Rheum vs Nephro?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.


Junior Member
10+ Year Member
5+ Year Member
15+ Year Member
Nov 21, 2004
Reaction score
I'm trying to decide between specializing in Rheum vs Nephro...Both I think are pretty intellectually stimulating, but differ in terms of lifestyle, etc..I know ultimately it will depend on what I find more interesting, but I'm kind of caught btwn having a better lifestyle (rheum) vs doing something I find a bit more interesting (nephro)..Any thoughts on both of these fields?

Members don't see this ad.
Nephro...it has way more interesting physiology...actually rheum's kinda boring. Also, nephro doesn't have such a bad lifestyle, my granpa's cousin is a nephrologist, he is over 70 and still practicing, he's not working as much time in the hospital as he used to when he was younger and he is focusing more in private practice now, but still, that says a lot about the job, obviously it doesn't take your life away.
I'm a Rheum fellow so my input is biased, but... You see the most downright interesting pathology as a Rheumatologist (at a large academic center) and you work with the most interesting system in the body (the immune system). We're not focused on a particular anatomic organ (heart, lung, gut, etc) which allows us to see the interesting cases that nephrologists see, as well as the cardiologists, neurologists, and pulmonologists. Look at the NEJM case reports--like half of them are rheumatologic illnesses. We actually have treatments that work now, RA patients today don't look like RA patients of yesterday, the research pipelines for future therapeutics especially in immunology (and heme/onc) is especially deep. Steroid injection for a painful joint has to be one of the most rewarding procedures out there. I've very commonly seen patients wheelchair bound in 10/10 pain walk out of my clinic. As mentioned in another thread, it is a great field if you want to do more research (particularly immuno) or if want to go into drug development/pharm.

And... last but not least, I cruise in to the hospital at around 8 or 9 each day while the poor 1st year nephro fellow has been in the hospital since 6 rounding on his ICU follow ups.

But you gotta do what you love...