CHALLENGES FOR NEPHROLOGY TRAINEES AND EARLY-CAREER NEPHROLOGISTS IN THE NEWLY INDEPENDENT STATES AND RUSSIA: PRELIMINARY RESULTS OF AN INTERNATIONAL CROSS-SECTIONAL STUDY

 

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https://storage.unitedwebnetwork.com/files/1099/bcb8e53f3a04d5cde7a307a5a1fbc766.pdf
CHALLENGES FOR NEPHROLOGY TRAINEES AND EARLY-CAREER NEPHROLOGISTS IN THE NEWLY INDEPENDENT STATES AND RUSSIA: PRELIMINARY RESULTS OF AN INTERNATIONAL CROSS-SECTIONAL STUDY

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Nikolay
Bulanov
Nikolay Bulanov nmbulanob@gmail.com 1Sechenov First Moscow State Medical University Department of Internal, Occupational Diseases and Rheumatology Moscow Russia *
Ekaterina Parshina pannn@yandex.ru Saint Petersburg State University Hospital Department of Nephrology and Dialysis Saint Petersburg Russia -
Alimzhan Muxunov alimzhan.muxunov@nu.edu.kz Nazarbaev University School of Medicine Department of Medicine Astana Kazakhstan -
Anna Khokhlova annkechina@gmail.com Veltishev Research and Clinical Institute for Pediatrics and Children Surgery Department of hereditary and acquired kidney diseases Moscow Russia -
Abduzhappar Gaipov abduzhappar.gaipov@nu.edu.kz Nazarbaev University School of Medicine School of Medicine Astana Kazakhstan -
Olimkhon Sharapov olimkhon@gmail.com Republican Specialized Scientific Practical Medical Center of Nephrology and Kidney transplantation department of Adult and Pediatric Nephrology Tashkent Uzbekistan -
Armenuhi Hazoyan hazoyan.armine@gmail.com Yerevan State Medical University after M. Heratsi Saint Gregory the Illuminator Medical Center, Nephrology Service Yerevan Armenia -
Aiperi Asanbek kyzy iperyipery@gmail.com Institute of Science Tokyo Department of Public Health Tokyo Japan - Osh State University International Medical Faculty Osh Kyrgyzstan
Nadzeya Rapetskaya n.rapetskaja@gmail.com Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology Transplant Nephrology Department Minsk Belarus -
Elnada Aghaeva elnadasadiqova@mail.ru Azerbaijan Medical University Department of Nephrology Baku Azerbaijan -
Ismoil Rashidov nefrontj@gmail.com National Medical Center “SHIFOBAKHSH” Department of Nephrology Dushanbe Tajikistan -
Nora Sarishvili norasarishvili@yahoo.com Tbilisi State Medical University Nephrology Department Tbilisi Georgia -
Dmytro Ivanov drivanovdd@gmail.com Bogomolets National Medical University Nephrology Department Kyiv Ukraine -
Meylis Rejepov meylisr2010@gmail.com Turkmen state medical university Department of Nephrology Ashgabat Turkmenistan -
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Real-world problems and needs of the young nephrologists in the Newly Independent States (NIS) and Russia region have not been properly studied. The aim of this study was to identify the most relevant region-specific challenges faced by the early career nephrologists and trainees in the NIS and Russia.

At the first step we performed a scoping review to identify the spectrum of potential problems faced by young nephrologists, and a survey comprising 69 questions was developed. The survey was translated into the national languages of the participating countries in accordance with language adaptation and validation procedures. Questions were categorized into the following blocks: “Job conditions and workload”, “Career opportunities”, “Administrative burdens”, “Education and training”, “Psychosocial wellbeing”. The responders expressed their agreement with the relevance of each problem on a 5-point Likert scale from “Strongly Disagree” (1 point) to “Strongly Agree” (5 points). 

At the next step we conducted an anonymous online survey in Google Forms among responders from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. We enrolled nephrologists with ≤5 years of practice and nephrology trainees aged ≤40 years.

The study was approved by the Biomedical Ethics Board of Saint Petersburg State University Hospital (21 November 2024, protocol #11/24). The study protocol was published online (http:osf.io/xqd34).

Statistical analysis was performed in Stata v.16.0. Quantitative variables are presented as means (SD). For each domain weighted average score was calculated by adjusting the sum of score to the number of statements in the domain. 

The survey involved 221 responders from 11 countries (fig. 1). The majority of the responders were females (77%), mean age was 31 (5) years, 51% were married and 12% were in long-term relationships, 42% had one or more children. The majority (70%) were nephrologists in practice, the others were trainees.

Mean score for all domains was 2.85 (0.70). The most relevant were challenges related to job conditions and workload and career opportunities with mean scores of 3.11 (0.70) and 3.07 (1.00), respectively (fig. 2). Administrative burdens were experienced as the least relevant. Most of the scores showed no association with gender, however, there was a trend for the challenges related to psychosocial wellbeing to be more relevant for female responders than for male (2.72 [0.90] vs. 2.44 [0.93], respectively; difference 0.28 [95% CI: -0.004; 0.57], р=0.054). Nephrologists in practice, compared to trainees, tended to prioritize problems related to education and training (2.90 [0.88] vs. 2.61 [1.10], respectively; difference 0.29 [95% CI: 0.01; 0.55], p=0.039), career opportunities (3.15 [1.0] vs 2.86 [1.1], respectively; difference 0.295 [95% CI: -0.005; 0.6], p=0.054), and working conditions (2.79 [0.91] vs 2.32 [0.83], respectively; difference 0.48 [95% CI: 0.22; 0.73], p<0.001).

Figure 1. Distribution of responders by the country of residence

Figure 2. Distribution of the scores for different domains: A – in the entire cohort; B – stratified by gender (males in blue, females in red); C – stratified according to the status (trainees in blue, nephrologists in practice in red).

Figure 1. Distribution of responders by the country of residence

Challenges related to working conditions and limited career opportunities are the most relevant for early career nephrologists and trainees in the NIS and Russia.

Kewords