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The Argentine Society of Nephrology has observed a decrease in nephrology residents over the past decade, resulting in a slowdown in the growth of specialists at a time when the demand for nephrologists is increasing due to the rise in Chronic Kidney Disease. In the survey "Nephrological Training in Argentina 2018," the reasons for this loss of interest of young graduates were investigated: extended training duration, loss of practices and procedures, low job remuneration, among others. Faced with this reality, the Evaluation, Accreditation, and Certification Committee of the Society set out to document existing nephrology specialization programs, update the number of nephrologists in training, and assess the coverage of residency positions and specialization programs in the last five years
The study, conducted in 2022, is quantitative, cross-sectional, and descriptive. Formative centers were analyzed based on regional location, program type, duration, certification granted, number of residents, nationality, available and filled positions between 2017 and 2021. The country was divided into four geographical areas: Buenos Aires City, Buenos Aires Province, Córdoba/Santa Fe provinces, and Other Provinces. Training programs were categorized into three types: Basic Residencies, Post-basic Residencies, and University Specialization Programs. Data analysis included measures of central tendency and dispersion, two-way tables, box and whisker plots, statistical tests
The study included data from 44 Training Centers (94% of the total) distributed in Buenos Aires City (27%), Buenos Aires Province (21%), Córdoba/Santa Fe region (25%), and Other Provinces (27%). The training programs consist of 17 Basic Residencies (duration 4 years/9,000 hours), 11 Post-basic Residencies (duration 6 to 7 years/20,000 hours), and 16 University Specialization Programs (duration 3 years/5280 hours). In 2022, there were 208 residents/students, of which 43% were foreigners, distributed as follows: 59% in Buenos Aires City, 17% in Buenos Aires Province, 12% in Córdoba/Santa Fe, and 12% in Other Provinces. The strong concentration of foreign residents (99%) in Buenos Aires City and Buenos Aires Province influences regional disparities. When considering only Argentine residents, the differences are less pronounced, but a significant difference persists between Buenos Aires City and other provinces. Between 2017 and 2021, there were 422 available positions, of which 341 (81%) were filled, leaving 81 (19%) vacant. Coverage was similar in each program (Basic Residencies: 83%, Post-basic Residencies: 81%, University Specialization Programs: 79%), but with notable regional disparities, with Buenos Aires City having the highest coverage (99%), followed by Buenos Aires Province (80%), Córdoba/Santa Fe (61%) and Other Provinces (57%)
In Argentina, there are three modalities for nephrologist training with different durations. Training Centers are in 13 provinces. With respect to the regional distribution of residents, the majority undergo their training in Buenos Aires City. Residency position coverage is 81%, with marked regional variations, and 43% covered by foreign doctors. There is evidence of lower interest in nephrology among Argentine graduates. This may impact the human capital required for Chronic Kidney Disease care, especially in provinces distant from the capital