Perceptions towards Nephrology Specialty: The Good, the Bad and the Ugly.
Bibliographic record
Abstract
Background: There is a decline in the interest in pursuing a career in nephrology globally as well as locally in Northern Ireland. There is also an expansion in the burden of kidney disease worldwide due to a combination of factors like higher detection rates, increase in population size and improved life expectancy. Workforce shortages in nephrology have a direct impact on provision of care for people with kidney disease. Understanding perceptions among doctors towards nephrology is an important factor in acknowledging the barriers in recruitment and advocating evidence based changes to improve current practices. Aim: The aim of this study is to explore both the positive and the negative perceptions among medical students and trainees towards nephrology as a specialty in order to understand the factors that are most influential in either choosing or forgoing a career in nephrology. Methods: Scoping review methodology was used to address the research question through a phenomenological lens. Sixteen articles were included that studied the perceptions towards nephrology mainly through questionnaires and also through direct quotations. Basic numerical analysis and content analysis was completed. Findings: A total of 3745 participants including medical students, trainees and consultants participated in the 16 studies were included in this review at an international level. Most of the studies used survey (questionnaire) as their methodology (n= 10). The seven themes that emerged to describe perceptions towards nephrology were exposure to specialty; complex specialty; mentorship; work-life balance; financial compensation; personal interest; and procedural component. Exposure to specialty was the most influential factor in future career choice decision. The other factors that could improve recruitment in nephrology include innovative and novel teaching methods, good role models, flexible training and working patterns, and adequate financial remuneration. Conclusions: In order to rekindle interest in nephrology we need a multi-pronged approach based on ensuring early exposure to the specialty, good mentorship, holistic clinical experience covering different aspects of the specialty and the opportunity of flexibly moulding one's interests and skills whilst ensuring service provision, and with an emphasis on adequate financial remuneration.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.034 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".