Study evaluates how well fellowship training prepares kidney specialists
A recent study examines how new kidney specialists feel their training has prepared them to care for patients. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), provide important information on how to improve the education of future nephrologists.
After completing a specialty training program, or residency, following medical school, physicians typically spend at least 2 years in fellowships to receive additional expertise. To evaluate the educational needs and interests of fellows focused on kidney care, Rob Rope, MD (Stanford University) and his colleagues analyzed survey results from 320 US nephrology fellows.
Most respondents rated overall quality of teaching in fellowships as either "good" (37%) or "excellent" (44%), and most (55%) second-year fellows felt "fully prepared" for independent practice. Fellows indicated a desire for more education in several core nephrology topics, including peritoneal dialysis and home hemodialysis, ultrasound, and kidney pathology. "The indication that fellows may be underprepared to use home dialysis modalities is, unfortunately, consistent with prior studies and represents a major barrier to the greater implementation of these patient-centered therapies," said Dr. Rope.
The results also highlighted tensions between patient care and educational needs. As the volume of work in academic medical centers increases over time, the challenge of meeting patient care needs may come at the expense of trainees' education. "This is a delicate balance fellowships may struggle with over time," said Dr. Rope.
Unfortunately, the survey also indicated that several ASN educational resources are not frequently utilized, despite delivering content on topics of interest to fellows, such as home dialysis. This information may be helpful in the development and evaluation of future educational tools.
This study identifies areas where improvements in nephrology fellowship structure and content could help ensure that patients with kidney disease—the 9th leading cause of death in the United States—receive the highest quality of care only a nephrologist can provide.