Determinants of Interest in Nephrology Career Choice among Internal Medicine Junior Residents in Nigeria.

INTRODUCTION

There has been decreased interest in postgraduate nephrology training over the years. This trend could worsen the shortage of nephrologists and inability to meet the health needs of patients with kidney diseases if not urgently addressed.

AIM

To determine interest in and determinants of nephrology career choice among junior internal medicine residents in Nigeria.

METHODOLOGY

This was a cross-sectional study that enrolled 273 junior residents in internal medicine across Nigeria. A self-administered questionnaire that was adapted from two previous studies was used for data collection.

RESULTS

The mean age of the respondents was 33.6±4.4 years with a male: female ratio of 1.8:1. This study showed that 16.8% and 21.6% of junior residents in internal medicine considered nephrology as their first and second choice area to specialize, respectively. Factors that ranked high as determinants of a decision to do nephrology were personal interest (94.3%), opportunities to perform renal procedures (93.3%), and exposure to nephrology training (85.7%). Factors that discouraged a choice of nephrology according to respondents were high mortality of renal patients (67.3%), poor outcomes of renal patients (70.2%), in ability to fund treatment by renal patients (66.1%), unsatisfactory life-work balance among nephrologists (60.7%), and late presentation of renal patients (59.0%). Others were high workload compared to available doctors (59.0%) and poor job satisfaction (55.4%). Factors that could stimulate more interest in nephrology according to respondents included creation of better working environment with adequate equipment for training (96.3%), provision of health insurance with adequate coverage for renal patients (97.4%), and increased government support for renal care services (99.3%).

CONCLUSION

There is a need to promote and sustain interest of residents in nephrology by ensuring improved survival of patients through better access to renal care, ensuring an adequate and well motivated work force, provision of adequate facilities and health insurance services.