I have no dog in this fight as I matched into cards. However, after failing to match the prior year I was bombarded by unsolicited emails from unfilled renal programs offering me a position. A number of programs tried sweetening they deal with promises of combined renal/interventional fellowships, or renal/CC, or how salaries/lifestyle in nephrology weren’t as bad as advertised. Here‘s one email excerpt that stood out.
”Most of the fellows secure a job in Interventional/General combined Nephrology practices in the country and the fellows that are in practice for 3+ years take home on an average 400-600K salary. I add that as there is general impression that nephrology salaries are low”
I was wondering if there was any truth to this, or if there’s some big catch?
The catch is you need to find a niche to be an Interventional Nephrologist
A) It is not an ACGME accredit subspecialty - though there is a governing body ASDIN
B) You need connections to get into an IN practice - it's hard enough to fight for the HD patients for general nephrology in a private setting in a given turf
C) The big cities are not lacking for nephrologists so it's harder to enter the market as private like that - you'll need to more to a rural place where turf wars are less with IR and vascular surgery.
As a entrepreneur with vision and dedication, it's definitely possible. But it is also possible to be an entrepreneur for primary care medicine and get an assembly line practice and make bank that way also. It just depends on expectations and what you can do with the training you pursue.
It's just ultimately about what specialty interests you.
To cite some anecdotal numbers (and big variation, but just to give you some idea)
NYC Big Academic Nephrology program with PD and Director well known in the ASN and worldwide
Clinical Instructor starting salary for a new attending just out of fellowship (someone I know) $150K base salary - given a "title" of PD Program Associate Director - might get incentives - hours 50-60 a week- lots of support staff - lots of time for research. Salary will go up with getting a higher academic rank and by obtaining more ESRD patients to follow.
There are those brutal travel to many centers and get abused by the older nephrology jobs too but let's not dwell on those.
Private Practice Nephrologist (one of my former attendings) who rounds at two hospitals, runs a busy outpatient HD service at two centers, and does smany inpatient consults and CRRT consults - makes about $500K per his report. He really worked at the business aspect of this though.
Nephrology isn't that bad. The topic is quite interesting and useful and makes you a better internist.
Just don't take those dead end jobs that make you a junior attending slave.
If you can't shrug off that "ugh but it's not as revered and respected as the cardiologist" feeling, then maybe do multiple subspecialties like me. Then you'll feel like a wild card.
