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Starting in 2012, the subspecialty match for positions starting in was moved to December, just 6 months prior to the start date july. This change generated issues among nephrology training curriculum directors about reductions in applicant numbers. This subset of applicants may be particularly vulnerable if they fail to match as nephrology has a high proportion of international medical graduates,10 many of whom have J-1 visas. Appropriately, they may select visa waiver roles, which are available early in the day within the scholastic year than the match, hence postponing subspecialty training. Preliminary information from the 2013 match suggest that a reduced quantity of applicants resulted in a growth in unmatched nephrology roles.12 This may be the evidence that is first of decrease in applications from international medical graduates, which supports the concern of nephrology program directors,13 or may mirror a broader reduction in applicants to any or all subspecialty fellowships.

What do other data tell us about nephrologists' choices? Garibaldi et al5 and West et al8 both stated that nephrologists value long-term patient care. Redesigning nephrology rotations for pupils and residents to incorporate contact with office that is ambulatory and dialysis continuity may allow trainees to see these rewarding aspects of our specialty.1, 14 One Canadian study noted that intellectual stimulation had been deemed very important for several medication residents selecting subspecialties7 as well as for those choosing academic training.15 On the other hand, Jhaveri and colleagues9 report this one concern of other subspecialty fellows was the perception that nephrology matter that is subject hard. Correctly, the stress in recruiting to nephrology rests between recognizing the discipline's intellectual challenge and choosing to work in a field that is difficult. This stress requires that instructors of renal pathophysiology and nephrology that is clinical clear while making the control more available. Particularly, the breadth of written content, which spans acid-base disorders, glomerular conditions, dialysis, and transplantation, requires these instructors to determine themes and unifying concepts both within the class and in the clinic.
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