Current Trends and Challenges in Nephrology Fellowship Training: Expansion of Education in Home Dialysis, Palliative Care, and Point-of-Care Ultrasound

How to incorporate generative artificial intelligence in nephrology fellowship education

Traditional nephrology education faces challenges due to expanding medical knowledge, case complexity, and personalized learning needs. Generative artificial intelligence (AI), like ChatGPT, offers potential solutions to enhance nephrology education through dynamic, adaptive, and personalized learning experiences. We discuss integrating generative AI into nephrology education at our institution, highlighting its importance and potential applications. It explores how AI can complement traditional teaching methods by addressing challenges like information overload, diverse learning needs, and continuous learning. Generative AI models should be actively utilized under human supervision to ensure accuracy when summarizing key teaching points, creating discussion topics for journal clubs, and aiding in curriculum development for our Nephrology fellowship. Potential future applications include simulation-based learning, interactive learning modules, personalized learning plans, and enhanced research capabilities. AI can also facilitate mentorship, improve assessment, and support administrative tasks. The integration of AI addresses challenges such as keeping pace with knowledge expansion, providing personalized learning experiences, and improving access to expertise. In summary, the integration of generative AI into nephrology education represents a paradigm shift in preparing future kidney specialists. While AI offers numerous benefits, challenges such as data privacy and maintaining the human element in patient care must be addressed. A balanced approach that preserves human mentorship while employing AI's capabilities is crucial for cultivating well-rounded, competent, and compassionate nephrologists ready to tackle future kidney health challenges.

American Board of Internal Medicine Nephrology Procedure Requirements for Initial Certification: Time for a Change and Pursuing Consensus in the Nephrology Community

In 1988, the American Board of Internal Medicine (ABIM) defined essential procedural skills in nephrology, and candidates for ABIM certification were required to present evidence of possessing the skills necessary for placement of temporary dialysis vascular access, hemodialysis, peritoneal dialysis, and percutaneous renal biopsy. In 1996, continuous renal replacement therapy was added to the list of nephrology requirements. These procedure requirements have not been modified since 1996 while the practice of nephrology has changed dramatically. In March 2021, the ABIM Nephrology Board embarked on a policy journey to revise the procedure requirements for nephrology certification. With the guidance of nephrology diplomates, training program directors, professional and patient organizations, and other stakeholders, the ABIM Nephrology Board revised the procedure requirements to reflect current practice and national priorities. The approved changes include the Opportunity to Train standard for placement of temporary dialysis catheters, percutaneous kidney biopsies, and home hemodialysis, which better reflects the current state of training in most training programs, and the new requirements for home dialysis therapies training will align with the national priority to address the underuse of home dialysis therapies. This perspective details the ABIM process for considering changes to the certification procedure requirements and how ABIM collaborated with the larger nephrology community in considering revisions and additions to these requirements.

Reimagining Nephrology Fellowship Education to Meet the Future Needs of Nephrology: A Report of the American Society of Nephrology Task Force on the Future of Nephrology

The American Society of Nephrology (ASN) Task Force on the Future of Nephrology was established in April 2022 in response to requests from the American Board of Internal Medicine and the Accreditation Council for Graduate Medical Education regarding training requirements in nephrology. Given recent changes in kidney care, ASN also charged the task force with reconsidering all aspects of the specialty's future to ensure that nephrologists are prepared to provide high-quality care for people with kidney diseases. The task force engaged multiple stakeholders to develop 10 recommendations focused on strategies needed to promote: ( 1 ) just, equitable, and high-quality care for people living with kidney diseases; ( 2 ) the value of nephrology as a specialty to nephrologists, the future nephrology workforce, the health care system, the public, and government; and ( 3 ) innovation and personalization of nephrology education across the scope of medical training. This report reviews the process, rationale, and details (the "why" and the "what") of these recommendations. In the future, ASN will summarize the "how" of implementing the final report and its 10 recommendations.