Pediatric nephrology 2006

Article Outline

• Copyright

This issue of The Journal contains another in an ongoing series of workforce data reports from the American Board of Pediatrics. This report addresses pediatric nephrology. With less than 500 diplomats, nephrology is one of the smaller pediatric subspecialties. While the overall pediatric nephrologists-to-children ratio (per 100,000) in the US is 0.6, this measure varies widely with geography. Six states have ratios over 1.0, but another six have no nephrologists.

Over the past nine years, during which time the number of nephrology trainees has nearly doubled, the data show that the specialty has followed a couple of demographic trends. The number of women in nephrology training programs has risen from less than half to nearly two-thirds of fellows. In parallel, graduates of American medical schools now occupy two-thirds of training positions, up from one third nine years ago.

These data provide complete, reliable information, although they have limitations acknowledged by the authors. First of all, no one purports to know the “ideal” number of pediatric nephrologists (or, indeed, pediatricians) that the population needs. Our Canadian friends seem able to deliver quality care with far fewer pediatric subspecialists than we.

A further complicating factor is brought on by the increasing representation of women in the field. These data make no distinction between full- and part-time practitioners. Although there is a general sense that women are overrepresented in the latter group, there are no reliable numbers to support this. Consequently, these and similar reports cannot provide us with information on the numbers of “full-time equivalent” physicians in any field.