I just recently did a Peds Nephrology elective, and have taken care of nephrology patients as a resident, so I have a good idea of what it is like
Clinical Responsibilities--includes inpatient (very low census usually of primary patients, consults in house, including NICU, PICU, and consults from other subspecialits), dialysis unit patients who usually come in scheduled for dialysis, outpatient clinic. Typically they are not seeing a ton of patients so their hours are not too bad (assuming that you are not the only one in the hospital doing it)
Diversity of Patients-- This will vary greatly depending on where you are. For example if there are transplants, renal or otherwise, there are going to be a lot of renal issues. If you have a big PICU and NICU will be more probs.
The primary inpatients are a good variety of bread and butter Nephro (s/p transplant, rejection, lupus, IgA, Nephrotic Syndrome, etc.)
Most of the consults are either hypertension management or electrolyte problems. This is the vast majority. Of course there is also hematuria and proteinuria as well.
Intelectual rigor is high. A lot of the consult questions are very tough and smart people have already taken a fair stab at them before they consult you.
They are usually pretty condifent in their diagnoses, even the really tough ones.
Income potential-- You are pretty much confined to being a salaried employee of a medical school. I am not aware of any private practice or independantly contracting groups of peds nephro. Depending on how desperate the place is for a nephro, I imagine that you might be able to negotiate a decent deal, but really I am not sure. I would guess that you start about 100 to 120K but am really not sure.
Future--great. Big shortage. Lots and Lots of chronically illl kids. Not a huge interest from peds residents in the field, so fellowship opportunity is great and demand will be there.
It is a really cool field. It has an internal medicine feel to it compared to most peds subspecialties because a lot of the diseases that affect kids are the same ones that affect adults.
If have any more questions post them and I'll answer
