It distresses me that few students and trainees wish to follow in my footsteps. I remember hoping that I would be good enough to get a position in an academic medical center when I rounded as a student. The doctors who trained us had the best job on earth, not only seeing interesting patients but also passing on their knowledge at many levels. Sure, you would make more money in most private practice settings, but I felt the intellectual stimulation and collegiality of The Ivory Tower made up for that little deficit.
Today's students, carrying 3 to 4 times my debt, often make different choices.
I remember falling in love with nephrology. Having done carcinogenesis research I thought hematology-oncology would be my path. My rotation on adult nephrology as a student was memorable mostly for its tedium. Our work focused on two things: general internal medicine problems in patients who happened to be on chronic dialysis and intensive care patients with kidney failure who died after a variable amount of time. Only during my pediatrics training did I discover the truly fun side of nephrology, in particular the puzzle of fluid and electrolyte disorders.
My nephrology fellowship finished almost 21 years ago. Very few students or residents want to follow these footsteps either.
Of course, even adult nephrology has trouble attracting students and residents, despite a growing population of permanent kidney failure patients needing care.
The American Society of Nephrology hopes to fix this problem. The video below addresses its new program "INTEREST in Nephrology Careers."
Please comment if you have any suggestions or answers. Pediatric Nephrology has been a great ride for me so far, and I'm still hanging tight to the reigns.