Dr. Reshma Bholah

“The kidneys are amongst the most vital organs in the body—they help regulate your hormones, growth, and blood pressure.”

Dr. Reshma Bholah is an Assistant Professor of Pediatrics at Weill Cornell Medicine-Qatar (WCM-Q) and a Consultant Pediatric nephrologist at Sidra Medicine. She received her medical degree from WCM-Q in 2011 and then spent a year researching reactive airways at Cornell University in New York. Dr. Bholah completed her residency in pediatrics in 2015 and her sub-specialty training in pediatric nephrology in 2018 at Virginia Commonwealth University in Richmond, Virginia. She is certified in general pediatrics and pediatric nephrology by the American Board of Pediatrics. Dr. Bholah spoke with “Hospitals” magazine on the importance of pediatric nephrology as a specialty and what a career in the practice would entail.

Can you explain broadly the practice of pediatric nephrology? 

Nephrology is the study of the kidneys, while pediatric nephrology focuses on the study of children with kidney problems. 

The kidneys are amongst the most vital organs in the body—they help regulate your hormones, growth, and blood pressure, remove toxins, and balance fluids, acid-base, salts, and minerals. Also, the kidneys send important signals to other organs in the body, so when the kidneys are affected, you see that impact on the entire body. Kidneys may be affected by conditions that are short-lived or those which are longstanding, requiring ongoing care and, at times, necessitating dialysis when the function of the kidneys is impaired. 

To become a pediatric nephrologist, I completed my initial training in pediatrics and subsequently did further training in pediatric nephrology.

Please describe your current professional role.

I teach various aspects of the medical curriculum at WCM-Q from the first to fourth year of medical school. During the first year, I teach the basics of first patient encounters, going through the motions of getting their medical history, and performing physical exams of the different organ systems.

At the same time, I also help students with medical documentation, the process of gathering information on each patient in a systematic way. Then, as students progress, I teach them about pediatrics and pediatric nephrology. Hence, I also lead ‘transition courses,’ such as the transition to clerkship course, which helps bridge students from pre-clinical to clinical setting, and a transition to residency course, which helps students transition from the undergraduate medical program to graduate medical education, which residency programs offer. 

What kinds of medical conditions do you typically encounter in your practice?

As pediatric nephrologists, we see patients from birth to adolescence. From birth, the patients we typically see have congenital defects of the kidneys, while the patients I follow chronically may have anything from blood in the urine, protein in the urine, kidney stones, complicated urinary tract infections, vesicoureteral reflux, and various other structural anomalies of the kidneys. I also see patients with high blood pressure and with a multitude of conditions that affect the filtering units of the kidneys—the glomeruli. 

I have to stress that nephrology is a specialty that takes an interdisciplinary approach to patients, meaning we do not work in silos. In addition to pediatric nephrologists, our care team includes a dietician, who is crucial for patients with chronic kidney disease since we need to ensure adequate nutrition. 

We also have a social worker who helps patients with financial resources and a team of nurses who specialize in supporting various forms of dialysis. Additionally, we work with physicians in other specialties, including ICU doctors, rheumatologists, endocrinologists, cardiologists, and urologists, to name a few, because we share patients who have systemic illnesses involving the kidneys and other organ systems. Working in partnership with other teams enables us to care for patients holistically, which is crucial to optimal patient care.

Which factors influenced your decision to pursue this career path?

During my pediatric training, I often cared for patients with kidney problems. I also developed a relationship with the pediatric nephrologists with whom I worked, and they helped me understand what the field was essentially all about. When you work with people who have a passion for what they do, their enthusiasm inspires you a lot. 

That said, it was not just the disease process that I found intellectually stimulating but also how the team approached it. I took an interest in seeing patients with various nuances of their disease processes. For example, when you tend to patients who are critically ill, you work alongside intensive care physicians in the pediatric or neonatal ICU while also taking care of patients who are much more stable in the general ward. What I love about this career is the possibility of having a different pace. The reason being is that I could not see myself sitting behind a desk and seeing patients at a clinic all day, every day. I love being able to change pace in what I do, and this career offers me that flexibility. 

What have you found to be particularly rewarding in your career? 

Well, the rewarding part of this career is being able to see patients longitudinally. What I love about this field is that I can follow patients for many years, which allows me to build rapport with my patients—I sincerely appreciate this aspect of patient care as a physician. 

I tend to think that the crucial aspect of medicine is the notion of helping. It is perhaps the general misconception—partially generated by modern practice—that the job of a physician is to prescribe drugs. On the contrary, it is about trying to understand every nuance of patient care so that you know exactly which resources to offer patients at every stage. By building rapport and having a sort of social intimacy, patients and their families open up to you. Therefore, unless you are able to develop this connection with patients and their families, you will not be able to fully help them. 

Additionally, if you want to be intellectually stimulated, this field will suit you well. Pediatric nephrology makes you humble because of the complexities of the inner workings of the kidneys, which bring about continuous research in the field and, thus, new knowledge. It motivates you to develop a good grasp on other bodily organs because the kidneys themselves are intertwined with them either causally or consequentially. 

Moreover, thinking critically and sharpening intuition regarding patients is what pediatric nephrology demands. Thus, it keeps you on your toes, and that is really rewarding. 

How do you envision the future of this area of specialization? 

Around the world, we are a very small subset of physicians who specialize in pediatric nephrology. If the current shortage of pediatric nephrologists continues, children suffering from various kidney-related conditions will not receive adequate care! This is going to become a challenge for different countries and populations who will not have the means to help these children grow and achieve the best of health. I am, however, optimistic that this pendulum will shift and that we will continue to attract more physicians into this really rewarding field.