ASN panel suggests changes in transplant, home dialysis education for nephrology fellows
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ORLANDO — Improvements in training in home dialysis and transplant are part of the recommendations in a new report from the American Society of Nephrology aimed at increasing interest among fellows to enter the specialty of nephrology.
The report, entitled “Reimagining nephrology fellowship training: Recommendations from the 2022 ASN task force on the future of nephrology,” includes 10 concepts to help increase recruitment of fellows to the specialty.
ASN said it received requests from the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Internal Medicine (ABIM) earlier this year to provide a perspective on nephrology fellowship training program requirements 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 reconsider “all aspects of the future of the specialty of nephrology.” An interim report was released earlier this year for comments; the final report and recommendations were presented at ASN Kidney Week.
Stakeholders
The task force received input from multiple stakeholders to compile the recommendations, including representatives from ABIM and ACGME, the ASN Workforce and Training Committee (WTC), patients with kidney diseases, nephrology fellows, nephrology fellowship training programs, private practice nephrologists and others, according to the ASN.
“The task force took a data-driven approach to the current state of nephrology training and practice that includes data from the ABIM Procedural Requirements survey of diplomates; the ASN WTC procedural requirement survey; and the ASN Data Resource Center's reports regarding the current and future workforce, nephrology practice patterns and fellow assessments of educational needs,” according to the ASN. Mark E. Rosenberg, MD, FASN, of the University of Minnesota, is the task force chair.
The task force agreed upon guiding principles in formulating the recommendations, including that the report provide the following:
- just, equitable and high-quality care for patients with kidney diseases;
- 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 across the scope of medical training.
Competency-based education
The recommendations, developed by Rosenberg and an eight-member committee, include the following:
- enhance competency-based nephrology education;
- establish individualized pathways to meet career goals;
- emphasize personalized care;
- reconsider expectations for training in procedures;
- close gaps in current nephrology training;
- promote the well-being of nephrology fellows;
- prioritize diversity, equity, inclusion and health care justice;
- ensure equal opportunities for all nephrologists;
- foster interprofessional and interdisciplinary practice; and
- inspire lifelong learning.
The recommendations, such as creating individual pathways to meet career goals, get “to the whole concept of personalized medical education, which is gaining momentum,” Rosenberg said. “Leveraging the second year of fellowship to go beyond level-1 competency is the goal. We’ve identified several areas where we believe more individualized training can be achieved.”
Rosenberg said that can also include education for fellows who want to focus on public policy or business training.
Likewise, improvement in training on modality options is important, Rosenberg said. “One area that we believe needs strengthening is the ACGME program requirements, particularly in home dialysis,” Rosenberg said. “This is an area that is not real robust.”
More information on the report is available at www.asn-online.org/FutureOfNephrology .
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Rosenberg M, et al. Reimagining nephrology fellowship training: Recommendations from the 2022 ASN task force on the future of nephrology. Presented at: ASN Kidney Week; Nov. 3-6, 2022; Orlando (hybrid meeting).
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