The changing face of nephrology

Projected requirements for nephrology physicians indicate a need for an increase in the number of nephrology trainees. In addition, government regulations are creating the climate to diminish the entry of international medical graduates into all residency programs. To meet the needs of renal patients, especially those with end-stage renal disease, and such areas of growth as nephrology research, more US medical graduates, particularly women and members of minority groups, will have to select nephrology as a career. This article discusses issues that this challenge raises for the specialty, including the impact on patient care, mentoring, and the use of nonphysician clinicians.