them? Lifestyle questions are included in many surveys, but several factors come under that heading: work hours and their predictability (11,12), call and intensity of work during calls, work stress including patient-related stress, and remuneration (3). We need to identify more clearly whether particular aspects of lifestyle are important to trainees, especially women and IMGs, who would otherwise be drawn to the discipline. We need to identify among our clinical colleagues various practice patterns so that trainees can find one that meets their needs. Within the academic community, we also have to insist on flexibility for faculty with family responsibilities to help them achieve work satisfaction and be successful. Economic issues are also factors. Did falling income contribute to dissatisfaction with nephrology in a 2004– 2005 survey of practicing physicians (12)? How does this translate to our trainees? In the article by Shah et al., poor income potential and poor job opportunities after graduation were the two factors listed highest in fellows’ dissatisfaction. This complex issue has previously been raised (19). Shah et al. imply that hospitalist jobs were somehow subpar for graduating nephrologists, which neglects the intricacies of life for many of our trainees. Those international graduates with training visas need positions that fulfill visa waiver requirements. Few pure nephrology jobs meet them, and some, such as with correctional Clin J Am Soc Nephrol 7: 1382–1384, September, 2012 Editorial: Attracting More Residents, Adams 1383 systems, may not appeal to most graduates, including IMGs. Graduates with no visa issues might still have reasons to work as a hospitalist, such as being part of a two-career couple with differing graduation dates, off-cycle training as might occur for maternity leave, or failure to meet nephrology board eligibility requirements necessary for a full-time nephrologist position. Nonetheless, we must understand better the market forces in nephrology positions and work to ensure good jobs for graduating fellows. Why This Matters The future of our patients requires high-quality care performed by intelligent and compassionate physicians and assisted by other health care personnel (13,16). The benefits of research breakthroughs and new therapeutic interventions require a workforce of many types of intellect and life experiences, which can only be accomplished with robust recruiting strategies for nephrology. Job satisfaction during one’s training and throughout their career will contribute to maintaining a vibrant nephrology workforce. Nephrology training program directors together with ASN groups and other organizations need to continue to enhance the educational programs for fellows, develop curricula which strengthen them (16,17,20,21), respond to new accreditation standards (22), develop or modify assessment tools that are reliable and easy to use, and expect that fellows will participate in their own education. We need to engage the entire nephrology community to invest in education. Nonetheless, in the end, students and residents who are not interested in nephrology will exist: we must not alienate them; we must engage them. We do need other specialists to care for our patients. Disclosures None References 1. Parker MG, Ibrahim T, Shaffer R, Rosner MH, Molitoris BA: The future nephrology workforce: will there be one? Clin J Am Soc Nephrol 6: 1501–1506, 2011 2. Watnick S, Klotman P: Nephrology workforce shortage: Current needs and opportunities. ASN Kidney News, 3(10): 12, 2011 3. Shah HH, Jhaveri KD, Sparks MA, Mattana J: Career choice selection and satisfaction among US adult nephrology fellows. Clin J Am Soc Nephrol 7: 1513–1520, 2012 4. Garibaldi RA, Popkave C, Bylsma W: Career plans for trainees in internal medicine residency programs. Acad Med 80: 507–512, 2005 5. West CP, Drefahl MM, Popkave C, Kolars JC: Internal medicine resident self-report of factors associated with career decisions. J Gen Intern Med 24: 946–949, 2009 6. Horn L, Tzanetos K, Thorpe K, Straus SE: Factors associated with the subspecialty choices of internal medicine residents in Canada. BMC Med Educ 8: 37, 2008 7. Kaminetzky CP, Keitz SA, Kashner TM, Aron DC, Byrne JM, Chang BK, Clarke C, Gilman SC, Holland GJ, Wicker A, Cannon GW: Training satisfaction for subspecialty fellows in internal medicine: Findings from the Veterans Affairs (VA) Learners’ Perception Survey. BMC Med Educ 11: 21, 2011 8. Parker MG, Owens S, Rosner MH: Nephrology as a career choice: An ASN Fellow Membership Survey [abstract]. J Am Soc Nephrol, 20[Suppl]: SA–PO2867, 2009 9. Jhaveri KD, Shah HH, Mattana J: Enhancing interest in nephrology careers during medical residency [published online ahead of print May 31, 2012]. Am J Kidney Dis doi:10.1053/j.ajkd. 2012.04.020 10. Adams ND: Longitudinal Nephrology Clinic [LNC] for residents [abstract]. J Am Soc Nephrol, 19: 811A, 2008 11. Lane CA, Brown MA: Nephrology: A specialty in need of resuscitation? Kidney Int 76: 594–596, 2009 12. Leigh JP, Tancredi DJ, Kravitz RL: Physician career satisfaction within specialties. BMC Health Serv Res 9: 166, 2009 13. Mehrotra R, Shaffer RN, Molitoris BA: Implications of a nephrology workforce shortage for dialysis patient care. Semin Dial 24: 275–277, 2011 14. Calderon KR, Vij RS, Mattana J, Jhaveri KD: Innovative teaching tools in