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How to Become a Nephrologist in 2023

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by Blen Tesfu in Residency

Do you want to know how to become a nephrologist? Are you interested in a medical career that provides not only patient care but also offers unique opportunities for medical research and is also in high demand?

If so, a nephrologist career may be the perfect choice for you. In this blog post, I will explain what a nephrologist does and how to become one, even if you’re only in high school.

Summary:
  • Nephrologists are doctors that specialize in treating conditions related to the kidney.
  • Nephrology is a sub-specialty of internal medicine. Internal medicine residency training is three years, in addition to 2 more years in a nephrology fellowship with an optional third year.
  • Going to a top medical school may help a bit. However, how you do on your USMLEs (Board) scores and in your med school class ranking will matter more.
  • Non-PhD degrees like MBAs and MPHs appear to have no advantages or disadvantages to becoming a nephrologist

Table of Contents

What Are Nephrologists?

Nephrologists are medical doctors who specialize in treating and managing kidney-related diseases. The kidneys are an essential part of the body, and they are responsible for filtering waste products and excess fluids from the blood. Nephrologists specialize in the anatomy and physiology of the kidneys and use that knowledge to diagnose and treat conditions related to them.

Nephrologists work with other healthcare providers to develop comprehensive treatment plans for patients. These include primary care physicians and surgeons.

Is a Nephrologist a Doctor?

Are nephrologists doctors? The answer to this question is yes; nephrologists are medical doctors.

A nephrologist is a specialized physician who has completed medical school, residency in internal medicine, and fellowship in nephrology. During this time, nephrologists train to care for and manage patients with kidney conditions.

Nephrologists vs. Urologists: What’s the Difference?

Nephrologists and urologists are both medical specialists who treat conditions related to the kidneys. But they have different areas of expertise.

Nephrologists are physicians who specialize in the treatment and management of kidney-related conditions. Nephrologists specialize in diagnosing, treating, and managing conditions that affect the kidneys, as well as helping patients manage and prevent kidney disease through lifestyle changes and medication management.

Urologists specialize in treating conditions affecting the urinary tract. The urinary tract includes the kidneys, bladder, ureters, and urethra. Urologists treat many conditions, including kidney stones and bladder and prostate problems. They often perform surgical procedures to treat these conditions.

In summary, nephrologists focus on the kidneys, while urologists treat a wider range of conditions affecting the urinary tract. Both specialties work together to diagnose and treat kidney-related conditions and often collaborate on patient care.

How Long Does It Take To Become a Nephrologist?

Becoming a nephrologist is no easy feat and requires considerable time and energy. But if you’re up to the challenge, the results can be gratifying.

Becoming a nephrologist takes a minimum of 13 years after high school. That includes four years of undergraduate education and four years of medical school, three years of internal medicine residency, and followed by two years of fellowship in nephrology. Along the way, you’ll have to take various standardized exams, including the SAT, the MCAT, and the USMLE Step 1 and Step 2 CK.

Undergraduate (4 Years)

The first step to becoming a nephrologist is entering and completing an undergraduate program. This means taking the SATs and doing well enough to be accepted into a college or university. Once accepted into an undergraduate program, you’ll have to complete a minimum of four years of academic coursework. This includes classes in biology, chemistry, physics, English, and other general education courses.

Medical School (4 Years)

The next step is to take the MCAT, a standardized exam that measures your knowledge and skills in biology, chemistry, physics, and psychology. You’ll need to score well on the MCAT for med school acceptance.

You’ll have to complete four years of academic and clinical training during medical school. This includes classes in anatomy, physiology, pharmacology, pathology, and other medical topics. You’ll also have to complete clinical rotations at hospitals and other healthcare facilities to gain hands-on experience.

Internal Medicine Residency (3 Years)

After you’ve completed medical school, you’ll have to match into an internal medicine residency. To do this, you’ll have to take the USMLE Step 1 and Step 2 CK exams. These exams measure your knowledge and skills in the areas of clinical medicine. Once you’ve passed these exams, you’ll be eligible to apply for residency.

Once matched, you’ll have to complete three years of clinical training to become an internist.

Fellowship (2 years with an optional third year)

Further training in a specialized area of nephrology after completing your internal medicine residency. Nephrology fellowships allow physicians to gain subspecialty expertise in kidneys. You may add another year to your fellowship to get more transplant or interventional nephrology training.

After Nephrology Fellowship: Licensing + Board Certification

As stated by the American Board of Internal Medicine or the American Osteopathic Association, nephrologists applying to take the board certification exam must be AOA board-certified internal medicine specialists. And must have completed two years of an ACGME Accredited or AOA-recognized fellowship program in Nephrology.

Becoming a nephrologist takes a minimum of 13 years after high school. It’s a long and arduous process, but if you’re dedicated and passionate about becoming a nephrologist, the rewards are worth it.

How Competitive is it to Become a Nephrologist?

The specialty required to become a nephrologist, internal medicine, is a less competitive specialty in matching into a residency program. Each year, thousands of hopeful medical school graduates apply for a limited number of positions in their preferred specialty. The Match system, run by the National Resident Match Program (NRMP), pairs applicants with training programs based on their preferences.

But how competitive is internal medicine in the US? To answer this question, it is important to look at the unmatched rates of US seniors by specialty. The unmatched rate refers to the percentage of US seniors who applied for a residency program in that specialty but did not get matched. It considers each applicant’s first-choice specialty. So, if you applied to a different specialty as a “backup” but didn’t match because you matched in your first choice, this wouldn’t be included. To learn more about how to maximize your chances at a dream residency through “The Match,” see this article.

In the 2022 Match, graduating US medical school seniors attending MD schools had a 2.0% unmatched rate to internal medicine. This makes it a less competitive specialty, unlike other specialties like plastic surgery (unmatched % 37.3%), orthopedic surgery (34.2%), or otolaryngology (sometimes called “ENT” for ear-nose-throat; 30.8%).

For more on the competitiveness of internal medicine relative to other medical specialties, see this article.

Nephrologist Annual Compensation

Salary is an important factor when considering your future in a specialty. Nephrologists have an average annual salary of $329,000. However, this can vary dramatically based on practice setting, specialty training, and experience level.

Nephrologist Annual Salary

Nephrologists make $329,000 per year on average

How Much Do Nephrologists Make an Hour?

You may also be wondering, how much do nephrologists make per hour? And how is the balance between time inside vs. outside the hospital for the specialty?

While there aren’t perfect data, we’ve compiled data re: hours/weeks worked and annual salary for various specialties, including nephrology.

Here are the data:

Average Annual SalaryAverage Hourly SalaryOn-Call ScheduleHours/WeekAvg Weeks Worked/Year
Allergy/Immunology$298,000.00$125.9349.3
Anesthesiology$405,000.00$146.24Medium6145.4
Cardiology$490,000.00$177.5457.5
Critical Care$369,000.00$114.9166.9
Dermatology$438,000.00$211.11Low45.445.7
Diagnostic Radiology$437,000.00$170.46Low5844.2
Emergency Medicine$373,000.00$169.59Medium46.447.4
Endocrinology$257,000.00$110.40Medium48.5
Family Medicine$255,000.00$101.85Medium52.647.6
Gastroenterology$453,000.00$168.53Medium5647.7
General Surgery$402,000.00$141.88High59.447.7
Infectious Diseases$260,000.00$101.44High53.4
Internal Medicine$264,000.00$100.81Medium54.947.7
Interventional Radiology$437,000.00
Nephrology$329,000.00$122.40Medium56
Neurological Surgery (Assistant Prof. Median)$600,500.00$214.96Medium58.2
Neurology$301,000.00$129.09Medium50.845.9
Obstetrics and Gynecology$336,000.00$123.26Medium5847
Oncology$411,000.00$143.43Low59.7
Opthalmology$417,000.00$173.97Medium5147
Orthopaedic Surgery$557,000.00$207.91Medium5747
Otolaryngology$469,000.00$184.01High53.148
Pathology$334,000.00$147.74Low47.1
Pediatrics$244,000.00$108.16Medium4748
Physical Medicine and Rehabilitation$322,000.00$147.7645.4
Plastic Surgery$576,000.00$230.77Medium52
Psychiatry$287,000.00$131.04Low46.547.1
Pulmonary Med$353,000.00$119.77Medium61.4
Radiation Oncology (Assistant Prof. Median)$393,734.00$158.36Low51.8
Rheumatology$289,000.00$112.3353.6
Urology$461,000.00$172.49High58.146
Total Average$381,233.35$147.4453.9

And the estimated physician salary per hour by specialty (nephrology highlighted in red):

Nephrologist Hourly Salary

Nephrologists make $122 an hour on average

Note: when data were unavailable for weeks worked per year, 48 weeks was used as an estimate to calculate the estimated hourly salary.

Getting AOA (Med School Honors) Helps in Becoming a Nephrologist

Medical school is one of the most challenging aspects of becoming a doctor. Many medical schools have established Alpha Omega Alpha (AOA) branches to recognize top students’ hard work and dedication.

Alpha Omega Alpha (AOA) is the medical school honors society for students who excel in their studies and demonstrate an exemplary commitment to professionalism and leadership. Each medical school may elect up to 20% of their graduating class to be inducted into AOA.

Induction into AOA is a prestigious honor that carries with it a variety of benefits. AOA members may be eligible for special scholarships and fellowships and can often receive priority consideration for residency positions.

The AOA advantage is particularly notable for the most competitive fields and/or residency programs. The 2022 Match data showed that the match rate for US medical school seniors with AOA membership was 2% greater than that of US seniors without AOA membership in internal medicine. In other words, AOA membership provided a modest advantage to matching into an internal medicine residency.

AOA Membership Advantage for Internal Medicine 2022

AOA membership correlated with a 2% match rate advantage for Internal Medicine in the 2022 Match

See this article for more on AOA medical schools and the importance of class rank for matching.

Do You Need to Attend a Top School to Become a Nephrologist?

When pursuing a career in internal medicine, a specialty required before a fellowship in nephrology, attending a top medical school can make a difference in matching into your desired specialty. According to a survey of program directors, over half of those surveyed reported considering applicants’ med school reputation when considering whom to interview, giving it an importance score of 3.8 out of 5.

Moreover, graduating from a school in the top 40 for NIH funding is associated with a 1% increase in the likelihood of matching into internal medicine as a field. This is potentially because top medical schools have more resources and access to clinical experience, which can help prepare students for the rigors of the specialty.

That said, it is important to remember that the name of the school alone does not guarantee success in any field. While attending a top medical school may have advantages, it is ultimately up to the individual to make the most of the opportunities presented. And while there is an advantage to being from a more prestigious institution, one’s record at the school will matter much more, including things like USMLE scores, class rank, and letters of recommendation.

Top 40 med school Internal Medicine match 2022

Graduating from a medical school ranked in the top 40 by NIH funding correlated with a 1% match rate advantage for Internal Medicine in the 2022 Match

Does an MPH or MBA Help You Become an Internist?

Medical training is long and arduous. Remarkably, many students consider completing other degrees before, after, or even while pursuing their medical studies. Degrees such as Master of Public Health (MPH) and Master of Business Administration (MBA) may seem attractive to potential internal medicine residents due to their additional qualifications. But do these additional degrees give applicants an edge in the residency application process?

The truth is that having an additional degree may not matter as much as one thinks. We crunched the numbers on the match rate for graduating students from MD schools for those with non-PhD other degrees vs. those that did not have a second degree. In internal medicine, the match rate was 0% (no advantage) for those with degrees like an MPH or MBA. This implies that having a second degree that isn’t a Ph.D. doesn’t appear to either help or alter your chances of matching into internal medicine.

Internal Medicine other degree MBA MPH advantage 2022

Having another degree like an MBA or MPH correlated with a 0% match rate disadvantage for Internal Medicine in the 2022 Match

It’s important to note that this study only looked at the overall match rates of medical students with another degree. The data doesn’t look at the type of degree, the school it was obtained from, and the quality of the applicant’s experience and credentials.

Having a second degree could open up some additional career opportunities. For instance, having an MPH or MBA may prove beneficial for those looking to go into healthcare administration or research.

Concluding Thoughts

Becoming a nephrologist is a challenging but rewarding career path. It is perfect for those who love kidney physiology, problem-solving and working as part of a team in renal-related situations. With hard work, dedication, and a desire to help others, nephrologists can make a real difference in the world of healthcare.

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