Renal medicine is an exciting specialty offering the challenge of looking after both acutely ill patients and those with a chronic disease requiring long term care with the help of a multidisciplinary team.
The majority of renal physicians receive training as specialist registrars in both Renal and General Internal Medicine, although not all renal physicians (particularly those in tertiary centres) will undertake acute general medical duties. However most general medical problems in renal patients are managed by the Renal team who have a close working relationship with many branches of medicine reflecting the various problems of co-morbidity present in most patients with chronic renal disease.
Most renal physicians will have responsibility for the care of patients with end stage renal failure requiring long term renal replacement therapy either by dialysis or transplantation. They also manage patients with a wide variety of general nephrology problems and those with acute renal failure, many of whom may require acute renal replacement therapy in the critical care setting. The majority of patients on chronic dialysis are managed in those District General Hospitals which have facilities for chronic haemodialysis and peritoneal dialysis; renal transplantation is performed in tertiary centres with most patients continuing long term follow up in the referring hospital. There are many opportunities for research either laboratory based (underlying mechanisms of renal disease, immunology of transplantation); clinical based (examining effects of treatment on various renal conditions), or epidemiological (looking at incidence of various renal diseases in different populations which impact on the planning and delivery of renal services).
The majority of applicants for Specialist Registrar posts will have obtained experience as a Senior House Officer in Renal Medicine although this is not an essential requirement. The Specialty Advisory Committee (SAC) has a membership reflecting all aspects of Renal medicine including an SpR representative. The SAC oversees training, which is organised by the regional Deaneries, and has introduced a new curriculum and is assisting the JCHMT in the development of new methods of assessment.