Is There a Nephrologist in the House?
Lackluster Interest Among U.S. Fellows and Government Restrictions Could Spell Disaster for Nephrology Specialty By Martin H. Osinski and Michael J. Kirschner Introduction After years of hearing about having the highest mortality rate in the world, renal care in the United States finally received some good news this year, courtesy of the l997Annual U.S. Renal Data System Report. It appears that the incidence rate, or new starts for patients on dialysis, is decreasing. And, patients who are on dialysis are showing improved survival rates from years past. Changes in the dialysis prescription-better KtlVs, hematocrits, and longer dialysis times may be having an impact. While the news presents a brighter picture of U.S. renal care, it creates a dilemma for the nephrologists in charge of caring for patients now on dialysis. The fellowship programs in this country are not producing enough nephrologists to meet current or future needs. There is a lack of interest among internal medicine resid
