Are Undergraduates Familiar with Nephrology as a Medical Specialty? A Single Site Survey of Undergraduate Students

Abstract

Background: Over the past decade, nephrology has experienced a 43% decline in the number of fellowship applicants. Previous studies examining why residents choose a fellowship program cite lack of exposure as a main factor having an impact against a career in nephrology; however, no studies have surveyed the undergraduate population to inquire whether they recognize nephrology as a medical specialty compared to other medical specialties. We conducted a survey at a primarily undergraduate institution in the southeast United States to test whether undergraduate students identified the word "nephrology". Methods: A total of 274 undergraduates responded to a survey that requested them to select every medical specialty that they recognized by name (15 real specialties/1 fictitious). Demographics regarding sex, race, collegiate level, high school location, premedicine track, and household income were collected. Correlations between survey findings and rates of application and average salary per specialty were assessed. Results: Out of 15 medical specialties, nephrology (29%) and pulmonology (40%) were the least recognized. pediatrics (97%) and surgery (97%) ranked highest. Sex, race, collegiate level, and household income were not different between those students that recognized "nephrology" versus those who did not. Premedicine students were about twice as likely to have recognized nephrology versus non premedicine students (49% vs. 22%, respectively, p<0.001). STEM majors were about twice as likely to identify nephrology versus non-STEM majors (40% vs. 20%, respectively, p<0.001). The proportion of undergraduate students who recognized a specific medical specialty significantly correlated only with the number of U.S. applicants per fellowship position across different medical specialties in year 2020 (p<0.05). Conclusions: Based on word association alone, nephrology is the one of the least recognized specialties by undergraduates. The discrepancy between nephrology and other specialties highlights a gap in name recognition at an early career stage, even amongst premedical students.