AMA, nephrology paint different pictures on workforce

Issue: August 2018

ByMark E. Neumann

In June, the House of Delegates for the AMA passed several resolutions during its annual meeting in Chicago. One called for taking steps to reduce the gender gap in physician compensation. The association estimates it is a $20,000 advantage, on average, for male physicians vs. female physicians.

Resolutions were also passed to address concerns regarding physician and medical student burnout, depression and suicide with efforts aimed at improving physicians’ access to mental health care services.

All those issues are important to today’s physician, including nephrologists. In fact, the American Society of Nephrology recently released a series of articles about identifying signs of burnout among nephrologists.

“As we worry about how to recruit residents into the field of nephrology, we need to consider how each resident is highly motivated to make the best career decision, not only for personal interests but also, for their health and family responsibilities,” John K. Roberts, MD, wrote in his article, “Burnout in nephrology: Implications on recruitment and the workforce.”

Roberts’ concern about recruiting residents into nephrology – an ongoing issue noted in past workforce studies done by ASN – seems in contrast to another AMA resolution released on June 13.

“Current data show that the number of U.S. medical student graduates is growing at a higher rate than the number of residency slots,” Karthik V. Sarma, MS, AMA board member and medical student, said in a press release. “Without expanding the number of residency positions available to future classes of medical school graduates, the number of graduates seeking positions will eventually exceed what is available.”

It would appear that the AMA has not reviewed the nephrology landscape recently, where the concern is finding medical students to fill residency slots. At its annual meeting a year earlier, it appeared the AMA was seeking support to expand residency slots.

“The AMA remains committed to expanding [graduate medical education] funding to ensure we train enough physicians to meet the nation’s changing health care needs,” Omar Z. Maniya, MD, AMA board member, said in a press release on June 14, during the AMA’s annual meeting.

In its most recent workforce report, released in October 2017, ASN painted a optimistic picture of engaging more student to pursue nephrology. Authored by researchers from the George Washington University Health Workforce Institute (GW-HWI), the “Report on the survey of 2017 nephrology fellows” is the latest in a series produced in collaboration with GW-HWI investigators.

“The job opportunities for new nephrologists have definitely improved over the past 4 years,” said lead researcher Edward Salsberg, MPA, in an ASN press release. “This is good news for the current fellows and for residents considering the specialty.”

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Other key findings from the report include:

anticipated salaries in 2017 were higher than in previous years with the median anticipated salary between $180,000 and $189,999 for all demographic groups (by internal medicine graduated status and sex);
a majority (71.8%) of fellows indicated they would recommend nephrology to current medical students and residents; and
the job market for U.S. medical graduates was significantly better than for internal medicine graduates, who represent a majority of the trainees.

However, the study also showed what medical students did not want as a nephrology resident, including weekend duties or frequent overnight calls, and wanted their job/practice in a desired setting. These appear to be important issues for the next generation of nephrologists. Can we resolve these to meet the demands of a growing ESRD population?