Survey study of trends in adult nephrology advanced training in Australia and New Zealand.
Australia and New Zealand
advanced training
employment
nephrology
survey
Journal
Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
revised:
06
09
2021
received:
19
05
2021
accepted:
10
09
2021
pubmed:
17
9
2021
medline:
18
3
2022
entrez:
16
9
2021
Statut:
ppublish
Résumé
There has been considerable growth in nephrology advanced trainee numbers in Australia and New Zealand, with uncertain effects on clinical experience, competence and employment outcomes. To review the perceived adequacy and temporal trends of advanced training in nephrology in Australia and New Zealand by evaluating training experiences, personal views on important aspects of training and nephrology, career paths and early employment outcomes. An online survey was distributed to members of the Australian and New Zealand Society of Nephrology through email in December 2020. Responses were sought from current trainees and from nephrologists qualifying since 2014. Likert scale proportions were calculated and group comparisons made using the Chi-squared test. A total of 88 participants returned the survey yielding a response rate of 32%, with a representative sample of trainees and consultants from across Australia and New Zealand. Training was reported as adequate in most aspects of clinical nephrology, although 88% of respondents felt poorly prepared for entering private practice and 61% reported inadequate training in kidney histopathology. Exposure to clinical procedures was variable, with adequate training in percutaneous kidney biopsy, but mostly inadequate training in dialysis access insertion. Sixty-nine percent of nephrologists completed their advanced training entirely in large urban centres and 85% worked in an urban area after training. Only 23% of consultants were engaged in full-time clinical employment in their first-year post-training and 78% were undertaking at least one of dual specialty training or a higher degree by research. Demand for subspecialty fellowships was high. Trainees and nephrologists in Australia and New Zealand are currently satisfied with their training in most aspects of nephrology; however, some clinical experiences are perceived as inadequate and early career paths after advanced training are increasingly diverse.
Sections du résumé
BACKGROUND
BACKGROUND
There has been considerable growth in nephrology advanced trainee numbers in Australia and New Zealand, with uncertain effects on clinical experience, competence and employment outcomes.
AIMS
OBJECTIVE
To review the perceived adequacy and temporal trends of advanced training in nephrology in Australia and New Zealand by evaluating training experiences, personal views on important aspects of training and nephrology, career paths and early employment outcomes.
METHODS
METHODS
An online survey was distributed to members of the Australian and New Zealand Society of Nephrology through email in December 2020. Responses were sought from current trainees and from nephrologists qualifying since 2014. Likert scale proportions were calculated and group comparisons made using the Chi-squared test.
RESULTS
RESULTS
A total of 88 participants returned the survey yielding a response rate of 32%, with a representative sample of trainees and consultants from across Australia and New Zealand. Training was reported as adequate in most aspects of clinical nephrology, although 88% of respondents felt poorly prepared for entering private practice and 61% reported inadequate training in kidney histopathology. Exposure to clinical procedures was variable, with adequate training in percutaneous kidney biopsy, but mostly inadequate training in dialysis access insertion. Sixty-nine percent of nephrologists completed their advanced training entirely in large urban centres and 85% worked in an urban area after training. Only 23% of consultants were engaged in full-time clinical employment in their first-year post-training and 78% were undertaking at least one of dual specialty training or a higher degree by research. Demand for subspecialty fellowships was high.
CONCLUSION
CONCLUSIONS
Trainees and nephrologists in Australia and New Zealand are currently satisfied with their training in most aspects of nephrology; however, some clinical experiences are perceived as inadequate and early career paths after advanced training are increasingly diverse.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
206-213Commentaires et corrections
Type : CommentIn
Type : ErratumIn
Informations de copyright
© 2021 Royal Australasian College of Physicians.
Références
Workforce Review Committee of the Australian and New Zealand Society of Nephrology. Report of the Workforce Review Committee of the ANZSN 2017. Sydney: ANZSN; 2017, 2017 [cited 2020 Dec 30]. Available from URL: https://www.nephrology.edu.au/workforce-report.asp
Amos L, Toussaint N, Phoon R, Elias T, Levidiotis V, Campbell S et al. Increase in nephrology advanced trainee numbers in Australia and associated reduction in clinical exposure over the past decade. Intern Med J 2013; 43: 287-93.
Beaton T, Krishnasamy R, Toussaint N, Phoon R, Gray N. Nephrology training in Australia and New Zealand: a survey of outcomes and adequacy. Nephrology 2017; 22: 35-42.
Eysenbach G. Improving the quality of web surveys: the checklist for reporting results of internet surveys (CHERRIES). J Med Internet Res 2004; 6: e34.
Department of Health. Modified Monash Model. Report No. 1. Canberra: Australian Government; 2019.
Stats NZ Tatauranga Aotearoa. Statistical Standard for Geographic Areas 2018. Wellington: Stats NZ; 2017 [cited 2020 Dec 30]. Available from URL: https://www.stats.govt.nz/methods/statistical-standard-for-geographic-areas-2018
Health Workforce Australia. Health Workforce 2025; Medical Specialties. No. 3. Adelaide: Health Workforce Australia; 2012.
Royal Australasian College of Physicians (RACP). Member Services of the RACP. RACP Member Statistics and Insights. Report No. 1. Melbourne: RACP; 2020.
Australian Institute of Health and Welfare (AIHW). Australia's Health 2018. Canberra: AIHW; 2018 [cited 2021 Mar 25]. Available from URL: https://www.aihw.gov.au/getmedia/0c0bc98b-5e4d-4826-af7f-b300731fb447/aihw-aus-221-chapter-5-2.pdf.aspx#:~:text=Around%207%20million%20people%E2%80%94about,people%20living%20in%20major%20cities
Medical Board of Australia Registration data; c2015-2020. Canberra: MBA; c2015-2020 [cited 2020 Jun 13]. Available from URL: https://www.medicalboard.gov.au/News/Statistics.aspx
Playford D, May J, Ngo H, Puddey IB. Decline in new medical graduates registered as general practitioners. Med J Aust 2020; 212: 421-2.
Gupta N, Taber-Hight E, Miller B. Perceptions of home dialysis training and experience among US nephrology fellows. Am J Kidney Dis 2020; 77: 713-18.
Royal Australasian College of Physicianss (RACP). Accredited Sites for Advanced Training. Melbourne: RACP; 2020 [cited 2021 Mar 24]. Available from URL: https://www.racp.edu.au/docs/default-source/trainees/accredited-settings/at-nephrology-accredited-sites-aus-os.pdf?sfvrsn=4f440b1a_44
Lane C. The Australian Nephrology Workforce Survey 2007. Report No. 1. Sydney: Australian and New Zealand Society of Nephrology; 2007.
Freed G, Turbitt E, Allen A. Public or private: where do specialists spend their time? Aust Health Rev 2017; 41: 541-5.
Tonelli M, Wiebe N, Manns B, Klarenbach SW, James MT, Ravani P et al. Comparison of the complexity of patients seen by different medical subspecialists in a universal health care system. JAMA Netw Open 2018; 1: e184852.
Lane C, Healy C, Ho MT, Pearson S-A, Brown MA. How to attract a nephrology trainee: quantitative questionnaire results. Nephrology 2008; 13: 116-23.
Williams S, Temple-Smith M, Chondros P, Spike N, Salamone A, Magin P et al. Are we preparing Victorian general practice registrars to be confident in all aspects of primary care paediatrics? Aust J Gen Pract 2020; 49: 759-66.
Barrios R, Ibeas J, Tey R, Guerrero MC, Bars AB, Delgado IC et al. Diagnostic and interventional nephrology in Spain: a snapshot of current situation. J Vasc Access 2019; 20: 140-5.
Department of Health. Nephrology 2016 Factsheet. Canberra: Australian Government; 2017 [cited 2021 Jun 25]. Available from URL: https://hwd.health.gov.au/webapi/customer/documents/factsheets/2016/Nephrology.pdf