Susan Quaggin @SusanQuaggin
Susan E. Quaggin, MD, FRCP(C), FASN, is a Canadian and graduate of the University of Toronto where she completed her residency and served as chief medical resident for the University’s St. Michael’s Hospital. Currently she is the Charles Horace Mayo professor of medicine at Northwestern University where she serves as the Chief of the Division of Nephrology & Hypertension and the Director of the Feinberg Cardiovascular and Renal Research Institute and PI of the Northwestern George M. O’Brien Center (NU-GoKIDNEY) . Dr. Quaggin was elected to the American Society for Clinical Investigation in 2006, the Association of American Physicians in 2013 and the National Academy of Medicine in 2019 and is President of the American Society of Nephrology.
If you care about the future of our subspecialty, the medical student interest team should take it all this year.
Workforce issues have been front and center in nephrology and a top concern for training program directors for several years. But …times have changed. Nephrology is no longer defined as the nerdy specialty (not that there’s anything wrong with that…); it is the choice for smart and engaged physicians with a passion for equitable and innovative patient care.
To quote Steve Coca (Mount Sinai Hospital, New York) — “we have reached a tipping point in our subspecialty”.
Despite the incredible challenges of 2020-21, the power and value of nephrology has never been so visible, providing a time-sensitive opportunity to attract the best and the brightest to our field.
Published in October 2020, stunning results from the DAPA-CKD trial signaled the beginning of a new era in nephro-therapeutics. If successfully implemented, powerful kidney-targeted therapies, such as the SGLT2 inhibitors, will save hundreds of thousands of people from death and kidney failure each year in the US alone.
The onset of the COVID-19 pandemic has highlighted the essential value of nephrologists to the medical community, trainees, and the world beyond. While state health departments and the lay press were heavily focused on ventilators at the beginning of the pandemic, it soon became apparent that ventilators weren’t the only machine in ICUs that were in short supply. In April 2020, the New York Times reported on an overlooked coronavirus crisis – the dire need for kidney dialysis.
Nephrologists and valued members of the kidney care team (nurses, dialysis techs and PAs) are routinely called upon to save the lives of critically ill patients in the emergency department, cardiac, surgical, and intensive care units. But during the COVID-19 pandemic, many more saw nephrologists for the super-heroes and inventors they are, as they developed innovative solutions — on the fly — to combat virus-induced clotting of dialysis circuits and adapt in the face of critical shortages of machines, staff and supplies to provide lifesaving kidney dialysis therapies. In the early days when PPE was unavailable, these lifesaving treatments were delivered by nephrologists and nurses who put themselves at risk of infection.
Amid the COVID-19 pandemic, the murder of George Floyd launched a nationwide civil rights movement and focused our attention exactly where it belongs — on the systemic racism that exists throughout the country and in our health care system.
Here, the medical students found their voices, became activists, and led in taking up the charge to question the use of race modifiers in clinical algorithms and challenging the use of race in estimating GFR equations. Their drive, passion and commitment to health equity will build the future of our specialty.
The burden of kidney failure in the US is 4x higher in Black Americans, 2.7x higher in Latinx, 1.7x higher in Native Americans, Pacific Islanders and Native Hawaiians. These numbers are unacceptable.
Medical students have what it takes to catalyze change. Let us leverage this moment in time and ask them to bring their talent and commitment to our community and drive the advances that will eliminate the excess burden of kidney disease in minoritized populations and dismantle racism in our institutions. We must seek out and engage these young leaders as early as possible in their careers, during medical school, to tap into the largest and most diverse pool of talent for the future of our specialty.
In the words of Deidra Crews (Johns Hopkins, Baltimore) – “Come for the GFR estimation, (please) STAY for the full dismantling of structural racism”.
Let’s begin by showing the medical students how important they are and how much we need their passion, talent, and leadership to advance kidney health. Reach out to the medical students at your institution or over social media, support initiatives like NephSIM and the STARS and TREKS programs at ASN and above all — vote for medical student interest to win it all this year in #NephMadness!
– Guest Post written by Susan Quaggin @SusanQuaggin
As with all content on the AJKD Blog, the opinions expressed are those of the author of each post, and are not necessarily shared or endorsed by the AJKD Blog, AJKD, the National Kidney Foundation, Elsevier, or any other entity unless explicitly stated.