Abstract
This article was migrated. The article was not marked as recommended. Background: Despite an increase in the number of chronic kidney disease patients, there is declining interest in careers in nephrology worldwide, including in Singapore. Singhealth is the largest sponsoring institution for residency in Singapore. A renal rotation is not a core internal medicine requirement of Singhealth, and it will be imperative for internists to help fill this gap. We report on an innovative nephrology elective which enhances learning in internal medicine trainees. Methods: The typical trainee was a 4th- or 5th-year internal medicine resident. The Kern six-step model was used to create and evaluate the course curriculum. The elective was of 4 weeks' duration and had both an inpatient and an outpatient component. An anonymized questionnaire was sent to the trainees to assess the learning value by comparing knowledge before and after the rotation. The trainees reported improvement in their ability to manage patients with kidney disease, fluid electrolyte disorders, and acid-base disorders (p<0.05). They were also more confident in their ability to teach these matters to junior doctors. Conclusions: The 4-week nephrology elective was found to greatly enhance learning in internal medicine residents. This format was also perceived favourably by IM residents, and might lead to more residents choosing careers in nephrology.
Highlights
Current estimates suggest that 8–16% of the world population has chronic kidney disease (CKD) (Hamer and El Nahas 2006, Sitprija 2003, Katz et al 2011, Jha 2013, Tonelli et al 2006)
As patients with acute kidney injury (AKI), CKD and fluid electrolyte imbalance are routinely admitted to medical wards, specialist nephrologists and internal medicine (IM) physicians will need to be conversant in their management
To be accredited as an IM physician, candidates are required by the Specialist Accreditation Board (SAB) to complete a further 2-year training programme known as the Advanced Internal Medicine (AIM) programme followed by an exit exam after a 3-year internal medicine residency
Summary
Current estimates suggest that 8–16% of the world population has chronic kidney disease (CKD) (Hamer and El Nahas 2006, Sitprija 2003, Katz et al 2011, Jha 2013, Tonelli et al 2006). As patients with acute kidney injury (AKI), CKD and fluid electrolyte imbalance are routinely admitted to medical wards, specialist nephrologists and internal medicine (IM) physicians will need to be conversant in their management. Singhealth is the largest sponsoring institution for residency in Singapore, with 34 programs under its purview. Since nephrology is not a core rotation, many trainees complete their training without sufficient exposure to renal patients in a structured learning environment. Despite an increase in the number of chronic kidney disease patients, there is declining interest in careers in nephrology worldwide, including in Singapore. Singhealth is the largest sponsoring institution for residency in Singapore. A renal rotation is not a core internal medicine requirement of Singhealth, and it will be imperative for internists to help fill this gap. We report on an innovative nephrology elective which enhances learning in internal medicine trainees
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