The Renal Medicine Trainee
Nephrology trainees generally start their training in posts with GIM, this will either be entirely GIM or split nephrology/GIM. 

During these early years the basic principles of nephrology will be learned, the assessment of fluid balance, review of referrals with acute renal failure and management of dialysis patients. This is combined with developing a solid grounding in GIM and learning how to be an effective medical SpR In these early years the trainee will be expected to become competent at basic procedures such as emergency dialysis line insertion, depending on the unit they may also become competent at tunnelled dialysis line insertion and renal biopsy.

When these core skills have been acquired the trainee will rotate to a larger unit, often doing nephrology alone and learning more about transplantation. This is also an opportunity to become more experienced at practical procedures. After this stage it is commonplace for trainees to enter a period of research if they wish, this usually takes the form of either a 2 year MD or a 3 year PhD though some trainees have completed MBAs. At the end of research the trainee will be placed in a unit most appropriate for their remaining educational needs prior to completion of training.

What should I do?
Any activities that show an interest in nephrology will be useful, getting involved in audits and other projects is helpful. In terms of useful foundation and core training jobs most specialties can be related to renal medicine but ITU, acute medicine, nephrology and rheumatology may be particularly useful. 

If you think that nephrology is for you then speak to your local nephrologist who will be able to give you more specific advice.