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Career OverviewNephrology or renal medicine is concerned with the care of patients suffering from all forms of kidney disease, with or without impairment of kidney function. There is some overlap with the specialty of urology, which encompasses malignancy of the renal tract and other surgical conditions. Nephrologists are also called on to care for renal transplant recipients, in both post-operative care and in long-term follow-up. Paediatric nephrologists specialise in caring for children with renal disease.
Within this specialty, there is a strong emphasis on prevention and early detection of kidney disease. Early detection minimises the chances of kidney failure, and requires collaborative working between nephrologists, primary care, and other specialities like diabetic medicine and hypertension.
Nephrologists deal with a wide variety of conditions, primarily in clinical practice. The specialty combines a problem solving approach with the need for human understanding. Nephrologists care for patients with renal, hypertensive, immunological and metabolic disorders, as well as dialysis and transplantation. A major part of their work is renal replacement therapy by dialysis or kidney transplantation.
There is an increasing number of patients receiving renal replacement therapy, with treatment is now available to anyone who needs it. Multi-specialty coordination can be very important to successful treatment. Nephrologists may work closely with transplant surgeons, specialist nurses and other clinical and laboratory health professionals.
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Career RequirementsAspirants to the specialty of nephrology must first be registered with the General Medical Council (GMC), and go through six to eight years of general postgraduate medical training, depending on the specialty.
After successfully completing formal type 1 programme training, the candidate is awarded a Certificate of Completion of Specialist Training (CCST).
Trainees are required to complete at least two years of General Professional Training (GPT) in approved Senior House Officer (SHO) posts, including at least six months of acute unselected medical take. In many cases, trainees will spend more than two years at the SHO grade in order to broaden their experience. This is also the period in which the trainee obtains the MRCP (UK) examination or equivalent. The nephrology physician requires a MRCP or equivalent.
This results in eligibility for higher medical training, which takes at least four years.
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Job OutlookThe career outlook for nephrology is very encouraging. Trainees are encouraged to perform research towards a higher degree in order to gain many Consultant posts. Many trainees obtain an additional MD or PhD. The number of SpR posts is expected to increase, but entry is still competitive.
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Career TrackTrainees in nephrology may be attracted by the challenges and satisfaction of managing acute renal failure and kidney transplantation. They must also spend much of their time looking after patients with chronic renal failure or on dialysis, which can be both rewarding and frustrating.
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CompensationGeneralist salaries range from £20,741 to £25,882, while those in specialist training in nephrology medicine may earn between £29,000 and £44,000.
Senior level salaries can range from £50,000 to £76,000, and full time consultants can earn between £70,000 and £94,000 per year.
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