Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr;61(4):540-6.
doi: 10.1053/j.ajkd.2012.10.025. Epub 2013 Jan 16.

Why not nephrology? A survey of US internal medicine subspecialty fellows

Kenar D Jhaveri  1 , Matthew A Sparks, Hitesh H Shah, Seyyar Khan, Arun Chawla, Tejas Desai, Edward Iglesia, Maria Ferris, Mark G Parker, Donald E Kohan
Affiliations

Why not nephrology? A survey of US internal medicine subspecialty fellows

Kenar D Jhaveri et al. Am J Kidney Dis. 2013 Apr.

Abstract

Background: There is a decreased interest in nephrology such that the number of trainees likely will not meet the upcoming workforce demands posed by the projected number of patients with kidney disease. We conducted a survey of US internal medicine subspecialty fellows in fields other than nephrology to determine why they did not choose nephrology.

Methods: A web-based survey with multiple choice, yes/no, and open-ended questions was sent in summer 2011 to trainees reached through internal medicine subspecialty program directors.

Results: 714 fellows responded to the survey (11% response rate). All non-nephrology internal medicine subspecialties were represented, and 90% of respondents were from university-based programs. Of the respondents, 31% indicated that nephrology was the most difficult physiology course taught in medical school, and 26% had considered nephrology as a career choice. Nearly one-fourth of the respondents said they would have considered nephrology if the field had higher income or the subject were taught well during medical school and residency training. The top reasons for not choosing nephrology were the belief that patients with end-stage renal disease were too complicated, the lack of a mentor, and that there were insufficient procedures in nephrology.

Conclusions: Most non-nephrology internal medicine subspecialty fellows never considered nephrology as a career choice. A significant proportion were dissuaded by factors such as the challenges of the patient population, lack of role models, lack of procedures, and perceived difficulty of the subject matter. Addressing these factors will require the concerted effort of nephrologists throughout the training community.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Subspecialties of survey respondents. Columns (left axis) show the total number of survey respondents within each subspecialty; the line graph (right axis) plots the cumulative percentages of total respondents with each subspecialty.
Figure 2
Figure 2
Respondents’ views of the most difficult topics in nephrology (question 4). Raw numbers of responses are plotted according to subspecialty. The right side of the graph gives an overall view of the frequency with which each response was selected. Abbreviations: AKI, acute kidney injury; HTN, hypertension; Tx, transplantation.
Figure 3
Figure 3
Responses to the questions “Did you ever consider doing a nephrology fellowship?” and “If you hadn’t matched into your current fellowship, was nephrology ever your second choice?” For each subspecialty, numbers of respondents and respondents answering yes are indicated. Proportions of affirmative responses are listed on the top of each column.
Figure 4
Figure 4
Responses to the question “What didn’t you like about nephrology?” Total number of respondents was 516.
See this image and copyright information in PMC

Comment in

  • Choosing nephrology--or not.
    Adams ND. Adams ND. Am J Kidney Dis. 2013 Apr;61(4):529-31. doi: 10.1053/j.ajkd.2013.02.003. Am J Kidney Dis. 2013. PMID: 23497766 No abstract available.

References

    1. Parker MG, Ibrahim T, Shaffer R, Rosner MH, Molitoris BA. The future nephrology work force: will there be one? Clin J Am Soc Nephrol. 2011;6(6):1501–1506. - PubMed
    1. Desai T, Ferris M, Christiano C, Fang X. Predicting the number of US medical graduates entering adult nephrology fellowships using search term analysis. Am J Kidney Dis. 2012;59(3):467–469. - PubMed
    1. National Resident Matching Program. Match Results Statistics: Specialties Matching Service 2012 Appointment Year. Washington, DC: National Resident Matching Program; 2011.
    1. Shah HH, Jhaveri KD, Sparks MA, Mattana J. Career choice selection and satisfaction among United States adult nephrology fellows. Clin J Am Soc Nephrol. 2012;7(9):1513–1520. - PubMed
    1. Parker MG, Owens S, Rosner MH. Nephrology as a career choice [abstract SA-PO2868] J Am Soc Nephrol. 2009;20:767A.

LinkOut - more resources