In Türkiye, very few internal medicine research assistants consider becoming nephrologists in the future

The global population of patients with kidney disease is steadily increasing; however, the number of nephrologists available to treat this patient group is concurrently declining. Although the underlying causes of this trend have been investigated in various countries, no such study has been conducted in Türkiye. Therefore, in this survey study, we aimed to examine the perspectives of internal medicine research assistants in our country regarding the nephrology subspecialty. This cross-sectional survey targeted all internal medicine research assistants working in 80 university and training/research hospitals across seven geographical regions of Türkiye. Data were collected through an online questionnaire developed by the researchers, created using Google Forms (Google LLC, Mountain View, CA, USA), and distributed to participants via e-mail or text message. A total of 2161 research assistants participated in the study, corresponding to a response rate of 60%. Of the participants, 52.1% were female and 47.9% male; 50.4% worked in university hospitals; and 89.6% had never worked in another specialty. The majority reported that they either did not wish to pursue nephrology (50.7%) or were undecided (27.7%). The three most frequently cited reasons for not choosing nephrology were: the high frequency of emergency cases (64.1%), the intense workload during regular working hours (51.7%), and the complexity and severity of the patient population (45.5%). Among those not planning to choose nephrology, 83.7% stated they might reconsider if on-call duties and shifts were less demanding, 44.3% if economic conditions improved, and 19.9% if they had the opportunity to attend a nephrology congress during residency. A heavy daytime workload, demanding on-call duties, limited financial incentives, and the presence of a chronically ill and complex patient population contribute to the low preference for nephrology in Türkiye. Implementing measures to address these issues may enhance the attractiveness of nephrology and strengthen the healthcare system in the future.