Glomerular Disease Education Experience across Nephrology Fellowship Programs: An International Survey

Abstract

Introduction: Glomerular disease (GN) education is an important, albeit a challenging component of nephrology fellowship training. We hypothesized that trainee experience varies widely across programs, leading to differences in self-reported comfort levels in the diagnosis and management of glomerular diseases. Methods: The Glomerular Disease Study & Trial Consortium (GlomCon) conducted an anonymous online survey to determine the educational experience of nephrology trainees. We used multiple-choice questions to obtain data about a) curriculum-based education, b) dedicated specialty clinic, and c) exposure to pathology. We leveraged a visual analogue scale of 1-100 (with a higher number indicating a higher comfort level) to assess self-reported levels of clinical comfort. The survey was disseminated via email to the subscribing members of GlomCon, and through Twitter. Results: In total, there were 109 respondents to our survey, and 56% were from training programs in the United States. Exposure to a specialized GN clinic was reported by 45%, while 77% reported the presence of an onsite nephropathologist at their training program. Self-reported comfort scores were 59±25 and 52±25 for diagnosis and treatment of glomerular diseases respectively. Days spent in GN clinic per year, years of fellowship and dedicated nephropathology didactics were associated with higher diagnosis and treatment comfort scores. Conclusion: Trainees report a wide variation in glomerular disease education across fellowship programs. A lack of nephropathology exposure and a dedicated GN curriculum were associated with lower scores in self-reported clinical comfort in caring for patients with glomerular disease.