Assessing Resident Preparedness and Educational Needs in Nephrology: A Survey-Based Quality Improvement Initiative

Background: Nephrology remains a complex and underrepresented area within internal medicine training.Understanding resident confidence and educational needs is critical to strengthening nephrology education and preparing residents for clinical practice.This study aimed to assess the confidence, exposure,and perceived educational gaps in nephrology among IM residents at a single academic program. Methods: A structured electronic survey was distributed to all 60 IM residents at a single academic institution in May 2025.The survey collected data on demographics,completion of a nephrology rotation,formal education in renal physiology/pathophysiology,confidence in managing nephrology topics (Likert scale:1–5),and perceived curricular gaps.Descriptive statistics were used to analyze the results. Results: 1.Survey response rate: 46 out of 60 internal medicine residents responded(77%). 2.Nephrology rotation: 25 residents(54%) had completed a clinical nephrology rotation. 3.Formal education: 41 residents(89%) reported receiving formal instruction in kidney physiology and pathophysiology. 4.Average confidence scores(1–5 scale): Acute Kidney Injury:3.83 Electrolyte Abnormalities:3.70 Chronic Kidney Disease:3.28 Acid–Base Disturbances:3.30 Hyponatremia:3.46 Dialysis (HD, PD, CRRT):2.70 5.Curriculum impact:41 residents(89%) agreed that a structured nephrology curriculum would support their future clinical goals. 6.Perceived gaps:20 residents(43%) identified underrepresented nephrology topics in their training, such as transplant nephrology, glomerular diseases. 7.Preferred educational formats: Case-based discussions, bedside/consult-based teaching, and pocket card decision aids. Conclusion: This survey highlights a critical gap between didactic nephrology education and clinical confidence among internal medicine residents particularly in dialysis-related care.Although most residents reported exposure to nephrology concepts,many felt underprepared for real-world application.The strong resident endorsement of a formal nephrology curriculumcombined with preferences for practical teaching formats, underscores the need for a more structured, hands-on approach. Tailoring nephrology education to align with resident learning styles may improve knowledge retention,boost clinical readiness,and potentially increase interest in nephrology as a career.