title: Race disparities in U.S. nephrology fellowship training.
abstract: OBJECTIVE
  Renal disease disproportionately affects African-American patients. Trust has been implicated as an important factor in patient outcomes. Higher levels of trust and better interpersonal care have been reported when race of patient and physician are concordant. The purpose of this analysis was to examine trends in the racial background of U.S. medical school graduates, internal medicine residents, nephrology fellows, and patients with ESRD.
  
  
  METHODS
  Data for medical school graduates were obtained from the Association of American Medical Colleges and data for internal medicine and nephrology trainees from GME Track. ESRD data were obtained from U.S. Renal Data System (USRDS) annual reports.
  
  
  RESULTS
  A significant disparity continues to exist between the proportional race makeup of African-American nephrology fellows (3.8%) and ESRD patients (32%). The low numbers of African-American nephrology fellows, and consequently new nephrologists, in light of the increase in ESRD patients has important implications for patient-centered nephrology care.
  
  
  CONCLUSIONS
  Efforts are needed to increase minority recruitment into nephrology training programs, to more closely balance the racial background of trainees and patients in hopes of fostering improved trust between ESRD caregivers and patients, increasing access to care, alleviating ESRD health care disparities, and improving patient care.
authors.affiliation: Department of Medicine, Minneapolis VA Medical Center, University of Minnesota, One Veterans Drive, Minneapolis, MN 55417, USA.
authors.forename: Chavon
authors.initials: C
authors.lastname: Onumah
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
authors.forename: Mark E
authors.initials: ME
authors.lastname: Rosenberg
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D002321:Career Choice; D003466:Cultural Characteristics; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data; D005257:Fellowships and Scholarships / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D007676:Kidney Failure, Chronic / Q000208:ethnology* / Q000628:therapy; D009398:Nephrology / Q000193:education*; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D013997:Time Factors; D035502:Trust; D014481:United States