Nephrologists have a major role in the care of patients with kidney disease. As a nephrologist you will be involved in the care of patients throughout their chronic kidney disease journey through the various stages of chronic kidney disease including the possibilities of dialysis, transplantation and conservative care. A nephrologist is required to have a team approach to the care of patients with kidney disease and to be able to work with specialist nursing staff and allied health. Nephrologists are also involved with patients in the acute care setting including managing complex acute kidney injury, acute kidney transplantation and other inpatient work.
The scope of work for a nephrologist can include:
- Acute kidney injury
- Acid-base disturbances
- Electrolyte imbalances
- Chronic kidney disease medical management
- Resistant hypertension
- Kidney transplant assessments
- Kidney donation assessments
- Adolescent chronic kidney disease transition
- Obstetric medicine involvement
- Renal genetic clinics involvement
- Interventional nephrology (kidney biopsies, insertion of PD catheters or central acces for dialysis)
- Research opportunities
- Conservative care management
- Consultative service to other inpatient or outpatient services
- Teaching activities in larger metropolitan hospitals
A privilege of working as a nephrologist is getting to know patients and their families over the course of their chronic kidney disease. The work of a nephrologist is very varied and typical days may include clinic outpatients, inpatient rounds, undertaking research activities, communicating with multidisciplinary teams and other specialties.
Nephrologists also work in many private settings including public and private hospitals in large metropolitan centres and regional areas.
As a nephrologist you will generally:
- be motivated to look after patients with chronic disease
- have an interest in human biology, physiology and immunology
- have good communication skills
- be able to work within a team setting
- enjoy working in a complex medical field.
The pathway to enter nephrology training is via the physician training pathway. Applicants are able to apply immediately after internship for basic physician training. Trainees once accepted into the basic physician training program undertake three years of attachments to different subspecialty medical units and general medical attachments in metropolitan settings. In the third-year trainees undertake a written exam and if successful are eligible to sit the clinical examination.
After passing the clinical exam applicants can apply to be accepted into the WA nephrology training program.
Advanced training in nephrology is usually a minimum of three years, with many trainees spending 6-12 months in complementary specialties, such as ICU, palliative care, immunology, endocrinology, and clinical genetics. Many trainees will also undertake out of program time to complete a higher degree.
Chronic kidney disease is growing in prevalence in Australia and there is a significant demand for skilled nephrologists. Nephrologists have the opportunity to work in the public and private setting and in both metropolitan and rural areas. Nephrologists can subspecialise in areas such as transplantation, dialysis, autoimmune diseases, and conservative care or remain general.