Pediatric Nephrology Training Worldwide 2016: Quantum Educatus?

To the Editor: Pediatric nephrology training is, by necessity, extensive. Pediatric nephrologists typically care for highly complex patients in tertiary academic medical centers, where they provide consultation and direct care to inpatients and outpatients and provide vital services to critically ill children. In most settings, practicing pediatric nephrologists also teach medical students, pediatric trainees, and nurses. Preparing neophyte pediatric nephrologists requires extensive education and experience in both inpatient and outpatient settings, as well as exposure to research, research methods, and faculty development. A high degree of perceived workforce inadequacy and difficulty recruiting pediatric nephrology trainees exists in most regions of the world. Concern about workforce adequacy in the United States has generated a discussion as to whether offering a shortened 2-year clinical track, as in adult nephrology, would increase the number of fellowship applicants. There is considerable tension, however, between meeting clinical training needs and the desire for pediatric nephrologists to be trained in research, since most work in academic settings. Requirements for qualification as a pediatric nephrologist vary from country to country. This report is a “snapshot” of requirements for training and certification for pediatric nephrologists around the world as of the beginning of 2016. This report also contains data on the opinions of U.S.-trained pediatric nephrologists on the value of a 2-year versus a 3-year fellowship.