Abstract: SA-PO006
A Unique Hybrid Nephrology Training-Hospitalist Medicine Track: The University of Kentucky Experience
Session Information
- Educational Research
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 800 Educational Research
Authors
- Khasawneh, Faris, University of Kentucky, Lexington, Kentucky, United States
- Webb, Jon C., University of Kentucky Medical Center, Lexington, Kentucky, United States
- Sawaya, B. Peter Emile, University of Kentucky Medical Center, Lexington, Kentucky, United States
Background
There has been a declining interest in nephrology training as evidenced by a decline in the number of applicants and increased number of unfilled positions through the Match. On the other hand, hospitalists are a growing group of physicians with some gaining mature interest in nephrology. However, salary disparity has been an obstacle to translate this interest into pursuing nephrology training. The creation of a hybrid program combining nephrology training and hospitalist work is a possible pathway that would be of value to Nephrology programs and interested hospitalists.
Methods
In 2016, the nephrology program at the university of Kentucky embarked in a systematic creation of a hybrid program combining nephrology training and hospitalist practice. A curriculum expanding over 4 years with alternating 6-month blocks was developed. The salary of the candidates alternates between PGY-4 or 5 remuneration and those of a full time hospitalist faculty. The curriculum was approved by the university graduate medical education (GME) and by the ACGME. ABIM recognizes this fellowship under the “interrupted” training track. A major obstacle is the alignment of the offices of human resources, hospital administration and GME. An effective communication system is necessary to signal the switching between the different status. A geographic separation where the training is in one hospital, while the faculty hospitalist practice is in another proved to be a practical mechanism to circumvent potential confusion. Once the program is approved, advertisement in prominent hospitalists journals was necessary.
Results
After 1 month of advertisement in two hospitalists journals at a cost of $2500, we identified 9 interested candidates after the match. We offered the position to two. The average yearly salary for the hospitalist-fellow trainee is $138,250/year. Moonlighting is allowed as a supplementation to their salary, provided that it does not interfere with the duty hours regulation. Currently, the two hybrid trainees have completed two years in this program with 1 year of accredited training toward nephrology. Their feedback has been very positive.
Conclusion
Nephrology Fellowship-hospitalist track appears to be a valid approach to ameliorate the negative impact of declining interest in nephrology fellowship on the manpower and overall training programs.