How to Become a Nephrologist

April 25, 2024


Reviewed by:

Luke Hartstein

Former Admissions Committee Member, NYU Grossman School of Medicine

Reviewed: 4/25/24

Are you interested in becoming a physician, specifically a nephrologist? We’ve got you covered! This article outlines how to become a nephrologist, what a nephrologist does, and the average salary for this career. 

Kidney disease ranks 12th as the leading cause of death globally and 9th in the U.S. Millions of people worldwide each year undergo treatment for various kidney illnesses. With the rise of kidney diseases, the demand for nephrologists has also been in demand. 

Nephrology, or renal medicine, is a specialty within internal medicine that focuses on diseases involving the kidneys. In the U.S., 15 percent of adults are believed to have chronic kidney disease. However, 90% of them don't know it and end up visiting a nephrologist after the disease has become severe. 

If you're reading this guide, you're probably considering a career as a nephrologist. This article will teach you everything you need to know about nephrologists. So if you're interested, keep on reading!

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What Does a Nephrologist Do?

A nephrologist is a physician who diagnoses, treats, and manages patients with kidney conditions. Some of the duties of a nephrologist include performing assessments of kidney functions to identify problems, developing a treatment plan for the patient, and performing surgery or administering treatments like dialysis.

Nephrologists recognize how kidney conditions can affect parts of the body. The main component of a nephrologist's job is to treat kidney conditions such as kidney stones, infections, failure and cancer.

Aside from diagnosing and treating renal disorders, nephrologists also recognize how kidney conditions can affect other parts of the body and cause ailments, such as cardiovascular disease, autoimmune disease, high blood pressure, fluid retention, and mineral imbalances.

In order to diagnose and create a treatment plan for a patient, nephrologists must perform medical examinations, such as blood or urine tests. Besides laboratory work, nephrologists may also perform procedures, such as imaging tests and kidney biopsies.

These tests help nephrologists detect signs of decreasing kidney function. If the physician sees signs of a kidney not functioning properly, they’ll either do more testing, or create a tailored treatment plan for the patient. 

Nephrologists work to ensure patients get the proper treatment they need for their kidney conditions. The kidneys are important because they filter the blood to remove waste and toxins. Nephrologists have a critical role in healthcare because they treat one of the essential organs in the body. Healthy kidneys entail a healthy body which is important.

Steps to Becoming a Nephrologist

Below are steps on how to become a nephrologist. 

1. Obtain a Bachelor's Degree

To become a physician, you must first go to medical school; however, before you even apply for medical school, you need to acquire a bachelor's degree. 

Although most medical schools don't have a requirement for what you major in, medical schools require students to have high grades in various subjects, such as biology, chemistry, physics, and math.

Typically, a bachelor's degree takes four years to complete. Those admitted into top medical schools like Harvard and Yale have an average GPA score of 3.9. It’s important to have a high GPA score when applying to medical schools, because they’re competitive to get into. 

2. Pass the MCAT

You must pass the MCAT to get into medical school. The MCAT is a four-section test that focuses on these subject areas:

  1. Chemical and Physical Foundations of Biological Systems
  2. Biological and Biochemical Foundations of Living Systems
  3. Psychological, Social, and Biological Foundations of Behavior
  4. Critical Analysis and Reasoning Skills

The MCAT is a crucial test because it’s what many medical schools will base your success in medical school on. Because of the competitiveness of medical school, your application, including your MCAT score, must be competitive as well. 

Preparation is key when it comes to doing well on the MCAT. Signing up for prep courses, getting a tutor, and doing some independent prep are all amazing ways to prepare yourself for the MCAT.

3. Complete Medical School

Medical school takes four years to complete, and it teaches potential nephrologists everything they need to know to be successful in the field. Medical students develop their skills and knowledge through their lectures and clinical rotations. 

Medical school requirements vary by school; however, there are standard criteria that most medical schools require for admission. They are: 

Once accepted into medical school, you’ll spend the first two years in lectures learning about different areas of medicine, such as anatomy, infection immunity, and endocrinology. 

The final two years involve clinical rotations, where you will work under the supervision of a licensed physician. A benefit of clinical rotations is that it gives students hands-on learning and experience, which will prepare them for their future medical careers.

4. Complete a Residency in Internal Medicine

To become a nephrologist, you must complete a residency in internal medicine. It takes three years to complete, and during this time, future nephrologists are trained in clinical assessment, treatment, and surgery. During residency, students work for a clinic or hospital under the strict supervision of a doctor.

While working in a clinic or hospital, students are also taught how to care for patients, work with a healthcare team, and provide treatment. After completing the residency program, students may pursue a fellowship in Nephrology. 

5. Complete a Fellowship in Nephrology 

A fellowship in nephrology takes about two to three years to complete. The fellowship focuses on studying kidney functions, diseases, and surgical techniques. During their fellowship, candidates also have the option to pursue a subspecialty.

6. Become Board Certified in Nephrology 

To be a licensed nephrologist, you must pass the board certification. The Board Exam is offered annually and takes eight hours to complete. Below is a list of subjects the Nephrology Certification Exam covers: 

  • Acute kidney injury and intensive care unit nephrology
  • Acid-base and potassium disorders
  • Calcium, phosphorus, and magnesium disorders
  • Chronic kidney disease
  • Hypertension
  • Kidney transplant
  • Pharmacology

This exam aims to test the candidate's knowledge of the medical field and gauge their ability to practice as a nephrologist.

Nephrologist Salary & Career Outlook

In recent reports, the average annual wage for a nephrologist in the U.S. is $285,214 a year. Below is a chart of the monthly, weekly, and hourly wages of various earners in this field.

Annual Salary Monthly Pay Weekly Pay Hourly Wage
Top Earners $338,00 $28,166 $6,500 $162
75th Percentile $338,000 $28,166 $6,500 $162
Average $272,280 $22,690 $5,236 $131
25th Percentile $260,000 $21,666 $5,000 $125

Source: Ziprecruiter 

Regarding the career outlook for nephrology, this career is projected to grow 3% from 2022 to 2032, which is slower than other occupations. This projection estimates 23,800 new career openings for physicians each year. 

With that many job postings available and how nephrology isn’t a competitive field, this is a career field that will keep growing and is worthwhile.

Becoming a Nephrologist: FAQs

If you still have questions after reading this guide, check out these frequently asked questions. 

1. Is It Hard to Be a Nephrologist?

It can be challenging if science isn't your strongest subject. However, if you do well in science, you should do well in school. If you're dedicated to this field of medicine and care about helping people, you should definitely pursue this career path.

2. Do Nephrologists Make a Lot of Money?

​​Yes, nephrologists do make a lot of money. According to ZipRecruiter, a nephrologist's salary averages around $272,280 in the U.S. This translates to $22,690 per month or $137 per hour.

3. Are Nephrologists in High Demand?

Yes, there is a high demand for nephrologists. However, only a few medical students are pursuing this field of medicine. It has been stated that the demand for nephrologists is increasing, while nephrology as a career has been declining for nearly a decade. This means that nephrologist residents will have a very good chance of finding a job in this field because of the high demand for them. 

4. Why Is Nephrology Not Competitive?

The reason why nephrology isn't competitive is that a lot of medical students end up pursuing other specialties. In the last decade, there has been a decline in medical students entering the nephrology field, therefore making the specialty not competitive.

Final Thoughts

If you're thinking of becoming a physician, you might want to consider becoming a nephrologist. Although many medical students don't pursue the field, it has been projected that kidney-related illnesses are expected to be on the rise in the U.S. This means that a career in nephrology will also be on the rise compared to other medical specialties. 

Moreover, this guide has taught you everything you need to know about nephrology and how to become a nephrologist. If you’re considering a career in this field, make sure you do well in your studies and research as much as you can about the field.

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