Why Internal Medicine Residents Don't Choose Nephrology

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Most non-nephrology internal medicine subspecialty fellows—such as those in cardiology, gastroenterology, critical care, and endocrinology—never considered nephrology as a career choice, in large part because of the challenges they believed they would face, according to a survey findings published online ahead of print in the American Journal of Kidney Diseases.

Researchers led by Kenar D. Jhaveri, MD, of Hofstra North Shore-Long Island Jewish School of Medicine, N.Y reported that, of 714 non-nephrology internal medicine subspecialty fellows who responded to the survey, only 26% had considered nephrology as a career choice. The top reason for not choosing nephrology—as indicated by 35% of respondents— was the belief that patients with end-stage renal disease are too complicated. Other reasons included the lack of a mentor during residency and medical school and not enough procedures in the field of nephrology.



In addition, about one-fourth of respondents indicated that they would have considered nephrology if the specialty had a higher income potential or the subject matter was taught well during medical school and residency training. The survey revealed that 31% of respondents indicated that nephrology was the most difficult physiology course taught in medical school.

Endocrinology fellows were the most likely to have considered nephrology as a career choice at some point during their residency, Dr. Jhaveri's group found. This is the first survey to ever evaluate non-nephrology internal medicine fellows' perceptions about nephrology.

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