Abstract: FR-OR003

Best Practices to Increase Resident Interest in Nephrology: A Mixed Methods Study

Session Information

Category: Nephrology Education

  • 1301 Educational Research


  • Sozio, Stephen M., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Pivert, Kurtis, American Society of Nephrology, Washington, District of Columbia, United States
  • Shah, Hitesh H., Hofstra Northwell School of Medicine, Great Neck, New York, United States
  • Asmar, Abdo, University of Central Florida Shool of Medicine, Orlando, Florida, United States
  • Morrow, Benjamin D., Uniformed Services University of the Health Sciences (USUHS), San Antonio, Texas, United States
  • Adams, Nancy Day, University of Connecticut Health Center, Hartford, Connecticut, United States

Interest in nephrology careers has declined. Understanding practices of internal medicine (IM) residency programs that successfully generate nephrology interest is sorely needed.


The Best Practices Project is an ASN Workforce and Training Committee project to increase nephrology interest. Residents graduating 2002-2012 were identified with the AMA Masterfile; programs were ranked by number of residents ultimately choosing nephrology. Nephrology training program directors (TPDs) from the top 30 institutions were sent a survey about their renal elective and educational experience for IM residents. Directed focus groups were conducted among IM-PDs (top 15 programs) probing key factors in each program's success. Survey results were analyzed across program ranking and compared to a previously-reported national survey. Transcripts from focus groups were analyzed using thematic content analysis.


19 nephrology TPDs (68%) responded to our survey and 4 IM-PDs (27%) directed focus group sessions were conducted. Most programs were in large tertiary centers. Nephrology TPDs noted faculty mentoring (78%), elective experience (72%), research opportunities (56%), and exposure to nephrology fellows (56%) were most effective in fostering interest. All programs offered renal electives; 33% were mandatory. 53% of programs’ typical electives incorporate outpatient experiences, higher than the national average (42%). Programs with more IM residents choosing nephrology were significantly more likely to offer ambulatory experiences in general nephrology in their elective (p=0.042) and have residents mentored in more impactful research projects (p=0.025). IM-PDs noted faculty exposure, quality of nephrology teaching, and demonstrating nephrology as a viable field were keys to success.

One exemplar quote: [Faculty] work hard and play hard. This group of faculty always hosts dinners at the end of the rotation. They actually make their own t-shirts. They kind of have their own branding of what they are


Integrating outpatient experiences in nephrology electives and mentoring residents in high quality research projects likely increase interest in nephrology. Faculty contact and teaching in both electives and core resident areas also contribute to generating nephrology interest. Interventions to enhance these activities are needed.