Why do medicine residents specialize in nephrology?

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RFN was curious to see why medicine residents decide to pursue nephrology training? Obviously, this in a decision that has multiple factors.

Results from the RFN poll (73 total)- 58% of all respondents to our poll thought that the ability to make challenging diagnoses was an important factor in making this decision. I was surprised to see that this was just as important as having an influential mentor (46% during residency and 12% during medical school). 47% of respondents felt that the mix of inpatient and outpatient care was important. As medical care becomes increasingly fragmented (i.e. hospitalist strictly stay in the hospital and family medicine/general internal medicine are increasingly restricted to the outpatient setting) nephrology remains one of the few internal medicine specialties with such a profound dual role. 31% of respondents felt that the ability to establish a long term relationship with a patient was important decision maker. ICU and kidney transplant exposure came in at 26% and 16% respectively. Interestingly, only 16% felt that nephrology being a financially rewarding career was important. I wonder what the results of GI or cardiology poll would look like? The future of nephrology is in our hands. Recruiting interested medicine residents in extremely important to ensure that our field continues to thrive. The field of nephrology has many interesting facets that are unique. I welcome any comments about the poll or if anyone has other reasons they chose nephrology please let us know.

It appears that most people decide to specialize in nephrology because it is challenging, offers an exposure to a wide array of patients (i.e. ICU vs. inpatient vs. transplant vs. outpatient) and they were significantly influenced by a mentor.


  1. The Renal Association is involved in many joint activities, and liaises with many other relevant groups. Some of the organisations with which we share formal committees are: – renal exam course

  2. Very good question. Would love to hear from a peds nephrology fellow. Why do peds residents pick nephrology?

  3. why do pediatric residents specialize in nephrology?

  4. Interesting article. Personally, I took up Nephrology because I was inspired by the Nephrologist in my previous centre. On hindsight, I'm not sure if it was the right decision.

  5. Great Poll. I think that the fact that nephrology offers interesting diagnosis, varied areas ( ICU, dialysis, transplant) is one of the reasons I chose it. It makes you think like a detective and hence I chose this field. It is a mentally stimulating field of medicine. Go for it if you truly love internal medicine.

  6. Thank you for a great post and a wonderful blog. Regarding the issue of Nephrology as a career, I'm an internal medicine resident and I'm seriously considering Nephrology. This is not just because of the stimulation of the specialty its self, but also because of the inspiration, passion and dedication of some of the fellows and staff Nephrologists I was fortunate to work with. Many people in medicine view Nephrology as a difficult specialty not just intellectually but also because of how potentially sick patients can become and the extra dedication required to take care of them. Granted this true for many other specialties, but some have a view this is without the same recognition and financial rewards as other specialties that also deal with similarly sick patients (Cardiology for example). This maybe a hindrance to future recruitment of potentially brilliant doctors who can further advance the specialty.

    Keep up the good work, and I'm hoping for more posts and discussion on this issue.


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