Introduction:
Nephrology is a critical and evolving medical subspecialty, yet it is often less favored by internal medicine residents in comparison to other fields such as cardiology and gastroenterology. In India, nephrology appears to be gaining attention, but the factors influencing residents’ choices remain unclear. This study aims to evaluate the perceptions and factors influencing internal medicine residents in India regarding choosing nephrology as a subspecialty.
Methods:
A quantitative cross-sectional survey was conducted among internal medicine residents across various medical programs in India. The survey comprised a 30-item questionnaire designed to assess residents' perceptions of nephrology, factors influencing their subspecialty choices, and their training experiences. Data were stratified by gender and year of residency. The survey was distributed online, and response rates were calculated along with participant characteristics and response distributions.
Results:
A total of 150 residents participated in the survey, with 30 (20%) expressing an interest in pursuing nephrology fellowship training. Over 90% of the respondents had experience managing kidney patients during their residency, yet 75% reported lacking mentorship for subspecialty selection, and 30% stated that their programs did not have a mandatory nephrology rotation. These figures were consistent across gender. Major deterrents included the complexity of nephrology and perceptions of the field as "depressing" due to the poor prognosis of chronic kidney disease (CKD) patients(cited by 70%). Additionally, 30% of residents felt that nephrology offered fewer procedural opportunities compared to other subspecialties. Despite this, many acknowledged good job prospects and financial incentives in nephrology. Poor work-life balance was a concern for 25% of the respondents.
Conclusions:
The study highlights several factors influencing internal medicine residents' decision-making regarding nephrology, including perceived complexity, poor patient outcomes, and a lack of mentorship. While job prospects and financial rewards are seen positively, addressing barriers such as better mentorship and training opportunities could enhance interest in nephrology as a subspecialty.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.