Zoccali: Dr Seibold why did you decide to specialize in nephrology?
Seibold: I
got in contact with nephrology during my doctoral thesis, when I screened Alport
patients for mutations in the COL4A5 gene. My doctoral advisor offered me a
clinical position in internal medicine after I had finished my studies. To be
honest, I did not know much about clinical nephrology at that time. But during
my training in internal medicine I got more and more interested in nephrology
and finally decided to specialize in this field without regret.
Zoccali: Could you briefly summarize how training programs in nephrology
are organized in Germany?
Seibold: First,
one has to attempt a clinical training program in general internal medicine
for 6 years, completed by an exam. During that time one rotates through the
different fields of internal medicine including intensive care medicine. Afterwards,
one has to attempt another clinical training program to specialize in nephrology
for another two years with another final exam. During that time one has to work
one year on a nephrology ward, 6 month in a dialysis centre and 6 month in renal
transplantation and an outpatient clinic. Additionally, at universities, one
can attempt a research training lasting for some years, which can be combined
with the clinical training program.
Zoccali: Would you make the same decision now or do you feel that other
specialties offer better professional prospects?
Seibold: I am very happy in internal medicine and especially in nephrology. Patients in nephrology usually not only suffer from renal diseases but also from cardiovascular, haematological, rheumatological, endocrinological, bone disease etc. Nephrology is a field with broadest insight in human disease and therefore satisfies highest demands to oneself. Prospects in nephrology are excellent due to a growing number of patients and an indispensable treatment of their diseases.
Zoccali: How many hours a week do you work? Do you have any hobby?
Seibold: I
work approximately 50-60 hours a week, thereof usually 40-50 hours in patient
care and additionally 10-20 hours in research. The family and my broad interests
in many different recreational activities take a lot of additional time, not
leaving enough occasions to pursue one single hobby intensively.
Zoccali: As you know a debate is ongoing in Britain and in the USA on
the high workload of junior doctors. Do you think that a huge workload is really
necessary for a young doctor to mature solid experience and the needed endurance
to face successfully the professional and personal challenges of clinical medicine?
Seibold: Certainly,
clinical medicine demands lots of experience and a solid theoretical background.
No doubt, junior doctors approve to spend plenty of time on learning and training.
However, junior doctors intelligibly complain about a huge workload due to paperwork
and bureaucracy etc. This is what has to be reduced to a reasonable amount -
not the clinical training.
Zoccali: Have you done or planned to do a work experience abroad? How
important it is for a German doctor making an experience abroad? Is this considered
an important element in professional curricula?
Seibold: Certainly
experience abroad can be an important element in professional curricula after
basic necessities such as knowledge, capability and their implementation. Altogether
I spent more than one year in USA and Great Britain during my studies. Unfortunately
clinical training programs for junior doctors are too different between countries,
so that I could not spend time abroad during my clinical training. Sometimes
German physicians finish their research training abroad, which is also still
an option for me in the near future.
Zoccali: Could you tell us which are the major problems or obstacles
that you encountered during your training years?
Seibold: Fortunately my supervisors were very keen to offer good training programs, so that I did not encounter major problems. Obstacles were an only marginal payment in the first years in contrast to the high work load and contracts not lasting for the complete training program.
Zoccali: What disappointed you most during your training years?
Seibold: Politics! For politicians physical health is a prevailing demand for all people and physicians are the responsible bureaucrats in charge of handling the distribution of this manor. Furthermore, politics is responsible for the long duration and humble payment of the training in Germany. At least 6 years of studies and additional 8 years for clinical training is simply an exorbitant requirement.
Zoccali: What rewarded you most during your training years?
Seibold: Patients! Most patients understand that physical health is a valuable manor and acknowledge that physicians do their best for the maintenance of their individual healthiness. The gratefulness of patients is consistently a motivation for further developments in research and clinical medicine.
Zoccali: Which advice would you give to a young colleague wishing to enter a career in nephrology?
Seibold: For your studies, choose a university with a low number of students, ensuring a higher attention to the individual student. For your doctoral thesis, choose a laboratory for molecular medicine, ensuring access to the basics of this growing field. For your clinical training, enter a program at a large institution, ensuring insight also into rare diseases. For your general development, enter a research training program, ensuring experience in how to ask the right questions and how to find the right answers.
