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Abstract: TH-PO005

Nephrologists as Internal Medicine Residency Program Directors: Trends From a National Survey

Session Information

  • Educational Research
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 900 Educational Research


  • Kao, Patricia F., Washington University in St Louis School of Medicine, St Louis, Missouri, United States
  • Kisielewski, Michael, Alliance for Academic Internal Medicine, Alexandria, Virginia, United States

Internal medicine (IM) resident interest in nephrology careers peaked in 2008, declined in subsequent years, and has remained low over the last decade. Studies cite a lack of nephrology role models and lack of exposure to nephrology as contributing factors (Beck, 2020). IM program directors (PDs) are important stakeholders and role models who influence nephrology exposure and education during residency training. The number of nephrologists in IM residency leadership roles is currently unknown. The objective of this study was to quantify the number of IM residency PDs who are nephrologists, and to explore historical trends.


The Association of Program Directors in Internal Medicine (APDIM) Annual Survey queries IM PDs from ACGME-accredited (“Continued” or “Initial” status) about their sub-specialty training. The 2021 Annual Survey included PDs from 439 APDIM member programs, representing 80.4% of the 546 accredited U.S./U.S. territory-based IM training programs. To assess historical trends, we performed a multivariate regression and a multivariate test of means with survey data collected using a similar methodology from 2008 to 2021.


Of the 267/439 (61.0%) PDs who completed the 2021 Annual Survey, only 10/267 (3.7%) reported specializing in nephrology. From 2008 to 2021, the modal percentage of IM PDs who reported being nephrologists occurred in 2008 (6.0%; 16/268), reaching a nadir in 2020 (1.5%; 4/260). The reported percentage of IM PDs who are nephrologists decreased from 2008 to 2021 (p<0.01). (Figure 1)


The percentage of IM residency PDs who are nephrologists is low and has declined over the past 14 years. This may represent a missed opportunity for nephrologists to serve as role models to medicine residents and to advocate for more exposure to nephrology during residency training. Attracting more trainees to the field of nephrology may require encouraging more nephrologists to pursue key stakeholder leadership roles in residency education.

Percentage of IM Residency Program Directors Who Are Nephrologists: 2008 to 2021