Shaping an Early Nephrology Fellowship Curriculum: Results from the American Society of Nephrology Fellow Survey.

KEY POINTS: A quarter of Nephrology Fellow Survey respondents reported feeling unprepared to start fellowship. Current fellows desire a focus on nephrology emergencies and executive functioning skills in an early-fellowship curriculum. Optimizing early fundamental nephrology education has potential to positively influence fellows' clinical success.

BACKGROUND

The transition between residency and nephrology fellowship can be difficult for many trainees because of nephrology's inherent complexity and high-intensity nature as well as the lack of standardization in internal medicine training. We aimed to assess self-perceived preparedness of nephrology fellows at the start of fellowship and explore learner preferences for educational methods and content for an early-fellowship curriculum.

METHODS

Data were collected using an instrument included in the 2025 American Society of Nephrology Fellow Survey.

RESULTS

Responses from 339 adult nephrology fellows were included in analysis. Most responding fellows (252 [74%]) reported feeling extremely prepared, very prepared, or moderately prepared when starting nephrology fellowship. Preparedness was associated with completing three or more weeks of nephrology rotations in residency (chi-squared test for independence, P = 0.004). Half of fellows (49%) reported participating in an early-fellowship curriculum before starting clinical rotations. Learner preferences for educational methods used in an early-fellowship curriculum were similar to those most commonly used in contemporary curricula (didactics, shadowing senior fellows, and case simulations), although there was a preference for small-group problem-based learning compared with procedural training. Fellows reported a preference for learning about common inpatient nephrology emergencies (AKI, dialysis prescriptions and complications, and electrolytes and acid/base) and executive functioning skills (workflow/efficiency and discussing dialysis and goals of care with patients) in their ideal early-fellowship curriculum.

CONCLUSIONS

These results can help inform development of future early-fellowship curricula on the basis of current fellows' experiences and perceived needs to promote successful clinical training.