The global pediatric nephrology workforce: a survey of the International Pediatric Nephrology Association

Abstract

BackgroundThe global pediatric nephrology workforce is poorly characterized. The objectives of our study were to assess pediatric nephrologists’ perceptions of the adequacy of the pediatric nephrology workforce, and understand regional challenges to fellow recruitment and job acquisition. Perceptions regarding optimal length of training and research requirements were also queried.MethodsA 17-question web-based survey comprised of 14 close-ended and 3 open-ended questions was e-mailed to members of the International Pediatric Nephrology Association. Quantitative and qualitative analyses were performed.ResultsWe received 341 responses from members of the International Pediatric Nephrology Association from 71 countries. There was a high degree of overall perceived workforce inadequacy with 67 % of all respondents reporting some degree of shortage. Perceived workforce shortage ranged from 20 % in Australia/New Zealand to 100 % in Africa. Respondents from Africa (25 %) and North America (22.4 %) reported the greatest difficulty recruiting fellows. Respondents from Australia/New Zealand (53.3 %) and Latin America (31.3 %) reported the greatest perceived difficulty finding jobs as pediatric nephrologists after training. Low trainee interest, low salary, lack of government or institutional support, and few available jobs in pediatric nephrology were the most frequently reported obstacles to fellow recruitment and job availability.ConclusionsGlobally, there is a high level of perceived inadequacy in the pediatric nephrology workforce. Regional variability exists in perceived workforce adequacy, ease of recruitment, and job acquisition. Interventions to improve recruitment targeted to specific regional barriers are suggested.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0299-2) contains supplementary material, which is available to authorized users.

Human resources for nephrology in South Africa: A mixed-methods study

“…Our findings on nephrologists' perceptions of their chosen discipline are largely in keeping with those described by others, with certain aspects unique to South Africa [14,27,29]. These include the challenges in making decisions about access to RRT, a propensity to consider emigration due to wider social problems, frustrations borne from bureaucratic burdens, and apprehension about the effects of NHI on the private sector.…”

“…Regarding human resources for the delivery of nephrology services, it is of concern that the global nephrology workforce is shrinking despite the growing burden of CKD [13]. Data from the UK, Australia and the USA indicate that contributing factors include decreased interest in a nephrology career amongst medical students and trainees, perceptions of poor remuneration, physician burn-out, increased reliance on immigrant nephrologists and early retirement [13][14][15]. In African countries, the nephrology workforce is further jeopardised by emigration to developed countries [16].…”

Pediatric Nephrology Training Worldwide 2016: Quantum Educatus?

“…In the United States and Canada, concerns exist about workforce adequacy. 1 , 14 , 15 , 16 In 2015, only 30% of pediatric nephrology fellowship positions were filled in the National Residency Matching Program (NRMP), which improved slightly to 44% in the 2016 match. 17 Pediatric nephrology recruitment compares unfavorably to other pediatric subspecialties, with only child abuse having a lower percentage of positions filled in 2016.…”

“…17 This disturbing trend suggests that factors other than length of training discourage young physicians from choosing nephrology. 1 , 6 , 15 …”

“…A high degree of perceived workforce inadequacy and difficulty recruiting pediatric nephrology trainees exists in most regions of the world. 1 Concern about workforce adequacy in the United States has generated a discussion as to whether offering a shortened 2-year clinical track, as in adult nephrology, would increase the number of fellowship applicants. There is considerable tension, however, between meeting clinical training needs and the desire for pediatric nephrologists to be trained in research, since most work in academic settings.…”