Transplant Nephrology

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JKWINNER

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Hi guys, second year resident who is interested in transplant nephrology. Love in the interdisciplinary interaction with other medical teams especially surgery as well as all the medicine that is involved (nephrology, immunology, BP management, infectious disease). Was wondering if anyone has an idea what the job market is like for transplant nephrology, the average salary, inpatient vs. outpatient split, and lifestyle in general. Thank you!

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Not a transplant nephrologist. But I have a few colleagues at the various academic medical centers in NYC who are transplant nephrology trained.
Basically they have a very nice job. You get to see so much kidney pathology (whether they went to transplant due to GN or they might get recurrent FSGS after transplant), you do kidney biopsies (of the transplanted kidney) with regularity, you are a true "boss" in that sense of the word for your expertise, you order all CRRT and plasmapheresis routinely.. you also get to get quite good at transplant ID as well being exposed to it all the time.

some of the renal transplant attendings also do general renal call but dont have to deal wit hchronic HD stuff.

the patients who get admitted for transplant are primary under the surgery team while the renal transplant team serves as secondary.


I can't comment on pay though on colleague mentioned started first year at $200K but its been a few years im sure this person has made more.
This person also has plenty of time to do resaerch and publish in the renal trapslant journals.
This person also goes some coverage for weekend inpatient renal coverage at times.
This person also has a few months of inpatient teaching renal service.

Great job. Not the highest paying ever but it takes all the best facets of nephrology and concentrates it into a thick juice for you to enjoy day in and day out and removes the chaff (chronic HD)
However you are tied to an academic center and will need to publish.

There is no "private practice" renal transplant job.
 
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Hi guys, second year resident who is interested in transplant nephrology. Love in the interdisciplinary interaction with other medical teams especially surgery as well as all the medicine that is involved (nephrology, immunology, BP management, infectious disease). Was wondering if anyone has an idea what the job market is like for transplant nephrology, the average salary, inpatient vs. outpatient split, and lifestyle in general. Thank you!
Problem with transplant renal is that the number of these jobs that are available is minimal.

If you like transplant related work and interdisciplinary interaction, you may also enjoy transplant hepatology. That was the only part of GI I truly enjoyed as a resident.
 
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Problem with transplant renal is that the number of these jobs that are available is minimal.

If you like transplant related work and interdisciplinary interaction, you may also enjoy transplant hepatology. That was the only part of GI I truly enjoyed as a resident.
The major difference being that transplant nephrology gets you more money and/or less work than your generalist colleagues, while transplant hepatology/GI gets you more work and far less money.

That said, while money is always an issue, career happiness and longevity is often as/more important.
 
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The major difference being that transplant nephrology gets you more money and/or less work than your generalist colleagues, while transplant hepatology/GI gets you more work and far less money.

That said, while money is always an issue, career happiness and longevity is often as/more important.
The right career is always hospitalist. Any other choice is, well...
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Transplant nephrology is a fun field and you do get interesting cases, but your bread and butter will be seeing patients in clinic and adjusting immunosuppression while counseling patients to take their meds and get age appropriate cancer screening plus treating their post-txp diabetes and other side effects. You tend to replace dialysis rounding with more outpatient clinic.

Agree with what others have said - generally, universities like transplant programs because they make them money, so they will often subsidize your salary as well, which may result in a higher pay than the general nephrologists. Though it all depends on volume and how your university salary is negotiated, and I've seen the transplant salary be lower than general neph at some places (generally the university and transplant surgeons take most of the money). It usually isn't a dramatic difference though between general and transplant. Typically, the ceiling is still lower than busy established private practice nephrologists.

On the downside, a lot of your lifestyle depends on your interactions with the abdominal transplant surgeons, as they tend to wield most of the power - I've seen places where this interaction is great and have also seen other places where it is pretty bad and the transplant nephrologist is basically just there to get blamed if something goes wrong post-surgery... Also, there tend to be a ton of unreimbursed meetings and some of the patients turn out to be extremely needy or clinical disasters that you can end up spending a ton of (questionably reimbursed) time on to ensure that they make it to the 1 year timepoint, so that the program doesn't get dinged. Honestly, I think that chronic dialysis rounding is easier for the money it pays (albeit maybe not as interesting).

Most of the people that I have seen do transplant fellowships (an extra year) are 1) people who love transplant and have academic/research aspirations and 2) people who need another year of a position for visa reasons. It is generally very non-competitive to get a spot.
 
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It's non-competitive sub-specialty to get because it doesn't make more money than a general nephrologist. Keep in mind the opportunity cost of 2 year nephrology fellowship plus 1 more year of transplant. I have a few friends who did transplant nephrology and are practicing. Generally starting salary for university transplant program is 200-250k/yr as faculty. Keep in mind you have residents/fellows helping you out here. If it's a community transplant center, starting salary in the 300-350k/yr range. Keep in mind you have no residents/fellows to help you out here and you are quite busy working full time. In terms of income per hr basis, hospitalists have you beat; but of course, you know that already and is doing in for the academic interest.
 
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