Nephrology fellowship interview questions
Nephrology interviewers listen for comfort with long-term care and with hard decisions: when to start dialysis, which kind, and when not to start it at all. They also want to see that you can reason through electrolyte and acid-base problems and explain kidney disease clearly to patients and other teams.
- Shared dialysis decisions
- Comfort with electrolytes
- Long-term patient relationships
What nephrology programs ask
Questions about the specialty itself, beside the ones every program asks.
How do you think about whether and when a patient with advanced kidney disease should start dialysis?
- What they're listening for
- Whether you see dialysis as a decision made with the patient, not a lab value reached.
- How to answer
- Talk about symptoms and complications as well as lab results, the patient's goals, other illnesses and daily life, and the options (hemodialysis, peritoneal dialysis, transplant, care without dialysis). Mention planning access early.
- Where it goes wrong
- Treating a lab value as the only trigger.
An older patient with several serious illnesses asks whether they have to go on dialysis. How do you answer?
- What they're listening for
- Whether you can present care without dialysis honestly as a real option.
- How to answer
- Find out what matters to them, explain what dialysis would and would not change for someone in their situation, and describe conservative care. Make the decision together, with family if they wish, and revisit it over time.
- Where it goes wrong
- Presenting dialysis as the only responsible choice.
You are called overnight about a high potassium in a patient with kidney disease. Walk me through what you do.
- What they're listening for
- Whether you handle a common, dangerous call safely and in order.
- How to answer
- See the patient, get an ECG and rule out a falsely high result, then protect the heart, lower the potassium and remove it from the body. Look for the cause (medications, diet, worsening kidney function) and know when urgent dialysis is needed and who to call.
- Where it goes wrong
- Treating the number without looking at the patient or the ECG.
You are asked to see a hospitalized patient whose kidney function is getting worse. How do you approach the consult?
- What they're listening for
- Whether you work through acute kidney injury systematically and communicate clearly.
- How to answer
- Review the timeline, volume status, medications and contrast exposure, urine studies and imaging, and sort the causes into prerenal, intrinsic and postrenal. Give the team specific steps (which drugs to stop or adjust, what to watch, when to call you).
- Where it goes wrong
- Writing "avoid nephrotoxins" and little else.
A patient on hemodialysis keeps missing sessions. What do you do?
- What they're listening for
- Whether you look for the reasons before labeling a patient.
- How to answer
- Ask about transport, work, how they feel during and after treatment, mood and how they feel about dialysis itself. Work with the social worker and dialysis team, and check whether their goals have changed.
- Where it goes wrong
- Calling the patient noncompliant and stopping there.
Transplant, glomerular disease, home dialysis, critical care nephrology or general nephrology: what draws you?
- What they're listening for
- Whether you have a direction in the field and know its range.
- How to answer
- Give your leaning, the patients or mentors behind it, and what you want to see during fellowship before you decide.
- Where it goes wrong
- Having no picture of the field beyond the dialysis unit.
The questions every program asks
Expect these too. Each is explained in full on the main questions page.
- Tell me about yourself.
- Why do you want to do a fellowship in nephrology?
- Tell me about your research.
- Do you see yourself in academic medicine or in clinical practice?
- Tell me about a case from residency that you still think about.
- How do you like to teach residents and students?
- That's everything from me. What questions do you have for us?
Questions to ask nephrology programs
Ask what their website doesn't answer. These show you have thought about training there.
- How much exposure do fellows have to home dialysis, including peritoneal dialysis?
- How do fellows take part in transplant care, before and after the transplant?
- Do fellows follow their own clinic and dialysis patients through the fellowship?
- What support is there for a research or quality project in kidney disease?
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