SUN-335 NEPHROLOGY IMMERSION: A SUCCESSFUL NATURAL EXPERIMENT

Abstract

The story began in January 2009 when Medical Resident 1 began working on Nephrology research tasks with the last author as an undergraduate student. This “natural experiment” arose unintentionally, not conceived of as an experiment until the present first author began doing similar Nephrology research tasks in January 2018 as a premed student and decided to test the “jumping into the deep end of the pool” immersion approach to learning kidney medicine and kidney pathology before medical school. This method is quite different from the usual stepwise acquisition of knowledge in classical medical education in medical school. Just like other immersive education, nephrology immersion was established by the inclusion of premedical students in a renal pathology and nephrology lab. The students worked with pathologists and clinicians on a daily basis, gaining knowledge of the specialty by attending weekly nephrology/pathology rounds, regularly studying renal biopsies from the hospital, and completing online and in-person curricula meant for nephrology trainees (eg. the American Society of Nephrology Kidney Week Early Program ‘Fundamentals of Renal Pathology’). The students demonstrated understanding of kidney pathology and nephrology material in several ways: successful completion of standardized curricula, weekly preparation and presentation of kidney biopsy cases at pathology/nephrology rounds, and training new pathology fellows. A necessary component is that the student must suspend belief that she has truly mastered the subject until she is in medical school and learns the surrounding context of related subjects necessary to fully understand nephrology. However, if this sort of nephrology immersion education can succeed safely and comfortably, such students preloaded with nephrology knowledge before medical school are a solution to the looming recruitment problems in Nephrology, because such students are very likely to choose a career in Nephrology because they are pre-equipped with specialized knowledge of the field. Standardized curricula make it easy to assess the knowledge of such immersion students and they perform at a level comparable to current nephrology fellows, despite lacking full “medical” understanding of the subjects. Immersion is an effective education technique in many other areas of human endeavour, and represents an additional innovative approach to kidney education, something the American Society of Nephrology (ASN) is seeking in several of its programs.