Factors associated with choosing Nephrology as a subspecialty by Internal Medicine Residents in Nigeria

Background: There is a projected shortage of kidney specialists in Nigeria and there is need to train more residents in nephrology to meet the need of the teaming population of patients with chronic kidney Disease. The study identify factors affecting the choice of Nephrology among resident doctors in selected training institutions in Nigeria. Methods: This cross-sectional study was conducted among the resident doctors in Internal Medicine in four randomly selected training institutions across the northern and southern parts of Nigeria. We developed a self-administered questionnaire in the English language after a thorough review of relevant literature. Data were gathered through the two-part questionnaire. In the first part, demography, gender, age, marital status, and level of training were documented and the second section included 24 questions about factors that influence the residents' choice of subspecialty. Results:Atotal of 78 respondents were interviewed. The mean age of the respondent was 33.52 ± 3.52. A higher proportion of the respondents were males (70.5%), 56.4% were senior registrars with the mean residency year of 3.46 ± 2.00. Atotal of 52.6% never had interested in nephrology as a career choice while of 47.4% that showed interest in nephrology, only 11.5% are currently in Nephrology. Most of those who had interest in Nephrology changed their mind along the line and are now registrars or senior registrars in other subspecialty. The most common factors identified were advice from other mentors or senior consultants (80.8%), outcome of most patients with renal condition (79.5%) and positive role model in nephrology medicine (76.9%). The least identified factors were prestige and respect accorded a nephrologist (35.9%) and societal expectation, peer encouragement and family's expectations (42.3%). Conclusion: There is an urgent need to address factors that affects the choice of Nephrology. Effective steps towards addressing these factors may go a long way in improving the internal medicine residents' choice of Nephrology as a career in the near future. Key words: career decisions, education, nephrology, training, Nigeri