The Fellowship Training Horizon
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The Fellowship Training Horizon

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  • I will try to work on the data to determine how this compares to other specialties.

The Fellowship Training Horizon The Fellowship Training Horizon Presentation Transcript

  • Pediatric Nephrology The Fellowship Training Horizon John D Mahan, MD Nationwide Children’s Hospital The Ohio State University
  • Objectives
    • Define the number of Pediatric Nephrologists in US and distribution by age and geography
    • Define the trends in Pediatric Nephrology Trainees from 1998 to present
    • Define the ABP board pass rates for Pediatric Nephrology Fellow Graduates
    • Define three obstacles to increasing the number of trainees in Pediatric Nephrology
  • Pediatric Nephrology ABP Certified Diplomates Age Distribution 29.2% > 60 years old Total = 631 Avg Age= 56.3 years
  • Number of ABP Certified Nephrology Diplomates by State
  • ABP Number of Diplomate Certificates Granted through 12/06
    • Total General Pediatricians 87,515
    • Pediatric Subspecialties 17,490
      • Adolescent Medicine 505 2.89%
      • Cardiology 2015 11.52%
      • Critical Care Medicine 1454 8.31%
      • Developmental-Behavioral 520 2.97%
      • Emergency Medicine 1446 8.27%
      • Endocrinology 1055 6.03%
      • Gastroenterology 872 4.99%
      • Hematology-Oncology 2051 11.73%
      • Infectious Diseases 992 5.67%
      • Medical Toxicology 31 0.18%
      • Neonatal-Perinatal Medicine 4421 25.28%
      • Nephrology 668 3.38%
      • Neurodevelopmental Disabilities 241 1.38%
      • Pulmonology 821 4.69%
      • Rheumatology 237 1.36%
      • Sports Medicine 120 0.69%
      • Transplant Hepatology 41 0.23%
  • Pediatric Nephrology Job Market
    • Number of open positions in US is unclear
    • If all BC pediatric nephrologists > 60 retire in the next 10 years, will need 189 replacements (19/yr)
    • Growth in need for pediatric nephrology services?
  • Number of Pediatric Residency Programs and Residents (end June 30, 2006) - AAP Source: Accreditation Council for Graduate Medical Education, 2005. 2 10,529 859 Total 181 51 Pediatric Gastroenterology 51 26 Developmental-Behavioral Pediatrics 191 67 Pediatric Endocrinology 12 8 Pediatric Sports Medicine 238 45 Pediatric Emergency Medicine 49 25 Pediatric Rheumatology 300 60 Pediatric Critical Care Medicine 118 46 Pediatric Pulmonology 276 48 Pediatric Cardiology 95 35 Pediatric Nephrology 525 97 Neonatal-Perinatal Medicine 165 62 Pediatric Infectious Diseases 72 25 Adolescent Medicine 320 60 Pediatric Hematology-Oncology 7936 204 General Pediatrics # of Matched Residents # of Accredited Programs Specialty/ Subspecialty # of Matched Residents # of Accredited Programs Specialty/ Subspecialty
  • Pediatric Nephrology Fellowship Programs
    • 2008 - 36 accredited programs in US
    • 150 approved training positions
    • 105 trainees (70% filled)
    ACGME.org/adspublic/ 4/4/08
  • Pediatric Nephrology Fellowship Trainees
  • Pediatric Nephrology All Fellowship Trainees
  • Nephrology Trainees Lost
  • Pediatric Nephrology All Fellowship Trainees 191% increase
  • Pediatric Nephrology Fellowship Trainees
  • Pediatric Nephrology Fellowship Trainees
  • ABP Data Total Fellows in Training 1998-2006
  • ABP Pediatric Nephrology Board Results
  • ABP Pediatric Subspecialty Board Results
  • Drop-out/Replacement Issues
    • 1999-2005: We qualified 139 board certified nephrologists out of 187 eligible third year fellows (74% of third years take and pass the exam).
    • We lose people at each stage – the reasons are not known and likely vary.
    • Overall, approximately 45-50% of 1 st year fellows become board certified pediatric nephrologists.
    • If all currently certified nephrologists > age 60 (n=196) retire in the next five years, we need to produce approximately 40 new successful graduates/year.
    • In 2005 there were 52 candidates who took the Boards (26/year).
  • Pediatric Nephrology Fellowship Training Challenges
    • Pool of qualified applicants
    • Funding
    • Costs of program (fellow salary, administration, teaching, etc)
    • Shared training experiences
    • Shared program content
      • Curriculum
      • Competency assessments
      • Board preparation
    • Training tailored to career needs
    • PD Support
    • Future efforts – ASPN, ASN