you could tailor your practice somewhat to concentrate on kidneys for stones and neoplasia, but that would assume you are in a large group that would allow such compartmentalization.

3- Anything is possible, but after a transplant fellowship and several years of transplant practice, it would be very difficult to transition to a general urologic practice.

Hope this helps.

 

[cpants]

Urologists are surgeons first and foremost. They only deal with medical renal disease peripherally as morbidity or comorbidity in patients undergoing surgery for other reasons or as an indication for renal surgery. Even in those cases, they will almost always have a nephrologist on board to manage the medical issues. If your interest lies in renal disease, I would take another look at nephrology as a specialty.

Transplant urology is cool, but it has largely been supplanted by transplant surgery in the US. There are still a few programs where urologists perform the transplants, but at most institutions urologists either only do the donor nephrectomies or are uninvolved altogether. Also, there is no point in doing the extensive training to become a transplant urologist if you only want to do that for a short time and then do something with better hours.

In short, I would rethink your options. Medical renal disease plus surgery does not equal urology. You should only seek out a career in urology if you have an interest in the breadth of urologic pathology and genitourinary surgery.

 

[sponch]

If I were you, I'd do transplant nephrology since that seems to be what's driving your interest in the kidney. You'll get a good mix of genera internal medicine, medical renal disease, and transplant immunology. Urology will have too many non-kidney things that you won't be interested in.