Racial Composition of Nephrology Fellows and Patient Population Don't Match

doi: 10.1097/01.NEP.0000395407.51457.cd
In Brief

There continue to be racial disparities between patients with end-stage renal disease (ESRD) and the physicians training to treat them, according to a study published in the Clinical Journal of the American Society of Nephrology (2011;6:390–394).

These disparities have persisted despite efforts to the contrary.

“A goal for many years has been to increase the number of African-American fellows in nephrology programs in an effort to improve health care delivery to an important population with CKD [chronic kidney disease],” the study authors wrote.

“The purpose of this analysis was to examine the trends in the racial backgrounds of ESRD patients and nephrology fellows and discuss the implications of these trends on ESRD care.”

The study was conducted by Chavon Onumah, MD, and Mark Rosenberg, MD, of the Department of Medicine at the Minneapolis Veterans Affairs Medical Center, and Paul Kimmel, MD, of the National Institute of Diabetes and Digestive and Kidney Diseases. Dr. Rosenberg is also Education Director for the American Society of Nephrology.

While African-Americans make up 13% of the US population, they only comprise 6.5% to 7.1% of US medical school graduates, 5.5% of internal medicine residents, and 3.8% of nephrology fellows, the study reported. Meanwhile, 32% of patients with ESRD are African-American.

“Given the integral role of patient and physician race concordance in the therapeutic relationship, efforts to increase the number of African-American nephrology trainees may help to optimize patient care and improve outcomes,” the authors wrote.

In addition, there was a 4.5% decrease in African-American nephrology faculty between 1998 and 2008, with only 28 (3.3%) academic nephrology faculty members of African-American race.

“It is critical that minorities are recruited to stay in academics and are represented on medical school faculties and key institutional committees, particularly in specialties such as nephrology in which racial disparities exist between patients and physicians,” the researchers wrote.

“Nephrology fellows should be encouraged and supported to enter academics as clinicians, educators, or researchers.”

© 2011 Lippincott Williams & Wilkins, Inc.