Nephrology foundation year posts (FY1 and FY2) and core medical training (CMT) and passed the Membership of the Royal College of Physicians (MRCP) exam before competing for a National Training Number (NTN) in renal medicine. The typical subspecialty training is five years and leads to a Certificate of Completion of Training (CCT) in both renal medicine and general (internal) medicine. Subspecialty trainees often interrupt their clinical training to obtain research degrees (MD/PhD). Nephrology training can be accomplished through one of two routes. The first pathway is through an internal medicine pathway leading to an Internal Medicine/Nephrology specialty, and sometimes known as
Nephrology "adult nephrology". The second pathway is through Pediatrics leading to a speciality in Pediatric Nephrology. In the United States, after medical school adult nephrologists complete a three-year residency in internal medicine followed by a two-year (or longer) fellowship in nephrology. Complementary to an adult nephrologist, a pediatric nephrologist will complete a three-year pediatric residency after medical school or a four-year Combined Internal Medicine and Pediatrics residency. This is followed by a three-year fellowship in Pediatic Nephrology. Once training is satisfactorily completed, the physician is eligible to take the American Board of Internal Medicine (ABIM) or American Osteopathic Board of Internal