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Semin Nephrol. 2017 May;37(3):224-233. doi: 10.1016/j.semnephrol.2017.02.003.

Nephrology Education and Continuing Education in Resource-Limited Settings.

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Division of Nephrology, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina. Electronic address:
Division of Nephrology and Immunology, University of Alberta, Edmonton, Canada.
Malawi College of Medicine, Chichiri, Blantyre, Malawi.
Department of Nephrology, Barts Health NHS Trust, London, United Kingdom.
Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN.


Nephrology training programs in high-income countries have transitioned from an apprenticeship model to a well-structured, resource-driven model that supports continual professional development. In contrast, in low- and middle-income countries, medical training and in particular nephrology training has lagged behind owing to resource limitations. Some of the challenges to adequately provide training to health care professionals in low- and middle-income countries include shortage of teaching faculty, difficulty in developing curricula to meet regional needs, and a lack of resources to provide competency-based medical education. The task of providing nephrology education becomes even harder when it comes to training physicians and health care workers to manage patients with complex kidney diseases without adequate infrastructure, government support, or proper health care policies. The nephrology training curriculum for low- and middle-income countries ideally should focus on local and regional needs, implementation of preventive measures for risk modification, education of a multidisciplinary health care workforce, raising general awareness of kidney disease, and optimizing the use of available resources. The ultimate goal being overall better recognition and care for patients with kidney disease.


Nephrology education; chronic kidney disease; health care; low middle income countries; training

[Indexed for MEDLINE]

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