Has anyone heard back from NYU?
Has anyone heard back from NYU?
Thanks! I've heard from Cornell but not Columbia. Would be great if whoever hears from them let me and the group knowNYU sent me an invite about a week ago. From the information I've gathered, the vast majority of NYC area programs have given out invites. However, I haven't heard anything about / from Presbyterian yet.
this thread was going so well....then some doofus has to voice his poor judgement and regrets...Become a traditional hospitalist..M-F, 8-4, one weekend a month, no calls, 200K atleast..Y all this
Some words of advice from a peer:
1. Aim for the best programs - the ratio of applicants to fellowship spots is skewed in favor of applicants. Do not sign pre-match just because a non top tier program offers one. This is the best time to get into a really good program.
2. As some people have written in this forum before - please ask hard questions to program directors such as what is back up plan for covering clinical services if program is less than full strength due to either not filling spots or fellows leaving. If the programs back up plan is to make existing fellows take more call and consult months - that program is probably not worth considering.
Difficult to predict the future but from personal experience - all fellows I know who graduated last year were able to find Nephrology jobs. The market seems to be correcting itself in terms of supply/demand - last year there were 0.68 candidates per fellowship spot - and some fellows left after starting fellowship. The job market is telling us that number of Nephrology spots need to be decreased by 50% - then salaries "might" rise for new entrants in the field.
Best luck to all and remember only do this if you really like it.
Funny stats. Why did programs increase fellowship positions when number of applicants kept declining each year? Are we so bad at math?
Hi everyone,
So with the absolutely full season in Nephro finally seeing the end of it, just wondering how would you rank these programs of the many available. Before you go into the 'it depends' thing, please ignore all other factors. Just the programs for their academic stature and the least donkey-work?
Yale
Wash U/Barnes-Jewish
Stanford
UCLA
U Penn
Vanderbilt
UAB
MUSC
Cleveland Clinic
Mayo Rochestet-except for its mandatory 3 years requirevent
Presbyterian Cornell
U Maryland
Mt Sinai
Emory
Chapel Hill
Wakeforest
Cedars Sinai
U Michigan
Baylor Texas
Thanks all and best of luck For skeptics, I know it's dead, but still love it to the last Nephron!!!
I read all the posts so far.
I am an attending Physician and in private practice.
My suggestion, is to ignore all negative aspects about work and compensation if you truly love nephrology.
It is true that starting salaries are low and indeed in comparison to being a hospitalist (especially since they get more.time off)
Median salary after partner is around 250 -300 depending on the practice.
Average medical directorship for 13 station unit is 70-90k
That money is on top of practice income.
It is true that you will drive more and mid-levels are doing more and more dialysis rounds.
Avg compensation for one medicare dialysis patient is 220 $ for one month and avg nephrologist after 4 years in practice. will have 60 patients.
This money is besides what you do in office and in hospital.
So if you accumulate enough esrd, which you will eventually, you will make good money.
It is true davita and fresenius own 70 % of the market share in dialysis.
There are however more and more smaller companies opening and operating joint ventures and if you choose the right one , depending on demographic and location and payor mix, a 13 station unit can generate a lot of profit
400-800k/ year if you own a 50 % in the jv and have a average unit with 40 patients and about 10 % commercial patients.keep in mind that with big companies like davita and fresenius ,are volume based companies and huge overhead so you are unlikley to do as well with them as they are in network with most insurances and there's is no hope of getting bought out (where you make the killing).
In short working with Davita and Fresenius is a dead end in my opinion and their contracts are predatory with large non-compete radius.
They prey on fellows at ASN and other meetings and have fellows sign up with groups affiliated with them with very smart marketing strategies.
New fellows are not well informed enough as fellowships do not teach business and by the time they learn(in most cases if they ever learn) it is often too late.
In my subjective opinion, with a looming bottle neck in nephrology in 5- 10 years, it is the best time to enter nephrology.
I have been very satisfied with my choice and enjoy full spectrum nephrology including HTN, icu nephrology,GN,plasmapheresis,ckd and dialysis and some teaching.
Very gratifying and monetarily do better than ever expected.far better than all my cohorts in lucrative specialities.
If you are willing to chart your own course, and work and establish yourself and not sign the medical directorship contracts out of fellowship or with a large group with already tight affiliations with dialysis companies like davita or fresenius, you can do exceedingly well.
My suggestion, during fellowship look for like minded individuals and set up independent practice in an area that you want after researching the need.
I did it on my own after it did not work out with a group and now we are a growing group of 4 and we are very happy with what we do.
Look for states with no CON (certificate of need for dailysis units), although a lot harder to put up units in states with CON need still possible and if suceed very lucrative.
Everyone will scare you that it is very hard to set up a practice and even harder to set up dialysis.
It's not that hard, you have to commit and not get greedy or sign up with a larger group in a moment of weakness or fall in the honey trap of medical directorships.
It's not easy either, but is doable.
If you chart your course, you will enjoy nephrology and be wealthy and satisfied with your career.
Do not let nay sayers dissuade you, they say nay because they do not know that it is possible.
Many of my friends have done similar things in different states, and they have all done great.
There of course are failures too, but more because of lack of commitment and intense competition in some oversataurated metro area (like phoenix, dallas) and lack of will of the guys to persevere.
I however know many sucess stories there too.
It comes down to the person (who you are and if you can handle it )
We are in a intensely competitive market too,in a metro area and we are surviving and thriving.
Good luck guys.
It's a great time, it's easy to match in top notch programs, do not listen to nay sayers if you love nephrology.
Just like Warren Buffet says, "be conservative when everyone is greedy and be greedy when everyone is conservative "
I am happy to answer if any questions come up.
I had no plans on doing business with nephrology, but it just happened and more I learnt, more surprised I was that so many young bright individuals are choosing other specialities just for compensation reasons.
Last thought,if you join a group with poor structure and no JV opportunity, and if they are affiliated with Davita or fresenius, what you read up there in the posts is mostly true unless.you are the top guys.
JV with Davita and Fresenius are terrible too.
Good luck
Hi everyone,
So with the absolutely full season in Nephro finally seeing the end of it, just wondering how would you rank these programs of the many available. Before you go into the 'it depends' thing, please ignore all other factors. Just the programs for their academic stature and the least donkey-work?
Yale
Wash U/Barnes-Jewish
Stanford
UCLA
U Penn
Vanderbilt
UAB
MUSC
Cleveland Clinic
Mayo Rochestet-except for its mandatory 3 years requirevent
Presbyterian Cornell
U Maryland
Mt Sinai
Emory
Chapel Hill
Wakeforest
Cedars Sinai
U Michigan
Baylor Texas
Thanks all and best of luck For skeptics, I know it's dead, but still love it to the last Nephron!!!
Agree wholeheartedly with the above but the key here is
"Last thought,if you join a group with poor structure and no JV opportunity, and if they are affiliated with Davita or fresenius, what you read up there in the posts is mostly true unless.you are the top guys."
These are the MAJORITY of the jobs you will find
if you can take risk and compete - go for it - large dialysis companies/old timers+ abundant oversupply of fellows is what killed this specialty - there are only so many ESRD patients and so many dialysis units - unless one thinks they can take a big chunk out of these big companies in the area by setting independent units. Posters like above keep the glimmer of hope for this speciality
I do not have the business skill to do this - hence stuck and will bear it till time comes to say " I am done and switch to IM/Hospitalist".
as far as the above mentioned bottle neck in 5-10 years - current/recent graduates all know - ho well ) ASN predicted the job need - their predictions were way off the mark leading to the current mess.
it is better to go and play Russian roullete than make career decisions based on ASN reports
Congrats to everyone who matched! Essentially, congrats to everyone who applied!
The ASN workforce data is pretty interesting. When I saw 2015's numbers, I thought that the field was undergoing a natural correction and shedding fellowship spots. Now it seems more likely that programs were dropping out of the match to make pre-match offers and put pressure on applicants.
I'm quite excited and nervous about fellowship. Do you think reading prior to fellowship will help me survive my first few months? Or is fellowship just like intern year and there's basically nothing that can prepare you for whats coming?
I wanted to exchange my personal experience . I just left the fellowship this month at the end of first year . It sound like total wast of time and futureless and extremely frustrating .dialysis patient are so sick with multiple issues and I behaved like PCP for them . multiple admission and keep doing the same thing .fellowship extremely demanding with abuse of fellows to the maximum . call system are the worst in all fellowship as I needed to come for each HD,PD and new transplant case which meant I came back average 2 times each night without any post call early dismissal . the shock came after I started exploring the market and apply for jobs , honestly there are jobs but all are ridiculous and like a jokes . most of jobs rounding in 2-3 hospital and 2 clinics 2-4 dialysis centers during the weekdays and on call every 3 night , weekend every 3 weekend and cover 6 hospitals(15-30 miles apart from each others) . hospitals and dialysis clinics are 30-40 miles apart too . the starting salary 170-180 ( stop laughing) . all of private group will tell you about partnership track after 3 years after they kill working like a dog and most of the people don't get any partnership at the end and they move to another group and start over again . very rarely to find a hospital employed position and they pay maximum like 140-150K and you will be very lucky if you find it . doing interventional does not help at all as it is non sellable skills as no hospital will heir you as employed interventionist as most being done by interventional radiology and vascular surgeon .if you joined any nephrology group and you worked interventional plus nephrology it simply mean more work and exposure to radiation and you still get the same freak in 170K . I personally think doing any other fellowship or even just doing hospitalist a lot better than what I mentioned above . I did not trust this forum last year as I thought people just exaggerating things but know I learn it the hard way . I wish for every body good luck .
and it didn't cross you mind to *maybe* research this BEFORE you applied to fellowship? who does that??!!
First the OP didn't complete his fellowship... And second he as much as admitted he didn't realize there were issues in nephrology ... When a little research on his part prior to applying to said fellowship would have given him info... Really? He didn't know dialysis pts are really sick people? And that as a fellow part of his requirements would be to write HD PD orders and follow transplant pts? I'm knocking his lack of research... It's one thing to going into a field eyes wide open and give feedback it's another to be Mary sunshine and not done your due diligence...What gives Rokshana????
A year ago on this some forum you posted:
"this thread was going so well....then some doofus has to voice his poor judgement and regrets...
leave them alone...it has been mentioned AD NAUSEUM about the issues in nephrology today...you are disrespectful to those on this thread who have decided that going into nephrology that you think that they are not capable knowing how to make a decision..."
People who had gone through the nephrology fellowship were posting their personal experiences and trying to help and give a perspective to others who are applying and making this big decision to do it or not to do it. You discouraged others who had been there and done it to talk openly about their experience to others and give a real and well, realistic perspective.
Now you are criticizing him for not doing his research prior to doing the fellowship.
You can't have it both ways Rokshana. You knock him for not researching the fellowship prior to applying but you also don't want people who completed the fellowship to share their honest experiences to potential applicants?