The programme demonstrated safe, expedited and efficient follow up with a clinical and web based programme. Support from the general practitioners and patients was encouraging, despite logistical issues. Ongoing evaluation of VC services will continue and feasibility to larger networks and more chronic diseases remains the long term goal.

Nephrology trainee recruitment is essential if we are to address the shortage of nephrologists in countries such as the USA, Canada, the UK and Australia. This Australian study determines barriers, following clinical exposure, to trainees' pursuing a career in nephrology.

Random spot urinary P/Cr predicts actual 24 h protein excretion with reasonable accuracy in patients with lower levels of protein excretion but is unreliable in patients with high protein excretion and should not be used in the clinical setting unless 24 h urine collection is unavailable.

Exposure to a nephrology term in early postgraduate years is an important factor in a decision to undertake nephrology training. During these rotations; trainees need to experience positive role modelling. Effective trainee recruitment strategies should utilize the positive influence of role models, and must consider restructuring workforce and training activities to improve work hour flexibility and remuneration. Negative perceptions, acting as barriers to the pursuit of a career in nephrology, must be addressed and any misinformation corrected.

SummaryBackground and objectives Competency-based training programs focus on the product of training rather than the process with the desired attributes and skills set of the specialist directing the training program. These ideal skills and qualities have yet to be formally identified for nephrology training. The objectives of our study were: (1) to define the attributes of a "high quality" nephrologist from the perspectives of the trainer (nephrologist), trainee, and renal patient and (2) identify components and relative frequencies of nephrologists' work practice.Design, setting, participants, & measurements Four substudies were undertaken, utilizing a combined quantitative and qualitative approach: (1) a national nephrology workforce study, (2) in-depth interviews of nephrology patients, (3) in-depth interviews of nephrology trainees, and (4) in-depth interviews of practicing nephrologists.Results Patients value good communication skills above other attributes. Nephrologists and trainees identify particular personal attributes, a holistic and evidence-based approach to patient care, and good clinical skills as paramount. Although nephrologists spend most of their time in clinical practice, substantial time is also spent in research, teaching, and administrative work.Conclusions For the first time, an evidence-based approach has been used to help define qualities desired in a practicing nephrologist. Along with training and assessment in clinical practice, this research supports nephrology training programs incorporating training in basic interventions, research skill acquisition, administration, and teaching. Training toward high standards in advanced communication and the maintenance of a holistic approach to patient care are necessary.