Official 2016-2017 Nephrology Fellowship Application Cycle

[gutonc]

Here it is. Good luck.

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[cute]

Nephrology is nice if your removed ESRD part lol.

Anyway you all know about nephrology. THE DOOMED fellowship. But if you like it go for it. It is harder than internship. Aim for the best program bcz you WILL GET ABUSED, so at least get good training. Be aware of these programs; UIC, U of Louisville, st. Louis. Big abuser programs with mediocre attending that are not willing to teach.

be prepared to make less money and work hard at least for 2-3 years after graduation. (another internship, I call it the second nephrology internship

good luck everybody....

 

[sandoram]

I wanted to exchange my personal experience . I just left the fellowship last 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 at night call 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 .

 

[quickshot]

Been hanging around the Nephrology application boards for the past month or so and deciding to take the plunge. I'll thank all of the posters on these boards (past, present, and future) for their brutal honesty. But, when you love something (and can't really picture yourself doing anything else), you owe it to yourself at least to try. Going to look for a research tract and really try to eventually find an academic job where I can do the big three (research, teaching, clinical work). I don't take anyone's negative posts regarding Nephrology personally and again, much appreciated for allowing me to consider the potentially heavy downsides of my decision. Pragmatism and all that. For my fellow applicants, consider their past posts carefully (knowing that a lot of the negative posts have truth) and be prepared for a potential life as a hospitalist (because I refuse to make under 150K). Learning is a monetary investment but hopefully I go to a place where the learning strengthens my overall clinical knowledge base as well.

Bonne chance.

 

[efrologo]

I have been waiting and waiting for this blog to open for this year.
I have seen all the bad marketing for nephrology but as you said, I does not matter how bad it is when you actually love it.
I am a family medicine physician, trained in the United States, could not get into Internal Medicine right away in 2007 , finished my FM residency and then my waiver. Got 5 years of experience as a hospitalist and then got into internal medicine residency again in 2015 as I really wanted to do nephrology, got some credit from prior residency and now excited to apply to nephrology.

I am stressed out because I do not have my documents ready until August the 1st. Is it still good time to apply?
I really want to get into a good program, is experience and passion considered in nephrology now that is not very competitive?

 

[rokshana]

I am stressed out because I do not have my documents ready until August the 1st. Is it still good time to apply?
I really want to get into a good program, is experience and passion considered in nephrology now that is not very competitive?

you won't have a problem...

 

[thierryhenry]

edited

 

[Docdoc123456]

Anon source: 07/15/16 - Cleveland Clinic

I saw you very active on the i nfectious diseases forum ?? Are you applying for both ?
I was in nephrology before and I left it and I am now in ID .

 

[quickshot]

I have been waiting and waiting for this blog to open for this year.
I have seen all the bad marketing for nephrology but as you said, I does not matter how bad it is when you actually love it.
I am a family medicine physician, trained in the United States, could not get into Internal Medicine right away in 2007 , finished my FM residency and then my waiver. Got 5 years of experience as a hospitalist and then got into internal medicine residency again in 2015 as I really wanted to do nephrology, got some credit from prior residency and now excited to apply to nephrology.

I am stressed out because I do not have my documents ready until August the 1st. Is it still good time to apply?
I really want to get into a good program, is experience and passion considered in nephrology now that is not very competitive?

You should do just fine I would expect.

 

[juggernaut16]

I have been waiting and waiting for this blog to open for this year.
I have seen all the bad marketing for nephrology but as you said, I does not matter how bad it is when you actually love it.
I am a family medicine physician, trained in the United States, could not get into Internal Medicine right away in 2007 , finished my FM residency and then my waiver. Got 5 years of experience as a hospitalist and then got into internal medicine residency again in 2015 as I really wanted to do nephrology, got some credit from prior residency and now excited to apply to nephrology.

I am stressed out because I do not have my documents ready until August the 1st. Is it still good time to apply?
I really want to get into a good program, is experience and passion considered in nephrology now that is not very competitive?

You will definitely match and possibly even prematch in an university program. There are 2 spots for every 1 applicant. You can do the math.

 

[juggernaut16]

I wanted to exchange my personal experience . I just left the fellowship last 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 at night call 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 .

I second that. If you decide to embark on this journey; be ready for hardships specially after the fellowship. Very limited job opportunities. You will have to make several compromises.

 

[Nephdoc99]

I wanted to exchange my personal experience . I just left the fellowship last 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 at night call 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 .

I am sorry you had this experience. As a clinician educator and nephrologist who works at an institution with a nephrology fellowship, I would describe your experience in the first year of fellowship as "typical" of the training programs up until just recently. Fellowships in nephrology have been historically very service oriented with tough clinical rotations and hard overnight call. That was my experience going through fellowship as well, but it was my passion and loved every minute of it. If fellowship was a cake walk, you would leave training not being prepared for the real world, which has strong clinical demands in EVERY specialty. This not specific just to nephrology.

Most nephrology fellowships are reorganizing their clinical needs to be less service oriented, allowing the training program to be more focused on education. If you are applying to nephrology programs, you should absolutely ask program directors what they are doing to balance the service and educational requirements of fellowship to prevent burnout. If they don't have a good answer, you should not rank that program. In our fellowship, we reorganized our clinical services to operate independent of fellow coverage. Fellow call coverage was reduced to one in four weekends and one weeknight per week. We emphasized case based didactics and simulation center experiences. There were many more changes, too many to list here. But the feedback we got from our fellows was universally positive.

As for jobs, all of our fellows who had no visa restrictions (ie, J1 or H1B) received multiple job offers. The fellows without geographic restrictions got the best opportunities to find the practice that worked best for them. If you don't like private practice, there are many university-based or hospital employer based jobs with good salaries throughout the nation. How do I know? Because I see the headhunter emails and occasionally check out the NEJM career center to see what's out there (not that I'm planning to change jobs--I love where I work). My current salary at a hospital based employer is much much much much higher than what you are quoting. Clearly you have no knowledge of actual salaries.

Ultimately, nephrology was never a good match for you. If you don't like sick and complex patients, critical care, and having long-term relationships with patients (which does involve some care coordination, but hardly qualifies as being a primary care doctor), than being a nephrologist and dialysis provider is not for you. Do yourself a favor and pick a specialty that is clinic oriented or be a hospitalist.

 

[Nephdoc99]

You will definitely match and possibly even prematch in an university program. There are 2 spots for every 1 applicant. You can do the math.

There is no pre-matching allowed. All nephrology fellowships are required to be "all-in" for the match by the ASN. All available spots have to be offered through the match.

 

[Docdoc123456]

Edited

 

[Docdoc123456]

Edited

 

[Docdoc123456]

I am sorry you had this experience. As a clinician educator and nephrologist who works at an institution with a nephrology fellowship, I would describe your experience in the first year of fellowship as "typical" of the training programs up until just recently. Fellowships in nephrology have been historically very service oriented with tough clinical rotations and hard overnight call. That was my experience going through fellowship as well, but it was my passion and loved every minute of it. If fellowship was a cake walk, you would leave training not being prepared for the real world, which has strong clinical demands in EVERY specialty. This not specific just to nephrology.

Most nephrology fellowships are reorganizing their clinical needs to be less service oriented, allowing the training program to be more focused on education. If you are applying to nephrology programs, you should absolutely ask program directors what they are doing to balance the service and educational requirements of fellowship to prevent burnout. If they don't have a good answer, you should not rank that program. In our fellowship, we reorganized our clinical services to operate independent of fellow coverage. Fellow call coverage was reduced to one in four weekends and one weeknight per week. We emphasized case based didactics and simulation center experiences. There were many more changes, too many to list here. But the feedback we got from our fellows was universally positive.

As for jobs, all of our fellows who had no visa restrictions (ie, J1 or H1B) received multiple job offers. The fellows without geographic restrictions got the best opportunities to find the practice that worked best for them. If you don't like private practice, there are many university-based or hospital employer based jobs with good salaries throughout the nation. How do I know? Because I see the headhunter emails and occasionally check out the NEJM career center to see what's out there (not that I'm planning to change jobs--I love where I work). My current salary at a hospital based employer is much much much much higher than what you are quoting. Clearly you have no knowledge of actual salaries.

Ultimately, nephrology was never a good match for you. If you don't like sick and complex patients, critical care, and having long-term relationships with patients (which does involve some care coordination, but hardly qualifies as being a primary care doctor), than being a nephrologist and dialysis provider is not for you. Do yourself a favor and pick a specialty that is clinic oriented or be a hospitalist.

My only response on you post is HUH, that is funny post man . I hope people will be belive that. Nephrology is sinking ship every body know and the earlier you jump out is the better .

 

[rokshana]

There is no pre-matching allowed. All nephrology fellowships are required to be "all-in" for the match by the ASN. All available spots have to be offered through the match.

ASN has no control over fellowships...ACGME (and in matching NRMP) do..."all in" means all in or all out...yes there can be prematches, but then ALL the positions have to be offered as prematches...and lets face it, if 2 parties want to make the arrangement, they certainly can under the table...and its nephrology...with a 65% unfilled rate, programs are going to do what they can to make sure their spots are filled...

 

[quickshot]

I am hoping that this is the case (and making sure to ask about on call schedules as well as trying to focus on university programs with good research and balanced learning environment). A couple of my friends who are Nephrology fellows now seem to have that balance.

 

[nephro007]

edit

 

[nephro007]

edit

 

[juggernaut16]

You are clearly protecting your interests as you are in academics and want to save your job. Be honest, you cannot survive without fellows. You want to sleep peaceful at night at your current job, so you need fellows to do your scut work. Also if there are no more fellows you will lose your job and unlikely you want to do private practice. Practice is brutal. Be honest, the free market has spoken and the specialty is dying. If you want it saved, cut down the spots by at least 80 percent

I don't think blaming academicians is the right thing to do. Many of the programs are genuinely interested in imparting quality research and clinical opportunities. The biggest downside of Nephrology is lack of decent jobs and academicians have no control over it. You have to make compromises with regards to location, income, lifestyle and your overall happiness in life. Sometimes you wish you were a GI fellow who is actively sought by recruiters rather than a renal fellow who has to beg for one .

 

[Nephdoc99]

ASN has no control over fellowships...ACGME (and in matching NRMP) do..."all in" means all in or all out...yes there can be prematches, but then ALL the positions have to be offered as prematches...and lets face it, if 2 parties want to make the arrangement, they certainly can under the table...and its nephrology...with a 65% unfilled rate, programs are going to do what they can to make sure their spots are filled...

The consequences of not signing the all-in agreement with the ASN is significant for any academic institution. You can read the ASN policy here: https://www.asn-online.org/education/training/match/

The vast majority of programs in the US have signed the MOU which commits them to being "all-in" for the match.

 

[Nephdoc99]

You are clearly protecting your interests as you are in academics and want to save your job. Be honest, you cannot survive without fellows. You want to sleep peaceful at night at your current job, so you need fellows to do your scut work. Also if there are no more fellows you will lose your job and unlikely you want to do private practice. Practice is brutal. Be honest, the free market has spoken and the specialty is dying. If you want it saved, cut down the spots by at least 80 percent

I survived just fine, thank you very much. We had one fellow last year. I covered 95% of my overnight calls without fellows and most of my weekends without fellows. Most on my service weeks on consults, I was lucky to have a resident. In the end, what I missed the most was being able to teach on an everyday basis. We matched all of our positions for this year, mostly because we make proactive efforts nearly 2 years ago to fundamentally change the service/education balance of our fellowship. This means, even with a nearly full fellowship, I still have uncovered months on consults, uncovered weekends, and uncovered nights. And you know what? I enjoy the uncovered time that I have, because it allows me to keep my skills sharp.

 

[rokshana]

The consequences of not signing the all-in agreement with the ASN is significant for any academic institution. You can read the ASN policy here: https://www.asn-online.org/education/training/match/

The vast majority of programs in the US have signed the MOU which commits them to being "all-in" for the match.

thanks! did not know that ASN sponsors the nephrology match...but interesting that they want to blame the reason for the low match rate to not being all in..having more openings and less applicants "might" be a more compelling reason...

 

[rokshana]

I survived just fine, thank you very much. We had one fellow last year. I covered 95% of my overnight calls without fellows and most of my weekends without fellows. Most on my service weeks on consults, I was lucky to have a resident. In the end, what I missed the most was being able to teach on an everyday basis. We matched all of our positions for this year, mostly because we make proactive efforts nearly 2 years ago to fundamentally change the service/education balance of our fellowship. This means, even with a nearly full fellowship, I still have uncovered months on consults, uncovered weekends, and uncovered nights. And you know what? I enjoy the uncovered time that I have, because it allows me to keep my skills sharp.

impressive that you matched all your spots...not so easy to do now a days in nephrology...

 

[Scope guy]

I am sorry you had this experience. As a clinician educator and nephrologist who works at an institution with a nephrology fellowship, I would describe your experience in the first year of fellowship as "typical" of the training programs up until just recently. Fellowships in nephrology have been historically very service oriented with tough clinical rotations and hard overnight call. That was my experience going through fellowship as well, but it was my passion and loved every minute of it. If fellowship was a cake walk, you would leave training not being prepared for the real world, which has strong clinical demands in EVERY specialty. This not specific just to nephrology.

Most nephrology fellowships are reorganizing their clinical needs to be less service oriented, allowing the training program to be more focused on education. If you are applying to nephrology programs, you should absolutely ask program directors what they are doing to balance the service and educational requirements of fellowship to prevent burnout. If they don't have a good answer, you should not rank that program. In our fellowship, we reorganized our clinical services to operate independent of fellow coverage. Fellow call coverage was reduced to one in four weekends and one weeknight per week. We emphasized case based didactics and simulation center experiences. There were many more changes, too many to list here. But the feedback we got from our fellows was universally positive.

As for jobs, all of our fellows who had no visa restrictions (ie, J1 or H1B) received multiple job offers. The fellows without geographic restrictions got the best opportunities to find the practice that worked best for them. If you don't like private practice, there are many university-based or hospital employer based jobs with good salaries throughout the nation. How do I know? Because I see the headhunter emails and occasionally check out the NEJM career center to see what's out there (not that I'm planning to change jobs--I love where I work). My current salary at a hospital based employer is much much much much higher than what you are quoting. Clearly you have no knowledge of actual salaries.

Ultimately, nephrology was never a good match for you. If you don't like sick and complex patients, critical care, and having long-term relationships with patients (which does involve some care coordination, but hardly qualifies as being a primary care doctor), than being a nephrologist and dialysis provider is not for you. Do yourself a favor and pick a specialty that is clinic oriented or be a hospitalist.

its prudent to remind you that about 50% of matched spots in nephrology are taken by IMGs on a visa. You mention that US citizens dont have any issues with finding decent jobs, Agreed, situation is far better for american citizens. However almost 100-120 IMGs every year graduate from nephrology programs and imagine their plight. Many are forced to do hospitalist waiver for three years (if on J1) or take jobs away from families or cities(for H1 ppl).

Even though there has been committees set by ASN after every disappointing fellowship result, the unanimous opinion is nephrology has more spots than they need. Why isnt anyone working on reducing positions in nephrology? My only explanation echoes along with many others in this page - academic program faculty dont want to take calls or do weekends. Even if they know a fellow wont get jobs, they are greedy enough to keep inflated positions and suck in medicine graduates, so that they can keep their work life balance, at the cost of a trainee.

 

[rokshana]

You are clearly protecting your interests as you are in academics and want to save your job. Be honest, you cannot survive without fellows. You want to sleep peaceful at night at your current job, so you need fellows to do your scut work. Also if there are no more fellows you will lose your job and unlikely you want to do private practice. Practice is brutal. Be honest, the free market has spoken and the specialty is dying. If you want it saved, cut down the spots by at least 80 percent

the specialty is cycling...its not like all of sudden there will be no more nephrology...in the 1990s no one wanted to do anesthesiology and it was an easy specialty to match into with a vast number of those FMGs...now? fairly competitive (though maybe trending down a bit)...

too any spots, not enough applicants...so no doubt programs will shrink, changes will happen and then who knows what will be the state in 10 years...

 

[sandoram]

The problem in nephrology is not single domain like job offer or visa candidates etc . the problem in nephrology it is collected all the disadvantage in one speciality . lake of jobs in general . rare jobs in big cities . the amount of driving and multiple places you need to go every day so it is not like working in one hospital and one clinic rather you will be covering 2-3 hospitals 20-30 miles a apart and 3-4 dialysis centers . also the very low starting salary like 170-180 and the very notorious partnership pathway in nephrology as most of the group will abuse the new nephrologist who join the group for 3 years just on hope of giving partnership at the end of the road if any . add to that all the newly graduated nephrologist who will join private groups will be worked like a dog regardless if you are a visa candidates or not , so it is a second visa waiver if you did one before . so I personally think visa is not a big issue here .passion wise . I don't think speciality like nephrology is being loved at the medical student level . that why very few local graduates go for nephrology . add to that the ESRD who keep missing HD and keep coming just to be redialysed again and again it is extremely frustrating and disappointing .most of the peoples went to nephrology are IMG from india , Pakistan Africa and middle east . most of those people debris of other fellowship failed to catch something better . all of them they think that nephrology after graduation like their original country where nephrologist work mainly in one hospital and one clinic . they don't know that they will work in 3-4 dialysis centers , 3-4 hospitals and 2-3 clinics .
The peoples who go for hospitalist represents 35-40% of nephrologist and many of them practiced nephrology for some years and they discovered that they can make 1.6 what they make in nephrology with working only 0.6 of what they used to work in nephrology . moving to hospitalist is not relevant to visa at all .and in general internal medicine you still see less frustrating patient than ESRD in nephrology . that is why hospitalist overcoming nephrology it is not jut the visa or money .
By the end of the day of you love nephrology and you want to compromise with all of your other life for it helped with the hope it may improve some a day no body know when (if any) .just go for it it is waiting for you .

 

[nephro007]

edit

 

[nephro007]

edit

 

[quickshot]

What a couple of posters mentioned regarding hospitalists and IMGs that may not have passion for Nephrology applying for it:

That just seems kind of sad to me. The mindset nowadays seems to be any specialty is better than no specialty at all and it seems that Nephrology is drawing a lot of people who think this. What is needed are people who are passionate about the field and its advancement. Nephrology spots should be cut down as there seems to be a real glut, especially in the Northeast. More focus needs to be given for programs to develop a real balance between scholarship and developing high clinical skill. This won't be a problem that will be magically solved by the time I am done with my prospective fellowship but I hope that there is some small positive turnaround.

For people who don't want to do Nephrology but feel the need to specialize: Primary care/Hospitalist likely pays more, you will work less, and you will be happier. Nephrology is hard enough as it is; don't add being miserable on top of it.

 

[sandoram]

Why not we make a list of programs that are well known to be malignant..so applicants can certainly stay away from them...??
For starters...all programs in Philadelphia are horrible( I don't know about UPENN) but Jefferson, Temple, Drexel all seemed like sweat shops...Avoid those...Henry Ford in Detroit has history of fellows quitting...any other thoughts people?

I agree that Philadelphia Programs are tough horrible . Henry Ford has a bad reputation and as you said historically fellow quitting and very aggressive attitude and slavery work . add to them most of Missouri program as I keep hearing from friends that Wash Univ. although big name they take advantage on fellows . St Louis Univ. they till candidates in interviews that they will teach them interventional and it will never happen attending are not interested in teaching . Univ of Missouri columbia running with half fellow number for the last few years and very small program limited educational experience . Jackson Memorial in FL is similar reputation to henry ford . also university of south florida sounds like tough one . I think LA programs are tough ones and many unfilled positions .

 

[nephro007]

Edited

 

[pulmoblast]

I am sorry you had this experience. As a clinician educator and nephrologist who works at an institution with a nephrology fellowship, I would describe your experience in the first year of fellowship as "typical" of the training programs up until just recently. Fellowships in nephrology have been historically very service oriented with tough clinical rotations and hard overnight call. That was my experience going through fellowship as well, but it was my passion and loved every minute of it. If fellowship was a cake walk, you would leave training not being prepared for the real world, which has strong clinical demands in EVERY specialty. This not specific just to nephrology.

Most nephrology fellowships are reorganizing their clinical needs to be less service oriented, allowing the training program to be more focused on education. If you are applying to nephrology programs, you should absolutely ask program directors what they are doing to balance the service and educational requirements of fellowship to prevent burnout. If they don't have a good answer, you should not rank that program. In our fellowship, we reorganized our clinical services to operate independent of fellow coverage. Fellow call coverage was reduced to one in four weekends and one weeknight per week. We emphasized case based didactics and simulation center experiences. There were many more changes, too many to list here. But the feedback we got from our fellows was universally positive.

As for jobs, all of our fellows who had no visa restrictions (ie, J1 or H1B) received multiple job offers. The fellows without geographic restrictions got the best opportunities to find the practice that worked best for them. If you don't like private practice, there are many university-based or hospital employer based jobs with good salaries throughout the nation. How do I know? Because I see the headhunter emails and occasionally check out the NEJM career center to see what's out there (not that I'm planning to change jobs--I love where I work). My current salary at a hospital based employer is much much much much higher than what you are quoting. Clearly you have no knowledge of actual salaries.

Ultimately, nephrology was never a good match for you. If you don't like sick and complex patients, critical care, and having long-term relationships with patients (which does involve some care coordination, but hardly qualifies as being a primary care doctor), than being a nephrologist and dialysis provider is not for you. Do yourself a favor and pick a specialty that is clinic oriented or be a hospitalist.

I love this academic fat cat trying to spin a web to save himself on SDN!!


Sent from my iPhone using SDN mobile app

 

[pulmoblast]

I survived just fine, thank you very much. We had one fellow last year. I covered 95% of my overnight calls without fellows and most of my weekends without fellows. Most on my service weeks on consults, I was lucky to have a resident. In the end, what I missed the most was being able to teach on an everyday basis. We matched all of our positions for this year, mostly because we make proactive efforts nearly 2 years ago to fundamentally change the service/education balance of our fellowship. This means, even with a nearly full fellowship, I still have uncovered months on consults, uncovered weekends, and uncovered nights. And you know what? I enjoy the uncovered time that I have, because it allows me to keep my skills sharp.

LOL


Sent from my iPhone using SDN mobile app

 

[nephron87]

Avoid community hospital in New York for nephrology...all unionized nursing staff
MAYO is good.
Cleveland Clinic-program director very rude to fellows at conference even on interview days..fellows looked miserable

Thanks for the info.

Anybody have thoughts regarding programs hiring their own graduates?

 

[quickshot]

Thanks for the info.

Anybody have thoughts regarding programs hiring their own graduates?

I would think it is a good thing if a program hires its own graduates, meaning that they trust the training that they give their own fellows. I think it may be a red flag if a program doesn't have ANY former graduates on staff.

 

[thierryhenry]

Lets leave this thread to posting about interviews.
Plenty of other threads bashing Nephrology on this board.
Thanks.

 

[Docdoc123456]

I think the best idea with what happening in nephrology ( the doomed fellowship ) is to shut down the fellowship applications completely for 5 years during that the ASN need to restructure the whole nephrology profession in this country including restructuring the training programs to be academically oriented rather a slavery oriented.
Other ideas is to cancel nephrology as an independent fellowship and create a new pathways like one year fellowship for HOSPITALIST if they want to do some nephrology work beside HOSPITALIST and one year of nephrology for intensivist who want to do some nephrology work beside ICU . In this case nephrology work will be an add on and people will be still making their main income from something more satisfying than just doomed nephrology alone .

 

[rokshana]

I think the best idea with what happening in nephrology ( the doomed fellowship ) is to shut down the fellowship applications completely for 5 years during that the ASN need to restructure the whole nephrology profession in this country including restructuring the training programs to be academically oriented rather a slavery oriented.
Other ideas is to cancel nephrology as an independent fellowship and create a new pathways like one year fellowship for HOSPITALIST if they want to do some nephrology work beside HOSPITALIST and one year of nephrology for intensivist who want to do some nephrology work beside ICU . In this case nephrology work will be an add on and people will be still making their main income from something more satisfying than just doomed nephrology alone .

why on EARTH would an IM trained person need a one year fellowship for hospital medicine...IM IS all you need...and if you really think that squeezing a 2 yr fellowship into a one year fellowship is going to make for less work, you have a weird sense of reality.

its not an all or none kinda thing...who do you think is gonna pick up their work? the hospitalist for inpt HD? the PCP for outpt HD? riiiighht...

its not the work of fellowship that is the issue (really? why do you think fellowship is suppose to be something cush?), but the fact that the job market sucks at the moment...and that there are too many fellows coming out and not enough of the old guard retiring...wait 10 more years and the pendulum will probably swing the other way...

the common thread has been too many fellow spots...DECREASING them makes sense...eliminating them does not...probably makes for more work for the fellow, but if the job market becomes more attractive, then people will be fine with it...

 

[sandoram]

why on EARTH would an IM trained person need a one year fellowship for hospital medicine...IM IS all you need...and if you really think that squeezing a 2 yr fellowship into a one year fellowship is going to make for less work, you have a weird sense of reality.

its not an all or none kinda thing...who do you think is gonna pick up their work? the hospitalist for inpt HD? the PCP for outpt HD? riiiighht...

its not the work of fellowship that is the issue (really? why do you think fellowship is suppose to be something cush?), but the fact that the job market sucks at the moment...and that there are too many fellows coming out and not enough of the old guard retiring...wait 10 more years and the pendulum will probably swing the other way...

the common thread has been too many fellow spots...DECREASING them makes sense...eliminating them does not...probably makes for more work for the fellow, but if the job market becomes more attractive, then people will be fine with it...

I agree eliminating nephrology as independant speciality and using the nephrology as add on could to other fields could be a good idea by still keeping the services for the patients but eliminating the need for a devoted nephrologist in the current situation of nephrology . specially in the view that the actual clinical training month in any program is only 12 month . in many countries over the world many general internist and intensivists do the nephrology work anyway in their hospital . this by itself could correct the nephrology environment as it will minimize the power in hand of private group who are behave like mafias .in the mean time still offering the services for the poor patients . if you speak about the market after 10 years will correct itself sound like a joke because who will go to such a fellowship and wait for 10 years ii . for the situation now is just we keep pretending that there is a viable speciality in this country called nephrology and we keep pretending here there still a fellowship application cycle and match and congratulate applicants for interviews ? what match is that if every 2 positions have less than one candidate . smart applicant could simply save application fees and interview costs and just wait till December ,by that time most of the program will be open and will just pick and choose .

 

[rokshana]

if you speak about the market after 10 years will correct itself sound like a joke because who will go to such a fellowship and wait for 10 years .. .

the same type of person that went into anesthesiology in the mid 1990s when the unfilled rate was ~ 50%...

 

[efrologo]

I survived just fine, thank you very much. We had one fellow last year. I covered 95% of my overnight calls without fellows and most of my weekends without fellows. Most on my service weeks on consults, I was lucky to have a resident. In the end, what I missed the most was being able to teach on an everyday basis. We matched all of our positions for this year, mostly because we make proactive efforts nearly 2 years ago to fundamentally change the service/education balance of our fellowship. This means, even with a nearly full fellowship, I still have uncovered months on consults, uncovered weekends, and uncovered nights. And you know what? I enjoy the uncovered time that I have, because it allows me to keep my skills sharp.

I saw the list of the fellowship Match results and saw that some of programs had filled positions and many had lots of unfilled positions.
Do you think the tendency of being filled or unfilled will continue for this year?

 

[quickshot]

I saw the list of the fellowship Match results and saw that some of programs had filled positions and many had lots of unfilled positions.
Do you think the tendency of being filled or unfilled will continue for this year?

I would think so as it does not seem that they do not seem to be reducing spots...but personally I would be sure to ask the PD (and the fellows) about research opportunities, didactic time, and call schedule. Check to make sure that the program was able to fill spots and their drop out rate (which I feel is becoming a bigger problem with Nephrology). Some of these questions might seem a little bit hardball but at the very least, Nephrology now should be a buyer's market. Know the job prospects of the last couple of fellows graduated and where they matched (and the board pass rate). Didactic time (at least a couple of times/week, less than that may be a red flag), whether they have a specialized renal pathologist and whether you can learn the basics of TRANSPLANT nephrology (even if you don't decide to do the fellowship). Don't just accept any program and be a critical puryevor. That's going to be my approach anyhow.

 

[Nephdoc99]

I saw the list of the fellowship Match results and saw that some of programs had filled positions and many had lots of unfilled positions.
Do you think the tendency of being filled or unfilled will continue for this year?

Short answer is: yes. There will be a lot of unfilled programs this year and for the many years to come. Most of the academic divisions in my region have reduced the size of their fellowships and reorganized their services with the expectation of having less fellows involved in training.

 

[Nephdoc99]

If you really did what you claim, I respect you and apologize for grouping you with the rest of the mafia. But again your not advocating reducing spots which is weird. If you really love what your doing which seems to be the case ,advocate cutting down the spots so graduates and academicians like yourself can remain employed

I did not specifically advocate for or against changes in the number of fellowship spots offered. At the end of the day, the number of applicants will determine the size of the training pool, and this was the case even when we had a 95% fill rate prior to 2010. The perception of there being a lack of jobs is driven primarily by IMGs who do not have flexible visas to give them access to the jobs in the major markets. In the current environment with how few nephrologists are completing fellowship, there will never be an oversupply of nephrologists. We will end up in a situation where we will struggle to find qualified people to fill jobs as we try to expand and grow.

 

[juggernaut16]

Absolutely, there will be a ton of unfilled spots. IM graduates are avoiding nephrology fellowship like the plague. Even the current fellows are hard to retain as the rats are deserting the sinking ship.

 

[juggernaut16]

I saw the list of the fellowship Match results and saw that some of programs had filled positions and many had lots of unfilled positions.
Do you think the tendency of being filled or unfilled will continue for this year?

Absolutely, there will be a ton of unfilled spots. IM graduates are avoiding nephrology fellowship like the plague. Even the current fellows are hard to retain as the rats are deserting the sinking ship.

 

[nephro007]

edit

 

[rokshana]

Ok..you are still talking about shortage...No use explaining. Your blaming visa candidates for this mess?????
How many img cardiology, pccm, hemonc fellows are jobless or doing hospitalist? If you really enjoy nephro..advocate a serious reduction in spots, else nephrology will be talked about in history text books

but how many visa needing FMGs are there in those specialties..there are some, but i would imagine the numbers are greater in nephrology...