The 2016 match for nephrology was just released. This is the
first year following the ALL-in policy for the nephrology match. Clearly, this
is a great way to benefit the candidate and the candidate get’s to see all
programs and ranks based on their choice.
ASN just released the key points that the match data
There was a increase in programs
(18%) and positions certified in the match.
Well this is because it was an ALL IN process so most programs
participated. No big deal.
The number of matched fellows
increased—great! That is good news but this doesn’t imply increased interests.
The number of applicants rose
11%- Perhaps reflection that we had ALL –in process and last few years-we never
saw those candidates data. Since both the numerator and the denominator
increased- we are counting candidates that we hadn't accounted for years ago.
Not really an improvement!!
Slight uptick in USA grads
applying and major down trend in IMGs applying- big loss as they were the main
stay for nephrology workforce last few years.
Unfilled positions rose to a new
high 58%-- biggest bummer of this process
More US grads. More overall applicants(
skeptic on that one as data is now due to ALL-in)
Still many more unmatched spots and programs.
There are programs in the country unmatched 100%.
While increasing interest in med school and
residency is important and critical- clearly it is NOT working at a national
level. At the end of the day,
re-imbursement of nephrologists calls the shots. We need to really push hard on the
government level for more reimbursement for renal physicians. A shortage will happen eventually, there will
be a major medical need crisis and then hopefully there will be an uptrend in
the salaries of nephrologists—even that is a dream in never never land.
What are programs going to do? Many programs
fear- "they might be next." Downsizing fellowship spots is
an option and perhaps hiring physician assistants to help out with day to day
duties. Researchers will be asked to
more clinical time, clinical educators will have to more clinical time and
teach less--- all trickling down to less innovation and research in nephrology
and less time with trainees.
Applicants to research positions are down-trending.
This means that pure clinical fellowships that are big university centers( 2
year)- will fill. The ones that won’t
will be large research positions and or small community programs(
perhaps). Perhaps programs need to cater
towards what the applicants want out of a renal fellowship-- times have changed( Nephrology was not what it was 20 years ago).
Time will change this. As any ups and downs
in an economy- there will be eventually a shortage of nephrologists as this
trend continues and eventually, there will be an upswing.
Clearly, I am being schizophrenic in this post but I am happy and sad with these results.
Clearly, the national strategy we have might
not be working. We need to all put our
heads together( both academic and private nephrologists) to really come up with
OUT of box ideas to change this trend.
It’s a call for HELP and we need it soon!