ASN panel suggests changes in transplant and home dialysis training for nephrology fellows

ORLANDO — Improvements in dialysis and home transplant training are among recommendations in a new American Society of Nephrology report aimed at increasing fellows’ interest in entering the specialty of nephrology.

The report, titled “Reinventing Nephrology Fellowship Training: Recommendations from the 2022 ASN Task Force on the Future of Nephrology,” includes 10 concepts to help increase fellowship recruitment in the specialty.

ASN said it received requests from the Accreditation Council for Higher Medical Education (ACGME) and the American Board of Internal Medicine (ABIM) earlier this year to provide perspective on the training program requirements. in nephrology and procedural requirements for initial certification. “These requests will have an impact on the future training of nephrologists”, according to the ASN website.

The ASN council responded with a request for 8 months to rethink “all aspects of the future of the specialty of nephrology”. An interim report was released earlier this year for comment; the final report and recommendations were presented during ASN kidney week.

Stakeholders

The task force received input from multiple stakeholders to compile the recommendations, including representatives from ABIM and ACGME, the ASN Membership and Training Committee (WTC), patients with kidney disease, nephrology fellows, nephrology training programs, private practice nephrologists and others, according to ASN.

“The task force took a data-driven approach to the current state of nephrology education and practice that includes data from the ABIM survey of procedural requirements of graduates; ASN’s WTC Procedural Requirements Investigation; and reports from the ASN Data Resource Center regarding the current and future workforce, nephrology practice patterns and colleagues’ assessments of educational needs,” according to ASN. Mark E. Rosenberg, MD, FASN, from the University of Minnesota, is the chair of the task force.

The working group agreed on guiding principles for formulating recommendations, including that the report provide the following:

• fair, equitable and high-quality care for patients with kidney disease;

• the value of nephrology as a specialty to nephrologists, the future nephrology workforce, the health care system, the public and government; and

• innovation and personalization of nephrology education throughout medical education.

Competency-Based Education

The recommendations, developed by Rosenberg and an eight-member committee, include the following:

• improve competency-based training in nephrology;

• establish individualized pathways to achieve career goals;

• emphasize personalized care;

• reconsider procedural training expectations;

• address gaps in current nephrology training;

• promote the well-being of nephrology fellows;

• prioritizing diversity, equity, inclusion and justice in health care;

• ensuring equal opportunities for all nephrologists;

• promote interprofessional and interdisciplinary practice; and

• inspire lifelong learning.

Recommendations, such as creating individual pathways to achieve career goals, touch “on the whole concept of personalized medical education, which is gaining momentum,” Rosenberg said. “Leveraging the second year of scholarship to go beyond Level 1 skills is the goal. We have identified several areas where we believe more individualized training can be achieved.

Rosenberg said it can also include educating fellows who want to focus on public policy or business training.

Likewise, improving training on modality options is important, Rosenberg said. “One area that we believe needs strengthening is the ACGME program requirements, particularly around home dialysis,” Rosenberg said. “It’s an area that’s not really robust.”

More information on the report is available at www.asn-online.org/FutureOfNephrology .

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American Society of Nephrology Annual Meeting