title: Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.
abstract: BACKGROUND
  Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents.
  
  
  METHODS
  This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology.
  
  
  RESULTS
  131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02).
  
  
  CONCLUSIONS
  The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several negative perceptions of nephrology, which may affect career choice.
authors.affiliation: Department of Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, United States of America.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Daniels
authors.affiliation: Department of Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, United States of America.
authors.forename: Sharon
authors.identifier: http://orcid.org/0000-0002-7004-248X
authors.initials: S
authors.lastname: Maynard
authors.affiliation: Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic Florida, Jacksonville, Florida, United States of America.
authors.forename: Ivan
authors.initials: I
authors.lastname: Porter
authors.affiliation: Network Office of Research & Innovation, Lehigh Valley Health Network, Allentown, Pennsylvania, United States of America.
authors.forename: Hope
authors.initials: H
authors.lastname: Kincaid
authors.affiliation: Department of Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, United States of America.
authors.forename: Deepika
authors.initials: D
authors.lastname: Jain
authors.affiliation: Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic Florida, Jacksonville, Florida, United States of America.
authors.forename: Nabeel
authors.initials: N
authors.lastname: Aslam
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D003430:Cross-Sectional Studies; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D009398:Nephrology / Q000193:education*; D010465:Perception; D010820:Physicians; D011795:Surveys and Questionnaires