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Abstract: FR-OR002

Specialty Choice and Nephrology: Perceptions Among Medical Students and Internal Medicine Residents

Session Information

Category: Nephrology Education

  • 1301 Educational Research


  • Nair, Devika, Vanderbilt University, Nashville, Tennessee, United States
  • Pivert, Kurtis, American Society of Nephrology, Washington, District of Columbia, United States

Fewer medical trainees are choosing to pursue nephrology. Only 60.8% of nephrology fellowship positions filled in the AY 2017 nephrology Match, especially concerning in the setting of a growing number of patients with kidney disease.


To understand perceptions about nephrology and assess factors influencing specialty choice among trainees, an anonymous survey was distributed to medical students and internal medicine residents at 30 US medical schools and residencies. Of 4199 recipients, 648 (15.4%) trainees responded, including 333 upper-level medical students, 304 residents, and three chief residents.


Interest in the subject matter was the most critical factor in choosing to pursue a specialty (92% of participants). Other key considerations included a suitable post-fellowship work-life balance (73%), access to mentors (70%), and adequate exposure to the subject (66%). Lack of interest was the most common reason to forgo a nephrology fellowship (79% of responses). Concerns about remuneration (43%), perceptions of an unsatisfactory work-life balance (39%), and inadequate exposure to nephrology during earlier training (32%) were frequently cited dissuading factors. Several respondents expressed a desire for a combined nephrology-critical care or nephrology-interventional radiology fellowship. Interest in renal physiology and access to mentors were noted as highly influential to those who considered a nephrology career at any point.


Lack of interest in nephrology was the leading factor in respondents’ decision to not pursue the specialty. Innovative ways to expose trainees to the meaningful rewards and worthwhile challenges of kidney care are needed to continue to attract qualified applicants.