Increase in nephrology advanced trainee numbers in Australia and associated reduction in clinical exposure over the past decade

Abstract

There has been a dramatic and significant increase in nephrology advanced trainee numbers over the past decade at a more rapid rate than the growth in dialysis and transplant patient numbers. This study suggests that training experience has diminished over the past decade and supports a 3-year core clinical nephrology training programme in Australia.

Nephrology training in Australia and New Zealand: A survey of outcomes and adequacy

“…From 2014, nephrology trainees in ANZ were required to complete a minimum of 3 years of core clinical nephrology, which compares with previous training requirements of two core clinical years and one non‐core or elective year . This change ensured nephrology training in ANZ was more aligned with other international nephrology training programmes such as the United Kingdom and Ireland and was also in response to concerns regarding decreased clinical exposure during nephrology training with increasing advanced trainee numbers …”

“…The number of nephrology advanced trainees in Australia and New Zealand (ANZ) has increased significantly in recent years. In 2014, there were 106 nephrology trainees across Australia compared with 23 in 2000 . New Zealand reported growth from 19 trainees in 2010 to 30 in 2014 (Advanced Training Committee in Nephrology, pers.…”

“…comm., August 2015). Reasons for this increase include efforts to promote nephrology training due to concerns of insufficient numbers of nephrologists in the workforce and the ability to cater for future community demand, introduction of safe work practices limiting hours doctors can work and a significant increase in the number of medical school graduates …”

“…A specific concern for nephrology training is that the increase in trainee numbers is disproportionally greater than the increase in patients with end‐stage kidney disease (ESKD) over the same time period. This has resulted in decreased clinical exposure, particularly to dialysis and renal transplant patients . The number of procedures performed by trainees, such as kidney biopsies and insertion of temporary vascular access catheters, has also reduced .…”

Nephrologists as Educators

“…We were left with 30 (41%) articles after applying the exclusion and inclusion criteria. Six articles were related to student learning (3)(4)(5)(6)(7)(8), five were related to postgraduate trainees (9-13), and 19 were related to fellows or fellowship training (1,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). None of the articles had teachers or faculty members as subjects of the educational investigation.…”