Kidney Biopsy Training and the Future of Nephrology

Robert S. Brown
  • Clinical Journal of the American Society of Nephrology, June 2018, American Society of Nephrology
  • DOI: 10.2215/cjn.05870518

Kidney Biopsy Training and the Future of Nephrology: What about the Patient?

What is it about?

Plain Language Summary There has been considerable discussion about the current requirement by the Accreditation Council for Graduate Medical Education (ACGME) that every nephrology fellow be trained to competently perform kidney biopsies since the biopsy is an integral part of the nephrology specialty. However, the patient has been left out of the discussion. Since about two-thirds of nephrologists never perform kidney biopsies after fellowship, the added risk to patients of training new fellows in this invasive procedure must be considered. As a quality measure of patient care, it is my opinion that the requirement be waived by the ACGME for fellows not interested in performing biopsies in practice.

Why is it important?

The ACGME and ABIM requirement that all nephrology fellows must perform kidney biopsies to graduate ignores the fact that most will not perform them after fellowship. More importantly, it exposes patients to the increased risks of a new learner without the commensurate value of training a physician who will use the skill.


Robert Brown (Author)
Beth Israel Deaconess Medical Center

I hope that more physicians will argue to update ACGME and ABIM requirements to be in synchrony with the changing environment in nephrology.

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