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Last Updated: 03/17/15

Nephrology Career Guide

Job Description

A physician who specializes in nephrology is highly trained in the diagnosis and treatment of diseases and conditions that involve or affect the kidneys. While nephrologists evaluate the kidneys and determine the best treatment and management for kidney disorders, they do not perform any of the surgeries their patient may receive. If a patient needs a transplant, their nephrologist will typically participate in the patient’s care after surgery, including administering antibiotics or anti-rejection drugs. Nephrologists are often consulted by a patient’s primary care physician when they suspect there to be an abnormality with the functioning of the kidneys. They will then evaluate and plan treatment or prevention which can be anything from just a special diet or medications that can slow kidney disease to a full kidney transplant.

Nephrologists also recommend dialysis as a treatment method for kidney disease. While this treatment does not cure kidney disease it can significantly increase quality and length of life. Other forms of treatment might include diathermy machines, catheters, radium emanation tubes or cystoscopes.

Most nephrologists work very long hours. In fact, working 60 to 70 hours a week is pretty common in this field. They often work rotating shifts and spend a significant portion of time on call. It is also common for nephrologists to work nights and weekends in order to accommodate the schedules of their patients. While a large portion of a nephrologist’s typical day is spent with patients and rounding, they also generally spend a significant amount of time doing paperwork for their cases.

Depsite the long work hours, nephrologists have a very high rate of marriage. In fact, in a 2012 Medscape survey on lifestyle, 85% of nephrologists said that they were married. This was the highest rate of all physician specialties that were polled, and higher than the marriage rate for the general US population. They also had the lowest percentage of divorce and separation. The same survey showed that nephrologists ranked their happiness with an average of 3.9 on a scale of 1 to 5 with 5 being the happiest.

Nephrology Training Requirements

In order to become a nephrologist you must complete a four year medical school program and then a two year residency in internal medicine. Before going on to a two to three year fellowship in nephrology you must also pass the American Board of Internal Medicine (ABIM) certification. After or during your fellowship you will need to become licensed, which is done by taking the Nephrology Certification exam given by the ABIM. You also will have to pass the United States Medical Licensing Examination (USMLE), which all physicians must pass before practicing medicine.

Nephrology Salary

According to a 2012 compensation report published by Medscape, nephrologists earned an average annual income of $209,000, which was a little lower than it was in 2011. The survey also found that nephrologists sit somewhere in the middle among all medical specialties as far as earnings are concerned. What you make as a nephrologist can depend on what region of the country you work in and what type of facility you work in, as those in private practices generally make more money. The Medscape survey showed that about 27% of nephrologists who responded earned more than $250,000, while 11% earned less than $100,000.

Job Outlook

The job opportunities for all physicians is projected to increase 14% through 2016 and the growing population will no doubt lead to an increased need for the specialized services of nephrologists. Also, there is expected to be significant increase in the amount of physicians retiring as the baby boom generation hits retirement age. This will leave many job openings for well-trained nephrologists. The skills that nephrologists have make them highly in demand in hospitals all over the country.


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