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Abstract: SA-PO009

Factors Influencing Residents Career Decision-Making

Session Information

  • Educational Research
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 800 Educational Research


  • Nakhoul, Georges, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Mehdi, Ali, Cleveland Clinic, Mayfield Hts, Ohio, United States
  • Taliercio, Jonathan J., Glickman Urological and Kidney Institute, Cleveland, Ohio, United States
  • Brateanu, Andrei, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Diwakar, Amit, Cleveland Clinic, Mayfield Hts, Ohio, United States
  • Daou, Remy, Saint Joseph University, Beirut, Lebanon
  • Sedor, John R., Cleveland Clinic, Mayfield Hts, Ohio, United States
  • Nally, Joseph V., Cleveland Clinic, Mayfield Hts, Ohio, United States
  • O'Toole, John F., Cleveland Clinic, Mayfield Hts, Ohio, United States
  • Bierer, S. beth, Cleveland Clinic, Mayfield Hts, Ohio, United States

Interest in nephrology as a specialty has been declining among US medical graduates and more than half of the nephrology fellowship programs remain unfilled. To better understand this phenomenon, we aimed to identify factors influencing residents’ choice of a “subspecialty career”.


A qualitative study was designed using the grounded theory methodology., Ten semi-structured interviews were conducted with randomly selected internal medicine residents (Postgraduate Year (PGY) 1 and 2 PGY2). The questions were guided by the Professional Identity (PI) Formation Framework, which captures key elements of the socialization processes contributing to the development of the PI. The residents’ answers were recorded and transcribed verbatim. Coding was performed by 2 independent reviewers who met to reach consensus on emerging themes. Data saturation was reached after the 8thinterview. Decision to stop interviewing was made after the 10thinterview.


Several recurring themes emerged in our analysis and were classified into three general categories: personal attributes (personality, family tradition, experiences and values), social factors (Mentors, transformative events, exposure, quality of instruction, performance and autonomy) and specialty-specific factors (Field, lifestyle and job-related factors) (Table 1). Among those themes, the role of role models/mentor stood out as the most important as it was mentioned by 100% of the residents. This adds new information to the factors that were previously identified by the ASN workforce.


We identified the factors influencing career decision-making in internal medicine residents and the key role of mentorship in this process. Understanding these factors could help the nephrology community understand the declining interest in the field and formulate interventions to potentially remedy the current situation.


  • Private Foundation Support