Nephrology (Renal Medicine) as a medical career
General information. See links and further info at the foot of the page
We train both
Nephrology is a varied specialty with at one end elements of acute, high-dependency medicine and acute referrals – the best of general medicine – and at the other, longitudinal care of a cohort of patients over decades during chronic renal failure, dialysis and transplantation. Its practice includes a broad range of general medicine, but also care of surgical patients, through transplantation and acute nephrology. Units that work well have strong multidisciplinary teams and close relationships with other specialties.
Basic training requirements are common to other medical specialties. A good medical training is essential to be able to practise nephrology well.
Higher specialist training in the new system takes up to 3 years (ST3-5) for Renal alone, but most at present enter aiming also for a CCT or similar qualification in GIM, which adds 2 years (ST3-7). Some do the first year of GIM but not the last, and there may be a more varied 4 year option.
In Edinburgh and South East Scotland trainees rotate through attachments to acute nephrology, general nephrology, transplantation, and dialysis, while maintaining continuing commitments to outpatient clinics, unit meetings and teaching. There will also be at least 6 months of nephrology experience in a DGH (Dunfermline and Kirkcaldy in Fife), and some of your GIM may be there too. Many trainees take a research break but this is not compulsory, nor has it been essential for some consultant posts in the recent past.
Most training centres offer comparable experience, though we believe that we have particular advantages:
- Excellent clinical teams, experiences, and training with an international name
- Excellent transplant unit undertaking renal, pancreatic and liver transplantation, jointly managed with very good collaboration and relationships with the surgical team.
- Most of the time you'll be based in Edinburgh, and even while in Fife, commuting is not difficult
- One of the strongest academic renal groups in the UK, with very good interactions with the renal and transplant services.
- Strong track record and interest in undergraduate and postgraduate education, and writing textbooks
- The www.edren.org website, possibly the most-read renal resource in the UK. Our info pages and also our protocols are read worldwide.
- Outstanding opportunities
- and it's a lovely place to live
Prospects: There are likely to be further consultant vacancies over the next decade as expansion of dialysis programmes continues. There are 15-18 training slots in Scotland based in one of 4 regions, so there should be an average of >3 vacancies in Scotland each year.
Part time training is possible and in some regions is quite common. There are more female trainees in nephrology than in most other acute specialties though most have trained 80-100% FT for the majority of their training. In South East Scotland, 6 of 10 full-time consultants are women.
Best aspects: Interesting patients and diseases, team work, and the remarkable opportunity to offer continuity of care over decades. It is extremely unusual to find bored or uninterested nephrologists – it’s a rewarding and varied job.
Worst aspects: Historically, fighting for and working with limited resources (staff, dialysis places), as nephrology has been underprovided. This has improved substantially and stability of patient numbers may be reached during your career.
Other aspects: Renal medicine has pioneered many novel approaches to deal with its particular problems – teaching patients to do complex treatments at home, sharing results very closely with patients, outcomes published by unit, bespoke IT systems to improve quality of care. You could write our iPhone application.
Desirable attributes: Must enjoy general medicine (the medicine, not the rotas). An enquiring mind. A reasonable to good academic record. You should be personable, and like other people. If you have these attributes you will not find it difficult.
Are the hours antisocial? Evenings and weekends tend to be busy but nights aren’t too bad. Most units have grown so that consultant rotas can be shared quite widely. Renal units always seem to have plenty of work to do.
Is it competitive to get into? On a scale of 0-10, about 7 but with wide local variation. Even in some teaching centres, a good CV and training may be enough, without need for an overly academic background.
Salary: Consultant salaries are now generous. There is very little private nephrology, and the majority of nephrologists consider that being free of this distraction is an asset.
Tips: Don’t be anxious about it. Try it. Early (FY1/2) experience is fine. Speak to people about the posts you might go for, including consultants, but remember that a ward-based FY/ST1-2 may see great general medicine but miss out on important aspects – such as clinics, healthy patients, long continuity of care.
Further information
- Applications for entry to training are handled through MMC Scotland. Short-term applications (LAT posts and similar) are handled by local deaneries and will be advertised by NES and possibly on the BMJ careers website.
- Further information about training - contact a nephrologist near you, or the relevant training programme director (see Trainers), or possibly they'll make it better, the Renal Association's Training pages (though they have been disappointly bad at keeping these up to date of late).
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