Why Nephrology Grads Cannot Expect To Earn The Same As Their Partners !

[Renal_Prometheus]

It's and open secret at this point that neph programs are indiscriminate on who they take. But the type of people who are choosing this option, are mostly people in desperation, living on false hope and promises that will never materialize. The same program who can't fill spots and have to "sale nephrology", cannot be counted on to give an honest account of market realities. I categorize neph applicants into these groups:

1) Burnt out hospitalists looking for an easy escape, only to find out that they jumped from fire into a volcano
2) People who didn't match their first choice specialty, who took a neph spot based on a cold call from PD
3) residents who didn't want to do hospitalist medicine, who went into nephrology because it's easy to get
4) People who couldn't get into critical care, hoping that doing neph will increase their chances
5) IMGs who couldn't land a residency in the US, hoping to get into the US medical system by doing nephrology

Do you see the pattern? Bunch of desperate people living on hopium that will all come crashing down once reality hits them.
Of course programs are more than willing to encourage this kind of thinking in order to fill their unwanted fellowship spots. Why
do people fall for the same traps year after year!!! Why is it that Nobody learns !!! Let me tell you why. Because of "hope" ; Once you destroy hope, everything comes crashing down.

---

Members don't see this ad.

 

[NewYorkDoctors]

It's and open secret at this point that neph programs are indiscriminate on who they take. But the type of people who are choosing this option, are mostly people in desperation, living on false hope and promises that will never materialize. The same program who can't fill spots and have to "sale nephrology", cannot be counted on to give an honest account of market realities. I categorize neph applicants into these groups:

1) Burnt out hospitalists looking for an easy escape, only to find out that they jumped from fire into a volcano
2) People who didn't match their first choice specialty, who took a neph spot based on a cold call from PD
3) residents who didn't want to do hospitalist medicine, who went into nephrology because it's easy to get
4) People who couldn't get into critical care, hoping that doing neph will increase their chances
5) IMGs who couldn't land a residency in the US, hoping to get into the US medical system by doing nephrology

Do you see the pattern? Bunch of desperate people living on hopium that will all come crashing down once reality hits them.
Of course programs are more than willing to encourage this kind of thinking in order to fill their unwanted fellowship spots. Why
do people fall for the same traps year after year!!! Why is it that Nobody learns !!! Let me tell you why. Because of "hope" ; Once you destroy hope, everything comes crashing down.

This is the population of residents who should NOT do nephrology under ANY CIRCUMSTANCES.

By doing nephrology, you HARM your chances of doing cardiology or PCCM. This has to do with the fact that you are using up your GME years and it costs more for a PGY7/8/9 than a PGY4. Granted, there is no law STOPPING a program from taking you on for a second fellowship that is unrelated. However, there usually needs to be a very good reason like you are a top notch candidate who does the research well or nepotism is in play. The hospital and GME department usually would like to save on the GME dollars otherwise.

Unless you have super tight connections and you plan to be a Cardio-Nephrologist and take over the HF division for a large academic institution and do aquapheresis research (I did see one doctor like this in one of the large metro area hospitals, there is NO REASON to accept Nephrology and hope to do cardiology after. Aside from CKD patient having a lot of CAD/CHF and the need for both subspecialties to debate about diuretic dosage, there is VERY LITTLE these two specialties have in common in terms of the day to day practice.

Just ignore the cold calls after you fail to Match into Cardiology or PCCM. DO hospitalist and do more research. Apply more broadly next time. You will get into Cardiology or PCCM. You will be happy.

 

[berenjena89]

It's and open secret at this point that neph programs are indiscriminate on who they take. But the type of people who are choosing this option, are mostly people in desperation, living on false hope and promises that will never materialize. The same program who can't fill spots and have to "sale nephrology", cannot be counted on to give an honest account of market realities. I categorize neph applicants into these groups:

1) Burnt out hospitalists looking for an easy escape, only to find out that they jumped from fire into a volcano
2) People who didn't match their first choice specialty, who took a neph spot based on a cold call from PD
3) residents who didn't want to do hospitalist medicine, who went into nephrology because it's easy to get
4) People who couldn't get into critical care, hoping that doing neph will increase their chances
5) IMGs who couldn't land a residency in the US, hoping to get into the US medical system by doing nephrology

Do you see the pattern? Bunch of desperate people living on hopium that will all come crashing down once reality hits them.
Of course programs are more than willing to encourage this kind of thinking in order to fill their unwanted fellowship spots. Why
do people fall for the same traps year after year!!! Why is it that Nobody learns !!! Let me tell you why. Because of "hope" ; Once you destroy hope, everything comes crashing down.

 

[berenjena89]

I agree. You should not do any sub- specialty that pays less than hospitalist unless that you have a real passion or even if it is your passion you have to think it twice because, endo, ID , renal , rheum . Usually have less earning potential than hospitalist as an employee and once you start working you realize that you ll work hard anyways and won’t make much money compared with other lucrative specialties including hospitalist that’s also leads to to burn out. Nephrology is a recipe for burn out. Work as an hospitalist and work harder in your application. You ll regret if you do nephrology

 

[bronx43]

I agree. You should not do any sub- specialty that pays less than hospitalist unless that you have a real passion or even if it is your passion you have to think it twice because, endo, ID , renal , rheum . Usually have less earning potential than hospitalist as an employee and once you start working you realize that you ll work hard anyways and won’t make much money compared with other lucrative specialties including hospitalist that’s also leads to to burn out. Nephrology is a recipe for burn out. Work as an hospitalist and work harder in your application. You ll regret if you do nephrology

I am rheum and was a hospitalist before fellowship. Rheum is by no means the most lucrative specialty out there but it’s definitely got a much higher ceiling than hospital medicine with banker hours and no call. The averages in the national surveys are skewed by older part timers and people who see like 12 patients a day. If you want to be productive and are willing to work hard, the money is actually quite good. Now, whether one can enjoy the content matter of rheum is a different matter…

 

[VA Hopeful Dr]

I am rheum and was a hospitalist before fellowship. Rheum is by no means the most lucrative specialty out there but it’s definitely got a much higher ceiling than hospital medicine with banker hours and no call. The averages in the national surveys are skewed by older part timers and people who see like 12 patients a day. If you want to be productive and are willing to work hard, the money is actually quite good. Now, whether one can enjoy the content matter of rheum is a different matter…

Our generation and below is starting to prioritize lifestyle, which overall I think is a good thing.

 

[NewYorkDoctors]

Our generation and below is starting to prioritize lifestyle, which overall I think is a good thing.

but by no means does this mean our generation (I am an earlier/ older Gen Y) does like not to work.

i seldom go to the hospital anymore unless its for a bronch or some procedure. even then I turf most bronchs for cancer over to thoracic surgery.

I would still do bronchs for infections or certain things that a basic bronch can diagnose like sarcoidosis, NTM, MTb, endobronchial lesion , etc.. but that's far a few in between now.

the academic group in the hospital are more than pleased to see my patients when they get admitted which honestly is not a lot.

despite that I work 80 hour work weeks .. out of choice not necessity.

 

[VA Hopeful Dr]

but by no means does this mean our generation (I am an earlier/ older Gen Y) does like not to work.

i seldom go to the hospital anymore unless its for a bronch or some procedure. even then I turf most bronchs for cancer over to thoracic surgery.

I would still do bronchs for infections or certain things that a basic bronch can diagnose like sarcoidosis, NTM, MTb, endobronchial lesion , etc.. but that's far a few in between now.

the academic group in the hospital are more than pleased to see my patients when they get admitted which honestly is not a lot.

despite that I work 80 hour work weeks .. out of choice not necessity.

Definitely, I didn't mean to imply we're lazy.

 

[NewYorkDoctors]

Definitely, I didn't mean to imply we're lazy.

right right. i wasn't directly trying to counter you or anything. i just also wanted to highlight this point to any one who had a different opinion of our generation. Gen Y and Z are not all snowflakes. Many are though.

 

[berenjena89]

I am rheum and was a hospitalist before fellowship. Rheum is by no means the most lucrative specialty out there but it’s definitely got a much higher ceiling than hospital medicine with banker hours and no call. The averages in the national surveys are skewed by older part timers and people who see like 12 patients a day. If you want to be productive and are willing to work hard, the money is actually quite good. Now, whether one can enjoy the content matter of rheum is a different matter…

You are right as rhem, endo you can make good money if you work hard. Most people in those specialties work part time or don’t see more than 12-15 pts per day

 

[Renal_Prometheus]

ultimately, it's the neph applicant who pays the price(with years wasted) for miscalculating the risk/reward ratio in entering nephrology.
Neph fellowship programs stand to gain from peoples cheap labor and some will intentionally mislead applicants into thinking the job market is much better than it is. What do you expect when they can't fill fellowship spots. The incentives in this system is broken. You ultimately need to look after your own interests and can't expect a free lunch.

 

[NewYorkDoctors]

if there are candidates out there (usually FMG and IMG) who have no student debt and do not have visa issues (maybe green card marriage or already naturalized or are US -IMG etc...) and feel like "it's better to have some subspecialty than none at at all," then consider nephrology if you LIKE THE SUBJECT MATTER. If you do not, do not suffer needlessly for two years.

Also remember that you do not need to do a private practice nephrology job upon graduating nephrology fellowship. You are not forced to take such a bad job unless you have beholden by visa issues. If so, you have no real recourse other than to gut it out. However, if you could have avoided doing nephrology in that case, your life will be much better.