According to the latest United States Renal Disease Report,1 home dialysis—peritoneal dialysis (PD) and home hemodialysis (HHD)—utilization among incident patients with kidney failure remains relatively nominal (14.1% PD and 0.4% HHD). A historic obstacle to the growth of home dialysis in the United States is insufficient nephrologist training. In a survey-based evaluation of self-perceived competency of fellows who graduated between 2004 and 2008 only 55.6% of respondents reported feeling well trained and competent in PD, while a mere 15.8% reported feeling competent in HHD.