PMID- 31035944 OWN - NLM STAT- MEDLINE DCOM- 20200423 LR - 20200423 IS - 1471-2369 (Electronic) IS - 1471-2369 (Linking) VI - 20 IP - 1 DP - 2019 Apr 29 TI - Perceptions of nephrology among medical students and internal medicine residents: a national survey among institutions with nephrology exposure. PG - 146 LID - 10.1186/s12882-019-1289-y [doi] LID - 146 AB - BACKGROUND: Fewer trainees are choosing to pursue nephrology. Only 60.1% of positions filled in the 2018 fellowship Match, which is concerning given the rising prevalence of end-stage kidney disease. Identifying factors influential in career choices is critical to inform focused approaches to recruit qualified applicants. METHODS: To understand perceptions of nephrology and assess factors influential in specialty choice among early career trainees, an anonymous survey was distributed to upper-level medical students and internal medicine residents at programs identified through the American Association of Medical Colleges (AAMC) and American Medical Association's Fellowship and Residency Electronic Interactive Database (FREIDA). RESULTS: Of 4199 recipients, 644 (15.3%) participants responded, including 315 upper-level medical students, 308 residents, and three chief residents from 30 institutions. An interest in the subject was the most critical factor in selecting a specialty (92%). Other key factors included a suitable work-life balance (73%), access to mentors (70%), and subject exposure (66%). Lack of interest was the most frequently-cited reason to forgo a nephrology fellowship (79%), followed by concerns regarding remuneration (43%), work-life balance (39%), and subject exposure (32%). In free-text responses, several participants described frustration with managing patients on hemodialysis and desired combined training with specialties such as critical care. Respondents who had considered nephrology at any point cited an interest in physiology or interface with a mentor as key driving factors. CONCLUSIONS: A lack of interest in and exposure to the subject, perceptions of poor earning potential and patient nonadherence, and concerns regarding work-life balance were influential in participants' decisions to forgo nephrology training. Incorporating novel educational tools and broadening the scope of the nephrology elective, highlighting ongoing areas of clinical and research innovation, expanding opportunities for interdisciplinary collaboration and procedural skills, and cultivating strategies to reduce burnout may be useful areas on which to focus future recruitment efforts. FAU - Nair, Devika AU - Nair D AUID- ORCID: 0000-0001-7164-715X AD - Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North S-3223, Nashville, TN, 37232-2372, USA. devika.nair@vanderbilt.edu. FAU - Pivert, Kurtis A AU - Pivert KA AUID- ORCID: 0000-0002-3428-2427 AD - American Society of Nephrology, Washington, DC, USA. FAU - Baudy, Adrian 4th AU - Baudy A 4th AD - Tulane University, New Orleans, LA, USA. FAU - Thakar, Charuhas V AU - Thakar CV AD - University of Cincinnati, Cincinnati, OH, USA. LA - eng GR - T32 DK007569/DK/NIDDK NIH HHS/United States PT - Journal Article DEP - 20190429 PL - England TA - BMC Nephrol JT - BMC nephrology JID - 100967793 SB - IM MH - Adult MH - Attitude MH - *Career Choice MH - Female MH - Humans MH - *Internship and Residency MH - Male MH - Needs Assessment MH - Nephrology/*education MH - Quality Improvement MH - Social Perception MH - Students, Medical/*psychology MH - United States PMC - PMC6489240 COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This study was approved by Tulane University's Institutional Review Board (IRB# 8576831). The study was deemed exempt due to minimal risks for participants and the anonymous nature of the survey tool. All participants viewed an online consent form prior to participation, and documentation of consent was waived. CONSENT FOR PUBLICATION: Consent from the participants' to publish this data was explicitly included in all recruitment emails and in the Institutional Review Board application. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2019/05/01 06:00 MHDA- 2020/04/24 06:00 PMCR- 2019/04/29 CRDT- 2019/05/01 06:00 PHST- 2018/04/20 00:00 [received] PHST- 2019/03/10 00:00 [accepted] PHST- 2019/05/01 06:00 [entrez] PHST- 2019/05/01 06:00 [pubmed] PHST- 2020/04/24 06:00 [medline] PHST- 2019/04/29 00:00 [pmc-release] AID - 10.1186/s12882-019-1289-y [pii] AID - 1289 [pii] AID - 10.1186/s12882-019-1289-y [doi] PST - epublish SO - BMC Nephrol. 2019 Apr 29;20(1):146. doi: 10.1186/s12882-019-1289-y.