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Kidney Week

Abstract: SA-PO008

Internal Medicine Residents' Perception of the Nephrology Specialty

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

Authors

  • 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
  • O'Toole, John F., Cleveland Clinic, Mayfield Hts, Ohio, United States
  • Nally, Joseph V., Cleveland Clinic, Mayfield Hts, Ohio, United States
  • Bierer, S. beth, Cleveland Clinic, Mayfield Hts, Ohio, United States
Background

Interest in nephrology as a specialty has been declining among US medical graduates As a result, more than half of the fellowship programs remain unfilled. To better understand this phenomenon, we intended to qualitatively explore the nephrology perceptions among Internal Medicine (IM) residents and to identify factors influencing their choice of a subspecialty career.

Methods

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). The interview 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. Interviews 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.

Results

Several recurring themes emerged in our analysis (Table 1). The negative factor that recurred most commonly was the lack of exposure to nephrology rotations both in the clinical and pre-clinical years. This was mentioned by 9 out of 10 residents. Other frequently recurring themes were: patient population (mentioned by 5/10 residents), lack of innovation in the field (4/10) and inability to make a difference (4/10). Factors positively influencing residents’ decision included: breadth (5/10) and complexity of pathology (7/10) and perception of nephrology as a highly intellectual specialty (7/10).

Conclusion

Lack of exposure to nephrology rotations in preclinical and clinical years appears to be the most important factor dissuading residents from pursuing a career in nephrology.

Funding

  • Private Foundation Support