“What do you think about nephrology?” A national survey of internal medicine residents
Abstract Background Interest in nephrology has been declining among internal medicine residents but the reasons behind this observation are not well characterized. Our objective was to evaluate factors influencing residents’ choice of subspecialty. Methods This is a mixed-method QUAL-QUAN design stu...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-05-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12882-021-02397-9 |
| _version_ | 1818597519012134912 |
|---|---|
| author | Georges N. Nakhoul Ali Mehdi Jonathan J. Taliercio Susana Arrigain Jesse D. Schold Abby Spencer Jessica Greenfield Amit Diwakar Grace Snyder John O’Toole Joseph V. Nally John R. Sedor Patricia F. Kao S. Beth Bierer |
| author_facet | Georges N. Nakhoul Ali Mehdi Jonathan J. Taliercio Susana Arrigain Jesse D. Schold Abby Spencer Jessica Greenfield Amit Diwakar Grace Snyder John O’Toole Joseph V. Nally John R. Sedor Patricia F. Kao S. Beth Bierer |
| author_sort | Georges N. Nakhoul |
| collection | DOAJ |
| description | Abstract Background Interest in nephrology has been declining among internal medicine residents but the reasons behind this observation are not well characterized. Our objective was to evaluate factors influencing residents’ choice of subspecialty. Methods This is a mixed-method QUAL-QUAN design study that used the results of our previously published qualitative analysis on residents’ perception of nephrology to create and pilot a questionnaire of 60 questions. The final questionnaire was distributed to 26 programs across the United States and a total of 1992 residents. We calculated response rates and tabulated participant characteristics and percentage of participant responses. We categorized choice of fellowship into 2 medical categories (Highly Sought After vs. Less Sought After) and fitted a logistic regression model of choosing a highly vs. less sought after fellowship. Results Four hundred fifteen out of 1992 (21%) US residents responded to the survey. Of the 268 residents planning to pursue fellowship training, 67 (25%) selected a less sought after fellowship. Female sex was associated with significantly higher odds of selecting a less sought after fellowship (OR = 2.64, 95% CI: 1.47, 4.74). Major factors deterring residents from pursuing nephrology were perception of inadequate financial compensation, broad scope of clinical practice and complexity of patient population. We observed a decline in exposure to nephrology during the clinical years of medical school with only 35.4% of respondents rotating in nephrology versus 76.8% in residency. The quality of nephrology education was rated less positively during clinical medical school years (median of 50 on a 0–100 point scale) compared to the pre-clinical years (median 60) and residency (median 75). Conclusion Our study attempts to explain the declining interest in nephrology. Results suggest potential targets for improvement: diversified trainee exposure, sub-specialization of nephrology, and increased involvement of nephrologists in the education of trainees. |
| first_indexed | 2024-12-16T11:49:05Z |
| format | Article |
| id | doaj.art-997546ec0fcd49049548e36a6b371744 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-16T11:49:05Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-997546ec0fcd49049548e36a6b3717442022-12-21T22:32:46ZengBMCBMC Nephrology1471-23692021-05-0122111210.1186/s12882-021-02397-9“What do you think about nephrology?” A national survey of internal medicine residentsGeorges N. Nakhoul0Ali Mehdi1Jonathan J. Taliercio2Susana Arrigain3Jesse D. Schold4Abby Spencer5Jessica Greenfield6Amit Diwakar7Grace Snyder8John O’Toole9Joseph V. Nally10John R. Sedor11Patricia F. Kao12S. Beth Bierer13Department of Hypertension and Nephrology, Glickman Kidney Urological Institute, Cleveland Clinic FoundationDepartment of Hypertension and Nephrology, Glickman Kidney Urological Institute, Cleveland Clinic FoundationDepartment of Hypertension and Nephrology, Glickman Kidney Urological Institute, Cleveland Clinic FoundationDepartment of Quantitative Health Sciences, Cleveland Clinic FoundationDepartment of Quantitative Health Sciences, Cleveland Clinic FoundationDepartment of Internal Medicine, Medicine Institute, Cleveland Clinic FoundationEducation institute, Cleveland Clinic FoundationDepartment of Internal Medicine, Cleveland Clinic Akron General HospitalDepartment of Internal Medicine, Texas Institute for Graduate Medical Education and Research HospitalDepartment of Hypertension and Nephrology, Glickman Kidney Urological Institute, Cleveland Clinic FoundationDepartment of Hypertension and Nephrology, Glickman Kidney Urological Institute, Cleveland Clinic FoundationDepartment of Hypertension and Nephrology, Glickman Kidney Urological Institute, Cleveland Clinic FoundationDepartment of Nephrology, Washington University in Saint LouisDepartment of Internal Medicine, Medicine Institute, Cleveland Clinic FoundationAbstract Background Interest in nephrology has been declining among internal medicine residents but the reasons behind this observation are not well characterized. Our objective was to evaluate factors influencing residents’ choice of subspecialty. Methods This is a mixed-method QUAL-QUAN design study that used the results of our previously published qualitative analysis on residents’ perception of nephrology to create and pilot a questionnaire of 60 questions. The final questionnaire was distributed to 26 programs across the United States and a total of 1992 residents. We calculated response rates and tabulated participant characteristics and percentage of participant responses. We categorized choice of fellowship into 2 medical categories (Highly Sought After vs. Less Sought After) and fitted a logistic regression model of choosing a highly vs. less sought after fellowship. Results Four hundred fifteen out of 1992 (21%) US residents responded to the survey. Of the 268 residents planning to pursue fellowship training, 67 (25%) selected a less sought after fellowship. Female sex was associated with significantly higher odds of selecting a less sought after fellowship (OR = 2.64, 95% CI: 1.47, 4.74). Major factors deterring residents from pursuing nephrology were perception of inadequate financial compensation, broad scope of clinical practice and complexity of patient population. We observed a decline in exposure to nephrology during the clinical years of medical school with only 35.4% of respondents rotating in nephrology versus 76.8% in residency. The quality of nephrology education was rated less positively during clinical medical school years (median of 50 on a 0–100 point scale) compared to the pre-clinical years (median 60) and residency (median 75). Conclusion Our study attempts to explain the declining interest in nephrology. Results suggest potential targets for improvement: diversified trainee exposure, sub-specialization of nephrology, and increased involvement of nephrologists in the education of trainees.https://doi.org/10.1186/s12882-021-02397-9Nephrology fellowshipSpecialty trainingEducation |
| spellingShingle | Georges N. Nakhoul Ali Mehdi Jonathan J. Taliercio Susana Arrigain Jesse D. Schold Abby Spencer Jessica Greenfield Amit Diwakar Grace Snyder John O’Toole Joseph V. Nally John R. Sedor Patricia F. Kao S. Beth Bierer “What do you think about nephrology?” A national survey of internal medicine residents BMC Nephrology Nephrology fellowship Specialty training Education |
| title | “What do you think about nephrology?” A national survey of internal medicine residents |
| title_full | “What do you think about nephrology?” A national survey of internal medicine residents |
| title_fullStr | “What do you think about nephrology?” A national survey of internal medicine residents |
| title_full_unstemmed | “What do you think about nephrology?” A national survey of internal medicine residents |
| title_short | “What do you think about nephrology?” A national survey of internal medicine residents |
| title_sort | what do you think about nephrology a national survey of internal medicine residents |
| topic | Nephrology fellowship Specialty training Education |
| url | https://doi.org/10.1186/s12882-021-02397-9 |
| work_keys_str_mv | AT georgesnnakhoul whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT alimehdi whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT jonathanjtaliercio whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT susanaarrigain whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT jessedschold whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT abbyspencer whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT jessicagreenfield whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT amitdiwakar whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT gracesnyder whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT johnotoole whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT josephvnally whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT johnrsedor whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT patriciafkao whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents AT sbethbierer whatdoyouthinkaboutnephrologyanationalsurveyofinternalmedicineresidents |