array:21 [
  "pii" => "X2013251411051696"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2011.Feb.10829"
  "estado" => "S300"
  "fechaPublicacion" => "2011-03-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia (English Version). 2011;31:155-61"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4689
    "formatos" => array:3 [
      "EPUB" => 277
      "HTML" => 3800
      "PDF" => 612
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699511051699"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2011.Feb.10829"
      "estado" => "S300"
      "fechaPublicacion" => "2011-03-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2011;31:155-61"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 7763
        "formatos" => array:3 [
          "EPUB" => 307
          "HTML" => 6828
          "PDF" => 628
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "titulo" => "Evolución de las plazas asignadas a nefrología en las convocatorias MIR (1985-2008)"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "155"
            "paginaFinal" => "161"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Trends in resident positions offered in nephrology (1985-2008)"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig1"
            "etiqueta" => "Tab.  1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "copyright" => "Elsevier España"
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "10829_108_13480_es_10829_t1.jpg"
                "Alto" => 420
                "Ancho" => 600
                "Tamanyo" => 230761
              ]
            ]
            "descripcion" => array:1 [
              "es" => "Evolución de las plazas adjudicadas a nefrología en las convocatorias MIR (1985-2008)"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => " Comisión Nacional de la Especialidad de Nefrología en España, C. Bernis Carro, Carmen Bernis Carro"
            "autores" => array:3 [
              0 => array:1 [
                "apellidos" => "Comisión Nacional de la Especialidad de Nefrología en España"
              ]
              1 => array:2 [
                "Iniciales" => "C."
                "apellidos" => "Bernis Carro"
              ]
              2 => array:2 [
                "nombre" => "Carmen"
                "apellidos" => "Bernis Carro"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251411051696"
          "doi" => "10.3265/Nefrologia.pre2011.Feb.10829"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051696?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511051699?idApp=UINPBA000064"
      "url" => "/02116995/0000003100000002/v0_201502091417/X0211699511051699/v0_201502091417/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251411051688"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2010.Dec.10660"
    "estado" => "S300"
    "fechaPublicacion" => "2011-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2011;31:162-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 6266
      "formatos" => array:3 [
        "EPUB" => 291
        "HTML" => 5332
        "PDF" => 643
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "titulo" => "Co-inheritance of autosomal dominant polycystic kidney disease and sickle cell trait in African Americans"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "162"
          "paginaFinal" => "168"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Co-herencia de poliquistosis renal autosómica dominante y hemoglobina con rasgo falciforme en afroamericanos"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Fig. 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "10660_108_14418_en_10660it1.jpg"
              "Alto" => 123
              "Ancho" => 600
              "Tamanyo" => 65980
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Clinical and haematological characteristics of the 4 patients with ADPKD and HbAS"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ramón Peces, R. Peces, Carlos Peces, C. Peces, Emilio Cuesta-López, E. Cuesta-López, Cristina Vega-Cabrera, C. Vega-Cabrera, Sebastián Azorín, S. Azorín, Virginia Pérez-Dueñas, V. Pérez-Dueñas, Rafael Selgas, R. Selgas"
          "autores" => array:15 [
            0 => null
            1 => array:2 [
              "nombre" => "Ramón"
              "apellidos" => "Peces"
            ]
            2 => array:2 [
              "Iniciales" => "R."
              "apellidos" => "Peces"
            ]
            3 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Peces"
            ]
            4 => array:2 [
              "Iniciales" => "C."
              "apellidos" => "Peces"
            ]
            5 => array:2 [
              "nombre" => "Emilio"
              "apellidos" => "Cuesta-López"
            ]
            6 => array:2 [
              "Iniciales" => "E."
              "apellidos" => "Cuesta-López"
            ]
            7 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Vega-Cabrera"
            ]
            8 => array:2 [
              "Iniciales" => "C."
              "apellidos" => "Vega-Cabrera"
            ]
            9 => array:2 [
              "nombre" => "Sebastián"
              "apellidos" => "Azorín"
            ]
            10 => array:2 [
              "Iniciales" => "S."
              "apellidos" => "Azorín"
            ]
            11 => array:2 [
              "nombre" => "Virginia"
              "apellidos" => "Pérez-Dueñas"
            ]
            12 => array:2 [
              "Iniciales" => "V."
              "apellidos" => "Pérez-Dueñas"
            ]
            13 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Selgas"
            ]
            14 => array:2 [
              "Iniciales" => "R."
              "apellidos" => "Selgas"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699511051680"
        "doi" => "10.3265/Nefrologia.pre2010.Dec.10660"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511051680?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051688?idApp=UINPBA000064"
    "url" => "/20132514/0000003100000002/v0_201502091641/X2013251411051688/v0_201502091641/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251411051700"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2010.Nov.10724"
    "estado" => "S300"
    "fechaPublicacion" => "2011-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2011;31:148-54"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 9522
      "formatos" => array:3 [
        "EPUB" => 269
        "HTML" => 8070
        "PDF" => 1183
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "titulo" => "New insights into the pathophysiology of oedema in nephrotic syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "148"
          "paginaFinal" => "154"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Avances en la fisiopatología del edema en el síndrome nefrótico"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "H. Rondon-Berrios"
          "autores" => array:2 [
            0 => null
            1 => array:2 [
              "Iniciales" => "H."
              "apellidos" => "Rondon-Berrios"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699511051703"
        "doi" => "10.3265/Nefrologia.pre2010.Nov.10724"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511051703?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051700?idApp=UINPBA000064"
    "url" => "/20132514/0000003100000002/v0_201502091641/X2013251411051700/v0_201502091641/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Trends in resident positions offered in nephrology (1985-2008)"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "155"
        "paginaFinal" => "161"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => " Comisión Nacional de la Especialidad de Nefrología en España, C. Bernis Carro, Carmen Bernis Carro"
        "autores" => array:3 [
          0 => array:1 [
            "apellidos" => "Comisión Nacional de la Especialidad de Nefrología en España"
          ]
          1 => array:4 [
            "Iniciales" => "C."
            "apellidos" => "Bernis Carro"
            "email" => array:1 [
              0 => "cbernis@senefro.org"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "Carmen"
            "apellidos" => "Bernis Carro"
            "email" => array:1 [
              0 => "cbernis&#64;senefro&#46;org"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital Universitario La Princesa, Madrid,   "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Nefrología, HU Princesa, Madrid,  Spain, "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Evoluci&#243;n de las plazas asignadas a nefrolog&#237;a en las convocatorias MIR &#40;1985-2008&#41;"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14751_en_10829t1.jpg"
            "Alto" => 417
            "Ancho" => 600
            "Tamanyo" => 181459
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Trends related to IMR nephrology places assigned &#40;1985-2008&#41;"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">INTRODUCTION</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara">The future for nephrology greatly depends on developing programmes that appeal to potential candidates&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Recently&#44; access and training in the field of nephrology has aroused reflection both in Spain<span class="elsevierStyleSup">2&#44;3</span> and overseas&#46;<span class="elsevierStyleSup">4-6</span></p><p class="elsevierStylePara">In this study&#44; we hope to contribute to the debate by providing concrete data concerning the number of internal medical residency &#40;IMR&#41; positions<a href="&#35;&#95;ftn1" class="elsevierStyleCrossRefs">&#91;1&#93;</a> assigned for nephrology in Spain during the past 24 years&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">MATERIAL AND METHOD</span></p><p class="elsevierStylePara">Data concerning the openings awarded from 1895 to 2008 was provided by the Spanish Ministry of Health&#46; Based on the broken down data&#44; we calculated the average number of points for each year &#40;including the average exam points and academic transcript&#41; and the average position for nephrology&#46; We collected data on the average position for the first and last junior doctor that chose nephrology each year&#44; as well as the number of openings assigned to nephrology and distribution by sex&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">RESULTS</span></p><p class="elsevierStylePara">Table 1 shows a summary of the data&#46;</p><p class="elsevierStylePara">The <span class="elsevierStyleItalic">number of positions</span> assigned to nephrology has increased from 17 to 96&#44; representing a 464&#37; increase throughout the study period &#40;Figure 1&#41;&#46; There is a significant variation between sexes &#40;Figure 2&#41;&#46; Throughout this period&#44; 65&#37; of nephrology junior doctors were women&#46; During the first 5 years&#44; this percentage was 42&#46;2&#37; compared with 72&#46;4&#37; over the past 10 years&#44; which seems to have stabilised&#46;</p><p class="elsevierStylePara">The <span class="elsevierStyleItalic">average annual number of points</span> for positions awarded to nephrology has decreased from 435 to 377 points &#40;Figure 3&#41;&#46; The <span class="elsevierStyleItalic">average position</span> has a clear trend to be delayed&#44; being 253 at the beginning of the period and 3457 at the end &#40;Figure 4&#41;&#46; The <span class="elsevierStyleItalic">ranking position of the first junior doctor</span> to choose nephrology<span class="elsevierStyleItalic"> </span>has changed significantly &#40;Figure 5&#41;&#46; The ranking position of the last junior doctor has moved backwards&#44; going from 937 position to 5485 position &#40;Figure 6&#41;&#46;</p><p class="elsevierStylePara">Table 2 shows the list of hospitals that have been requested by the top 5 IMR nephrology trainees during the study period&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">DISCUSSION</span></p><p class="elsevierStylePara">The number of nephrology IMR openings awarded throughout this period has markedly increased until 2009&#46; This 464&#37; increase is in line with the general context of the specialist positions awarded within the Ministry of Health policy<span class="elsevierStyleSup">7</span> and the National Clinical Speciality Commissions&#46;<span class="elsevierStyleSup">2</span> This increase has remarkably made this speciality one of three medical specialities that have increased the most&#46;<span class="elsevierStyleSup">8</span> Recently&#44; there has been a lack of nephrologists to cover the estimated needs<span class="elsevierStyleSup">2</span> and increasing demand was forecast in view of an ageing population&#46;<span class="elsevierStyleSup">2&#44;3</span> However&#44; this specialist growth rate could continue&#44; bringing with it a &#8220;surplus&#8221; of nephrologists&#44; as described in Gonz&#225;lez L&#243;pez Valc&#225;rcel and Patricia Barber&#8217;s latest 2009 report on the supply and demand of specialist doctors in Spain&#58; 2008-2025&#46;<span class="elsevierStyleSup">8</span> In this respect&#44; the Speciality Commission has approved that the number of openings awarded be reduced&#46; Calculating future needs is always a difficult task&#44; resulting as an estimate&#44;<span class="elsevierStyleSup">2&#44;7&#44;9</span> given that it is partly dependent on the number of active nephrologists and their age&#46;<span class="elsevierStyleSup">2&#44;7&#44;8</span> However&#44; it also depends on the ageing population and health priorities&#44; meaning that there are several possible scenarios&#46;</p><p class="elsevierStylePara">Regarding distribution by sex&#44; there was a significant increase in the number of women choosing nephrology&#46; Feminisation of the medical profession is a well recognised process that has grown stronger throughout the world over the past 30 years&#46;<span class="elsevierStyleSup">9-11</span> Throughout the study period&#44; 65&#37; of IMR trainees were women&#46; During the first 5 years&#44; this percentage was 42&#46;2&#37; compared with 72&#46;4&#37; over the past 10 years&#44; which seems to have stabilised&#46; When considering the whole IMR population &#40;i&#46;e&#46; all specialities&#41;&#44; 80&#37; of trainees are women&#46;<span class="elsevierStyleSup">8</span> Nephrology training data for the USA show that 30&#37; are women&#46;<span class="elsevierStyleSup">5</span> European nephrology training data are considered within overall internal medicine data&#44; showing a similar phenomenon&#46;<span class="elsevierStyleSup">14</span> The total of active female nephrologists in Spain is 42&#46;8&#37;&#44;<span class="elsevierStyleSup">8</span> being one of the highest ranking specialities&#44; only coming after haematology &#40;52&#37;&#41;&#44; general practice &#40;49&#46;2&#37;&#41; and paediatrics &#40;60&#46;1&#37;&#41;&#46;<span class="elsevierStyleSup">8</span> There are even more female nephrologists in France&#46;<span class="elsevierStyleSup">13</span> A recent study has been published in the Spanish journal <span class="elsevierStyleItalic">Nefrolog&#237;a</span> on female integration and participation within nephrology in Spain&#46;<span class="elsevierStyleSup">15</span></p><p class="elsevierStylePara">The average annual number of points for positions awarded to nephrology has decreased from 435 to 377 points &#40;Figure 3&#41;&#46; The ranking position of the first junior doctor to choose nephrology<span class="elsevierStyleItalic"> </span>has changed significantly &#40;Figure 5&#41;&#59; and that of the last junior doctor has moved backwards&#44; going from 937 position to 5485 position &#40;Figure 6&#41;&#46; All of these data show us that our speciality is becoming less and less attractive to young professionals&#46; Nephrology is positioned 29<span class="elsevierStyleSup">th</span> of the 47 specialities offered on the IMR training programme&#46;<span class="elsevierStyleSup">8 </span>It is astonishing to see that in the USA there is a difficulty to fill all of the nephrology training openings with American juniors&#44; meaning that this speciality has the most foreign professionals &#40;41&#37;&#41;&#46;<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara">In recent years&#44; some specialities have had high drop out rates&#46; In this respect&#44; it seems that the drop out rate for nephrology programmes is low&#44; being around 6&#37;&#44; which is similar to that of internal medicine &#40;5&#46;8&#37;&#41;&#44; lower than biochemical medicine &#40;40&#37;&#41; and higher than cardiology &#40;1&#46;4&#37;&#41;&#46;<span class="elsevierStyleSup">8</span></p><p class="elsevierStylePara">Data concerning the ranking of the first junior doctor to choose nephrology &#40;Figure 5&#41; and most requested hospitals for the top 5 trainees are interesting&#44; but they are quite incidental &#40;Table 2&#46;&#41; Personal choice for these few positions could be influenced by multiple aspects&#44; from the size of the centre&#8217;s population&#44; whether there is a university with school of medicine&#44; or the number of positions offered&#44; amongst others&#46;</p><p class="elsevierStylePara">In brief&#44; our study suggests that this speciality is becoming less attractive in Spain&#44; which is a common concern in other countries&#44; as described in various studies&#46;<span class="elsevierStyleSup">4-6&#44;16</span> There are doubtlessly many factors involved&#44; from the job market perspectives to the training programme&#8217;s content and methodology&#46; Understanding the situation and the opinions of those involved is an important step forward&#46;<span class="elsevierStyleSup">3&#44;6</span> As nephrologists&#44; we need to actively develop interesting programmes that appeal to motivated individuals&#44; introducing innovation&#44; enthusiasm&#44; intensity and integrity&#46;<span class="elsevierStyleSup">16</span></p><p class="elsevierStylePara">The way that we conceive medical training has changed&#44; being based on assessing skills&#44; new simulation techniques&#44; and introducing evidence as a teaching tool&#46;<span class="elsevierStyleSup">1&#44;3&#44;4&#44;18</span> Although there are still very few publications about nephrology&#44; there are opportunities for developing new teaching techniques&#46; However&#44; we must highlight that interventional nephrology has contributed interesting studies that link the learning process with outcome&#46;<span class="elsevierStyleSup">19-21</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">EDITOR&#8217;S NOTE</span></p><p class="elsevierStylePara">The content of this article is without a doubt extremely important for the future of Spanish nephrology&#46; The editors therefore invite Spanish nephrologists to send their opinions and observations on the matter&#44; using the &#8220;Letters to the editor&#8221; format&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><a href="&#35;&#95;ftnref1" class="elsevierStyleCrossRefs">&#91;1&#93;</a> Medicine graduates wishing to take part in an IMR training programme must sit an official exam&#46; The mark of the exam is worth 75&#37; of the final score&#44; with an academic transcript taking up the remaining 25&#37;&#46; Candidates are then put on a ranking list and those with the most points have first choice of IMR speciality and the hospital where they will complete the programme&#46; Medical graduates must complete IMR training to work in the public sector&#46;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14751&#95;en&#95;10829t1&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14751_en_10829t1.jpg" alt="Trends related to IMR nephrology places assigned &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Table 1&#46; Trends related to IMR nephrology places assigned &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14752&#95;en&#95;10829t2&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14752_en_10829t2.jpg" alt="Summary of centres requested by the top five nephrology IMR trainees &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Table 2&#46; Summary of centres requested by the top five nephrology IMR trainees &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14753&#95;en&#95;10829f1&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14753_en_10829f1.jpg" alt="Trends related to IMR places assigned to nephrology &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 1&#46; Trends related to IMR places assigned to nephrology &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14754&#95;en&#95;10829f2&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14754_en_10829f2.jpg" alt="Distribution by sex of IMR nephrology places assigned &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 2&#46; Distribution by sex of IMR nephrology places assigned &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14755&#95;en&#95;10829f3&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14755_en_10829f3.jpg" alt="Average number of points for IMR nephrology trainees &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 3&#46; Average number of points for IMR nephrology trainees &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14756&#95;en&#95;10829f4&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14756_en_10829f4.jpg" alt="Average position for IMR nephrology trainees &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 4&#46; Average position for IMR nephrology trainees &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14757&#95;en&#95;10829f5&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14757_en_10829f5.jpg" alt="Nephrology IMR&#58; trends related to first trainee to choose this speciality &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 5&#46; Nephrology IMR&#58; trends related to first trainee to choose this speciality &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14758&#95;en&#95;10829f6&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14758_en_10829f6.jpg" alt="Nephrology IMR&#58; trends related to last trainee to choose this speciality &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 6&#46; Nephrology IMR&#58; trends related to last trainee to choose this speciality &#40;1985-2008&#41;</p>"
    "pdfFichero" => "P1-E518-S2900-A10829-EN.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "es" => array:5 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441249"
          "palabras" => array:1 [
            0 => "Educaci&#243;n"
          ]
        ]
        1 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441251"
          "palabras" => array:1 [
            0 => "Feminizaci&#243;n"
          ]
        ]
        2 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441253"
          "palabras" => array:1 [
            0 => "Nefrolog&#237;a"
          ]
        ]
        3 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441255"
          "palabras" => array:1 [
            0 => "Especializaci&#243;n"
          ]
        ]
        4 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441257"
          "palabras" => array:1 [
            0 => "Docencia"
          ]
        ]
      ]
      "en" => array:5 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441250"
          "palabras" => array:1 [
            0 => "Education"
          ]
        ]
        1 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441252"
          "palabras" => array:1 [
            0 => "Feminization"
          ]
        ]
        2 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441254"
          "palabras" => array:1 [
            0 => "Nephrology"
          ]
        ]
        3 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441256"
          "palabras" => array:1 [
            0 => "Fellowship"
          ]
        ]
        4 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441258"
          "palabras" => array:1 [
            0 => "Teaching"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "resumen" => "<p class="elsevierStylePara">This article reviews the trends in positions of internal medicine resident &#40;IMR&#41; assigned to nephrology in Spain from 1985 to 2008&#46; We analyse the number of positions&#44; the changes of average points received &#40;435 to 377&#41;&#44; and the average position for nephrology &#40;253 to 3457&#41;&#46; We also observed the distribution by sex for the candidates &#40;from 42&#37; to 72&#37; feminisation&#41; over the 24 years examined&#46; Nephrology is positioned 29th of the 47 specialities offered on Spanish IMR training programmes&#46; These data should be an indication to all nephrologists that change is needed&#46; We must examine which factors are involved in the lessening interest in Nephrology as a career among medical graduates and then strive to resolve the problems&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<p class="elsevierStylePara">Analizamos la evoluci&#243;n de&#160;las plazas asignadas a nefrolog&#237;a en la convocatoria MIR&#160;desde 1985 a 2008&#46; Se recoge el n&#250;mero de plazas y se calculan la calificaci&#243;n media anual y el n&#250;mero de orden promedio&#46; El n&#250;mero de plazas adjudicadas ha aumentado&#160;un 464&#37; &#40;de 17 a 96&#41;&#44; con una progresiva feminizaci&#243;n&#160;que llega al 72&#44;5&#37; en los &#250;ltimos a&#241;os&#46; La calificaci&#243;n media anual de los candidatos ha disminuido&#160;de 435 a 377 puntos&#160;y el puesto medio&#160; de elecci&#243;n se ha ido retrasando del 233 al 3&#46;457&#46;&#160;Los datos sugieren una p&#233;rdida de atractivo de la especialidad que debe llevar a examinar y corregir los factores implicados&#46;&#160;</p> <p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p>"
      ]
    ]
    "multimedia" => array:8 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14751_en_10829t1.jpg"
            "Alto" => 417
            "Ancho" => 600
            "Tamanyo" => 181459
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Trends related to IMR nephrology places assigned &#40;1985-2008&#41;"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig2"
        "etiqueta" => "Fig. 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14752_en_10829t2.jpg"
            "Alto" => 454
            "Ancho" => 600
            "Tamanyo" => 212880
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Summary of centres requested by the top five nephrology IMR trainees &#40;1985-2008&#41;"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig3"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14753_en_10829f1.jpg"
            "Alto" => 321
            "Ancho" => 600
            "Tamanyo" => 97162
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Trends related to IMR places assigned to nephrology &#40;1985-2008&#41;"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig4"
        "etiqueta" => "Fig. 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14754_en_10829f2.jpg"
            "Alto" => 282
            "Ancho" => 600
            "Tamanyo" => 118700
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Distribution by sex of IMR nephrology places assigned &#40;1985-2008&#41;"
        ]
      ]
      4 => array:8 [
        "identificador" => "fig5"
        "etiqueta" => "Fig. 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14755_en_10829f3.jpg"
            "Alto" => 334
            "Ancho" => 600
            "Tamanyo" => 103153
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Average number of points for IMR nephrology trainees &#40;1985-2008&#41;"
        ]
      ]
      5 => array:8 [
        "identificador" => "fig6"
        "etiqueta" => "Fig. 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14756_en_10829f4.jpg"
            "Alto" => 320
            "Ancho" => 600
            "Tamanyo" => 97219
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Average position for IMR nephrology trainees &#40;1985-2008&#41;"
        ]
      ]
      6 => array:8 [
        "identificador" => "fig7"
        "etiqueta" => "Fig. 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14757_en_10829f5.jpg"
            "Alto" => 333
            "Ancho" => 600
            "Tamanyo" => 105839
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Nephrology IMR&#58; trends related to first trainee to choose this speciality &#40;1985-2008&#41;"
        ]
      ]
      7 => array:8 [
        "identificador" => "fig8"
        "etiqueta" => "Fig. 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14758_en_10829f6.jpg"
            "Alto" => 313
            "Ancho" => 600
            "Tamanyo" => 101374
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Nephrology IMR&#58; trends related to last trainee to choose this speciality &#40;1985-2008&#41;"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:21 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Perazella MA. Nephrology fellowship training in the 21st century: where do we stand? Clin J Am Soc Nephrol 2010;5(3):387-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20093345" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Ortega Suárez F. Situación de la especialidad de Nefrología en relación a las necesidades de nefrólogos y a su formación. Nefrologia 2008;28(3):241-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18590486" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "3.\u{A0}Quereda C, por la Comisión Nacional de la Especialidad de Nefrología en España\u{A0}(Presidente: F. Ortega Suárez. Vicepresidente y Secretario: C. Quereda Rodríguez-Navarro. Vocales: A.L. Martín de Francisco Hernández, R. Matesanz Acedos, R. Alcázar Arroyo, A. Sanz Boix, C. Bernis Carro, P. Abaigar Luquin, A. Sánchez Casajús, E. Mérida Herrero, M.A. García Pérez). Algunos aspectos de la situación de la formación de especialistas en España.\u{A0}Nefrologia. 2008;28(3):263-71. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18590492" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Parker MG. Nephrology training in the 21st century: toward outcomes-based education. Am J Kidney Dis 2010;56(1):132-42. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20418002" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Rosenberg ME. Adult nephrology fellowship training in the United States: trends and issues. J Am Soc Nephrol 2007;18(4):1027-33. Epub 2007 Feb 28. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17329571" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Berns JS. A survey-based evaluation of self-perceived competency after nephrology fellowship training. Clin J Am Soc Nephrol 2010;5(3):490-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20089491" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "González López Valcárcel\u{A0}B,\u{A0}Barber P, del Grupo de Investigación de Economía de la Salud de la Universidad de Las Palmas de Gran Canaria «Oferta y necesidad de médicos especialistas en España 2006-2030», marzo 2007. Accesible en: http://www.mspsi.es/profesionales/formacion/docs/necesidadesEspecialistas06_30.pdf"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "8.\u{A0}González López Valcarcel B,\u{A0}Barber P,\u{A0}del Grupo de Investigación de Economía de la Salud de la Universidad de Las Palmas de Gran Canaria «Oferta y necesidad de médicos especialistas\u{A0}en España\u{A0}2008-2025», marzo 2009. Accesible en: http://www.mspsi.es/profesionales/formacion/docs/necesidadesEspecialistas2008_2025.pdf"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Matesanz R. Las necesidades de especialistas: el hilo de Ariadna. Nefrologia 2005;25:589-90 <a href="http://www.ncbi.nlm.nih.gov/pubmed/16514896" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Bernis Carro C, Cámara González C. Liberación y utopía. En: Durán MA (ed.). La mujer y la medicina. Akal, 1982.\u{A0}"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Levinson W, Lurie N. When\u{A0}most doctors are women: What lies ahead? Ann Intern Med 2004;141:471-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15381521" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Arrizabalaga P, Bruguera M. Feminización y ejercicio de la medicina. Med Clin (Barc) 2009;133(5):184-6."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Arrizabalaga P. Feminización y ejercicio de la nefrología. Nefrologia\u{A0}2010;30:1010-3."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Palsson R, Kellett J, Lindgren S, Merino J, Semple C, Sereni D; For the EFIM/UEMS Working Group on Competencies in Internal Medicine in Europe. Core competencies of the European internist: A discussion paper. Eur J Intern Med 2007;18(2):104-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17338961" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Legmann M, Kahn Bensaude I, Romestaing P. Atlas de la démographie médicale en France. Situation au Javier\u{A0} 2009. Conseil National de l Ordre des Médicins. Accesible\u{A0}http:www.web.ordre.medecin.fr/demographie/atlas2009.pdf"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Kohan DE, Rosenberg ME. Nephrology training programs and applicants: a very good match. Clin J Am Soc Nephrol 2009;4(1):242-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19056616" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Barrio Lucia V, García López F, Quereda Rodríguez-Navarro C. Los suplementos de Nefrología basada en la evidencia como instrumento para la formación continuada. Nefrologia 2008;28(Suppl 2):1. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19018730" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Niyyar VD, Work J. Interventional nephrology: core curriculum 2009. Am J Kidney Dis 2009;54(1):169-82. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19481319" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Goh BL, Ganeshadeva Yudisthra M, Lim TO. Establishing learning curve for Tenckhoff catheter insertion by interventional nephrologist using CUSUM analysis: how many procedures and in which situation? Semin Dial 2009;22(2):199-203."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Haq NU, Sayeed S, Ali SA. Impact of training in interventional nephrology on hemodialysis vascular access types. Semin Dial 2009;22(1):90-2. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19000113" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Vachharajani TJ, Moossavi S, Salman L, Wu S, Maya ID, Yevzlin AS, et al.\u{A0}Successful models of interventional nephrology at academic medical centers. Clin J Am Soc Nephrol 2010;5(11):2130-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20930089" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003100000002/v0_201502091641/X2013251411051696/v0_201502091641/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35446"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Special Originals"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003100000002/v0_201502091641/X2013251411051696/v0_201502091641/en/P1-E518-S2900-A10829-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051696?idApp=UINPBA000064"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Trends in resident positions offered in nephrology (1985-2008)
Evolución de las plazas asignadas a nefrología en las convocatorias MIR (1985-2008)
Comisión Nacional de la Especialidad de Nefrología en España, C.. Bernis Carrob, Carmen Bernis Carroc
b Servicio de Nefrología, Hospital Universitario La Princesa, Madrid,
c Servicio de Nefrología, HU Princesa, Madrid, Spain,
Read
8290
Times
was read the article
2183
Total PDF
6107
Total HTML
Share statistics
 array:21 [
  "pii" => "X2013251411051696"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2011.Feb.10829"
  "estado" => "S300"
  "fechaPublicacion" => "2011-03-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia &#40;English Version&#41;. 2011;31:155-61"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4689
    "formatos" => array:3 [
      "EPUB" => 277
      "HTML" => 3800
      "PDF" => 612
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699511051699"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2011.Feb.10829"
      "estado" => "S300"
      "fechaPublicacion" => "2011-03-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2011;31:155-61"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 7763
        "formatos" => array:3 [
          "EPUB" => 307
          "HTML" => 6828
          "PDF" => 628
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "titulo" => "Evoluci&#243;n de las plazas asignadas a nefrolog&#237;a en las convocatorias MIR &#40;1985-2008&#41;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "155"
            "paginaFinal" => "161"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Trends in resident positions offered in nephrology &#40;1985-2008&#41;"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig1"
            "etiqueta" => "Tab.  1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "copyright" => "Elsevier Espa&#241;a"
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "10829_108_13480_es_10829_t1.jpg"
                "Alto" => 420
                "Ancho" => 600
                "Tamanyo" => 230761
              ]
            ]
            "descripcion" => array:1 [
              "es" => "Evoluci&#243;n de las plazas adjudicadas a nefrolog&#237;a en las convocatorias MIR &#40;1985-2008&#41;"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => " Comisi&#243;n Nacional de la Especialidad de Nefrolog&#237;a en Espa&#241;a, C. Bernis Carro, Carmen Bernis Carro"
            "autores" => array:3 [
              0 => array:1 [
                "apellidos" => "Comisi&#243;n Nacional de la Especialidad de Nefrolog&#237;a en Espa&#241;a"
              ]
              1 => array:2 [
                "Iniciales" => "C."
                "apellidos" => "Bernis Carro"
              ]
              2 => array:2 [
                "nombre" => "Carmen"
                "apellidos" => "Bernis Carro"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251411051696"
          "doi" => "10.3265/Nefrologia.pre2011.Feb.10829"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051696?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511051699?idApp=UINPBA000064"
      "url" => "/02116995/0000003100000002/v0_201502091417/X0211699511051699/v0_201502091417/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251411051688"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2010.Dec.10660"
    "estado" => "S300"
    "fechaPublicacion" => "2011-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2011;31:162-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 6266
      "formatos" => array:3 [
        "EPUB" => 291
        "HTML" => 5332
        "PDF" => 643
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "titulo" => "Co-inheritance of autosomal dominant polycystic kidney disease and sickle cell trait in African Americans"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "162"
          "paginaFinal" => "168"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Co-herencia de poliquistosis renal autos&#243;mica dominante y hemoglobina con rasgo falciforme en afroamericanos"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Fig. 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier Espa&#241;a"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "10660_108_14418_en_10660it1.jpg"
              "Alto" => 123
              "Ancho" => 600
              "Tamanyo" => 65980
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Clinical and haematological characteristics of the 4 patients with ADPKD and HbAS"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ram&#243;n Peces, R. Peces, Carlos Peces, C. Peces, Emilio Cuesta-L&#243;pez, E. Cuesta-L&#243;pez, Cristina Vega-Cabrera, C. Vega-Cabrera, Sebasti&#225;n Azor&#237;n, S. Azor&#237;n, Virginia P&#233;rez-Due&#241;as, V. P&#233;rez-Due&#241;as, Rafael Selgas, R. Selgas"
          "autores" => array:15 [
            0 => null
            1 => array:2 [
              "nombre" => "Ram&#243;n"
              "apellidos" => "Peces"
            ]
            2 => array:2 [
              "Iniciales" => "R."
              "apellidos" => "Peces"
            ]
            3 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Peces"
            ]
            4 => array:2 [
              "Iniciales" => "C."
              "apellidos" => "Peces"
            ]
            5 => array:2 [
              "nombre" => "Emilio"
              "apellidos" => "Cuesta-L&#243;pez"
            ]
            6 => array:2 [
              "Iniciales" => "E."
              "apellidos" => "Cuesta-L&#243;pez"
            ]
            7 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Vega-Cabrera"
            ]
            8 => array:2 [
              "Iniciales" => "C."
              "apellidos" => "Vega-Cabrera"
            ]
            9 => array:2 [
              "nombre" => "Sebasti&#225;n"
              "apellidos" => "Azor&#237;n"
            ]
            10 => array:2 [
              "Iniciales" => "S."
              "apellidos" => "Azor&#237;n"
            ]
            11 => array:2 [
              "nombre" => "Virginia"
              "apellidos" => "P&#233;rez-Due&#241;as"
            ]
            12 => array:2 [
              "Iniciales" => "V."
              "apellidos" => "P&#233;rez-Due&#241;as"
            ]
            13 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Selgas"
            ]
            14 => array:2 [
              "Iniciales" => "R."
              "apellidos" => "Selgas"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699511051680"
        "doi" => "10.3265/Nefrologia.pre2010.Dec.10660"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511051680?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051688?idApp=UINPBA000064"
    "url" => "/20132514/0000003100000002/v0_201502091641/X2013251411051688/v0_201502091641/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251411051700"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2010.Nov.10724"
    "estado" => "S300"
    "fechaPublicacion" => "2011-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2011;31:148-54"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 9522
      "formatos" => array:3 [
        "EPUB" => 269
        "HTML" => 8070
        "PDF" => 1183
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "titulo" => "New insights into the pathophysiology of oedema in nephrotic syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "148"
          "paginaFinal" => "154"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Avances en la fisiopatolog&#237;a del edema en el s&#237;ndrome nefr&#243;tico"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "H. Rondon-Berrios"
          "autores" => array:2 [
            0 => null
            1 => array:2 [
              "Iniciales" => "H."
              "apellidos" => "Rondon-Berrios"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699511051703"
        "doi" => "10.3265/Nefrologia.pre2010.Nov.10724"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699511051703?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051700?idApp=UINPBA000064"
    "url" => "/20132514/0000003100000002/v0_201502091641/X2013251411051700/v0_201502091641/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Trends in resident positions offered in nephrology &#40;1985-2008&#41;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "155"
        "paginaFinal" => "161"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => " Comisi&#243;n Nacional de la Especialidad de Nefrolog&#237;a en Espa&#241;a, C. Bernis Carro, Carmen Bernis Carro"
        "autores" => array:3 [
          0 => array:1 [
            "apellidos" => "Comisi&#243;n Nacional de la Especialidad de Nefrolog&#237;a en Espa&#241;a"
          ]
          1 => array:4 [
            "Iniciales" => "C."
            "apellidos" => "Bernis Carro"
            "email" => array:1 [
              0 => "cbernis&#64;senefro&#46;org"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "Carmen"
            "apellidos" => "Bernis Carro"
            "email" => array:1 [
              0 => "cbernis&#64;senefro&#46;org"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital Universitario La Princesa, Madrid,   "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Nefrología, HU Princesa, Madrid,  Spain, "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Evoluci&#243;n de las plazas asignadas a nefrolog&#237;a en las convocatorias MIR &#40;1985-2008&#41;"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14751_en_10829t1.jpg"
            "Alto" => 417
            "Ancho" => 600
            "Tamanyo" => 181459
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Trends related to IMR nephrology places assigned &#40;1985-2008&#41;"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">INTRODUCTION</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara">The future for nephrology greatly depends on developing programmes that appeal to potential candidates&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Recently&#44; access and training in the field of nephrology has aroused reflection both in Spain<span class="elsevierStyleSup">2&#44;3</span> and overseas&#46;<span class="elsevierStyleSup">4-6</span></p><p class="elsevierStylePara">In this study&#44; we hope to contribute to the debate by providing concrete data concerning the number of internal medical residency &#40;IMR&#41; positions<a href="&#35;&#95;ftn1" class="elsevierStyleCrossRefs">&#91;1&#93;</a> assigned for nephrology in Spain during the past 24 years&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">MATERIAL AND METHOD</span></p><p class="elsevierStylePara">Data concerning the openings awarded from 1895 to 2008 was provided by the Spanish Ministry of Health&#46; Based on the broken down data&#44; we calculated the average number of points for each year &#40;including the average exam points and academic transcript&#41; and the average position for nephrology&#46; We collected data on the average position for the first and last junior doctor that chose nephrology each year&#44; as well as the number of openings assigned to nephrology and distribution by sex&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">RESULTS</span></p><p class="elsevierStylePara">Table 1 shows a summary of the data&#46;</p><p class="elsevierStylePara">The <span class="elsevierStyleItalic">number of positions</span> assigned to nephrology has increased from 17 to 96&#44; representing a 464&#37; increase throughout the study period &#40;Figure 1&#41;&#46; There is a significant variation between sexes &#40;Figure 2&#41;&#46; Throughout this period&#44; 65&#37; of nephrology junior doctors were women&#46; During the first 5 years&#44; this percentage was 42&#46;2&#37; compared with 72&#46;4&#37; over the past 10 years&#44; which seems to have stabilised&#46;</p><p class="elsevierStylePara">The <span class="elsevierStyleItalic">average annual number of points</span> for positions awarded to nephrology has decreased from 435 to 377 points &#40;Figure 3&#41;&#46; The <span class="elsevierStyleItalic">average position</span> has a clear trend to be delayed&#44; being 253 at the beginning of the period and 3457 at the end &#40;Figure 4&#41;&#46; The <span class="elsevierStyleItalic">ranking position of the first junior doctor</span> to choose nephrology<span class="elsevierStyleItalic"> </span>has changed significantly &#40;Figure 5&#41;&#46; The ranking position of the last junior doctor has moved backwards&#44; going from 937 position to 5485 position &#40;Figure 6&#41;&#46;</p><p class="elsevierStylePara">Table 2 shows the list of hospitals that have been requested by the top 5 IMR nephrology trainees during the study period&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">DISCUSSION</span></p><p class="elsevierStylePara">The number of nephrology IMR openings awarded throughout this period has markedly increased until 2009&#46; This 464&#37; increase is in line with the general context of the specialist positions awarded within the Ministry of Health policy<span class="elsevierStyleSup">7</span> and the National Clinical Speciality Commissions&#46;<span class="elsevierStyleSup">2</span> This increase has remarkably made this speciality one of three medical specialities that have increased the most&#46;<span class="elsevierStyleSup">8</span> Recently&#44; there has been a lack of nephrologists to cover the estimated needs<span class="elsevierStyleSup">2</span> and increasing demand was forecast in view of an ageing population&#46;<span class="elsevierStyleSup">2&#44;3</span> However&#44; this specialist growth rate could continue&#44; bringing with it a &#8220;surplus&#8221; of nephrologists&#44; as described in Gonz&#225;lez L&#243;pez Valc&#225;rcel and Patricia Barber&#8217;s latest 2009 report on the supply and demand of specialist doctors in Spain&#58; 2008-2025&#46;<span class="elsevierStyleSup">8</span> In this respect&#44; the Speciality Commission has approved that the number of openings awarded be reduced&#46; Calculating future needs is always a difficult task&#44; resulting as an estimate&#44;<span class="elsevierStyleSup">2&#44;7&#44;9</span> given that it is partly dependent on the number of active nephrologists and their age&#46;<span class="elsevierStyleSup">2&#44;7&#44;8</span> However&#44; it also depends on the ageing population and health priorities&#44; meaning that there are several possible scenarios&#46;</p><p class="elsevierStylePara">Regarding distribution by sex&#44; there was a significant increase in the number of women choosing nephrology&#46; Feminisation of the medical profession is a well recognised process that has grown stronger throughout the world over the past 30 years&#46;<span class="elsevierStyleSup">9-11</span> Throughout the study period&#44; 65&#37; of IMR trainees were women&#46; During the first 5 years&#44; this percentage was 42&#46;2&#37; compared with 72&#46;4&#37; over the past 10 years&#44; which seems to have stabilised&#46; When considering the whole IMR population &#40;i&#46;e&#46; all specialities&#41;&#44; 80&#37; of trainees are women&#46;<span class="elsevierStyleSup">8</span> Nephrology training data for the USA show that 30&#37; are women&#46;<span class="elsevierStyleSup">5</span> European nephrology training data are considered within overall internal medicine data&#44; showing a similar phenomenon&#46;<span class="elsevierStyleSup">14</span> The total of active female nephrologists in Spain is 42&#46;8&#37;&#44;<span class="elsevierStyleSup">8</span> being one of the highest ranking specialities&#44; only coming after haematology &#40;52&#37;&#41;&#44; general practice &#40;49&#46;2&#37;&#41; and paediatrics &#40;60&#46;1&#37;&#41;&#46;<span class="elsevierStyleSup">8</span> There are even more female nephrologists in France&#46;<span class="elsevierStyleSup">13</span> A recent study has been published in the Spanish journal <span class="elsevierStyleItalic">Nefrolog&#237;a</span> on female integration and participation within nephrology in Spain&#46;<span class="elsevierStyleSup">15</span></p><p class="elsevierStylePara">The average annual number of points for positions awarded to nephrology has decreased from 435 to 377 points &#40;Figure 3&#41;&#46; The ranking position of the first junior doctor to choose nephrology<span class="elsevierStyleItalic"> </span>has changed significantly &#40;Figure 5&#41;&#59; and that of the last junior doctor has moved backwards&#44; going from 937 position to 5485 position &#40;Figure 6&#41;&#46; All of these data show us that our speciality is becoming less and less attractive to young professionals&#46; Nephrology is positioned 29<span class="elsevierStyleSup">th</span> of the 47 specialities offered on the IMR training programme&#46;<span class="elsevierStyleSup">8 </span>It is astonishing to see that in the USA there is a difficulty to fill all of the nephrology training openings with American juniors&#44; meaning that this speciality has the most foreign professionals &#40;41&#37;&#41;&#46;<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara">In recent years&#44; some specialities have had high drop out rates&#46; In this respect&#44; it seems that the drop out rate for nephrology programmes is low&#44; being around 6&#37;&#44; which is similar to that of internal medicine &#40;5&#46;8&#37;&#41;&#44; lower than biochemical medicine &#40;40&#37;&#41; and higher than cardiology &#40;1&#46;4&#37;&#41;&#46;<span class="elsevierStyleSup">8</span></p><p class="elsevierStylePara">Data concerning the ranking of the first junior doctor to choose nephrology &#40;Figure 5&#41; and most requested hospitals for the top 5 trainees are interesting&#44; but they are quite incidental &#40;Table 2&#46;&#41; Personal choice for these few positions could be influenced by multiple aspects&#44; from the size of the centre&#8217;s population&#44; whether there is a university with school of medicine&#44; or the number of positions offered&#44; amongst others&#46;</p><p class="elsevierStylePara">In brief&#44; our study suggests that this speciality is becoming less attractive in Spain&#44; which is a common concern in other countries&#44; as described in various studies&#46;<span class="elsevierStyleSup">4-6&#44;16</span> There are doubtlessly many factors involved&#44; from the job market perspectives to the training programme&#8217;s content and methodology&#46; Understanding the situation and the opinions of those involved is an important step forward&#46;<span class="elsevierStyleSup">3&#44;6</span> As nephrologists&#44; we need to actively develop interesting programmes that appeal to motivated individuals&#44; introducing innovation&#44; enthusiasm&#44; intensity and integrity&#46;<span class="elsevierStyleSup">16</span></p><p class="elsevierStylePara">The way that we conceive medical training has changed&#44; being based on assessing skills&#44; new simulation techniques&#44; and introducing evidence as a teaching tool&#46;<span class="elsevierStyleSup">1&#44;3&#44;4&#44;18</span> Although there are still very few publications about nephrology&#44; there are opportunities for developing new teaching techniques&#46; However&#44; we must highlight that interventional nephrology has contributed interesting studies that link the learning process with outcome&#46;<span class="elsevierStyleSup">19-21</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">EDITOR&#8217;S NOTE</span></p><p class="elsevierStylePara">The content of this article is without a doubt extremely important for the future of Spanish nephrology&#46; The editors therefore invite Spanish nephrologists to send their opinions and observations on the matter&#44; using the &#8220;Letters to the editor&#8221; format&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><a href="&#35;&#95;ftnref1" class="elsevierStyleCrossRefs">&#91;1&#93;</a> Medicine graduates wishing to take part in an IMR training programme must sit an official exam&#46; The mark of the exam is worth 75&#37; of the final score&#44; with an academic transcript taking up the remaining 25&#37;&#46; Candidates are then put on a ranking list and those with the most points have first choice of IMR speciality and the hospital where they will complete the programme&#46; Medical graduates must complete IMR training to work in the public sector&#46;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14751&#95;en&#95;10829t1&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14751_en_10829t1.jpg" alt="Trends related to IMR nephrology places assigned &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Table 1&#46; Trends related to IMR nephrology places assigned &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14752&#95;en&#95;10829t2&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14752_en_10829t2.jpg" alt="Summary of centres requested by the top five nephrology IMR trainees &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Table 2&#46; Summary of centres requested by the top five nephrology IMR trainees &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14753&#95;en&#95;10829f1&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14753_en_10829f1.jpg" alt="Trends related to IMR places assigned to nephrology &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 1&#46; Trends related to IMR places assigned to nephrology &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14754&#95;en&#95;10829f2&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14754_en_10829f2.jpg" alt="Distribution by sex of IMR nephrology places assigned &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 2&#46; Distribution by sex of IMR nephrology places assigned &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14755&#95;en&#95;10829f3&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14755_en_10829f3.jpg" alt="Average number of points for IMR nephrology trainees &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 3&#46; Average number of points for IMR nephrology trainees &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14756&#95;en&#95;10829f4&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14756_en_10829f4.jpg" alt="Average position for IMR nephrology trainees &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 4&#46; Average position for IMR nephrology trainees &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14757&#95;en&#95;10829f5&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14757_en_10829f5.jpg" alt="Nephrology IMR&#58; trends related to first trainee to choose this speciality &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 5&#46; Nephrology IMR&#58; trends related to first trainee to choose this speciality &#40;1985-2008&#41;</p><p class="elsevierStylePara"><a href="grande&#47;10829&#95;108&#95;14758&#95;en&#95;10829f6&#46;jpg" class="elsevierStyleCrossRefs"><img src="10829_108_14758_en_10829f6.jpg" alt="Nephrology IMR&#58; trends related to last trainee to choose this speciality &#40;1985-2008&#41;"></img></a></p><p class="elsevierStylePara">Figure 6&#46; Nephrology IMR&#58; trends related to last trainee to choose this speciality &#40;1985-2008&#41;</p>"
    "pdfFichero" => "P1-E518-S2900-A10829-EN.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "es" => array:5 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441249"
          "palabras" => array:1 [
            0 => "Educaci&#243;n"
          ]
        ]
        1 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441251"
          "palabras" => array:1 [
            0 => "Feminizaci&#243;n"
          ]
        ]
        2 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441253"
          "palabras" => array:1 [
            0 => "Nefrolog&#237;a"
          ]
        ]
        3 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441255"
          "palabras" => array:1 [
            0 => "Especializaci&#243;n"
          ]
        ]
        4 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec441257"
          "palabras" => array:1 [
            0 => "Docencia"
          ]
        ]
      ]
      "en" => array:5 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441250"
          "palabras" => array:1 [
            0 => "Education"
          ]
        ]
        1 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441252"
          "palabras" => array:1 [
            0 => "Feminization"
          ]
        ]
        2 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441254"
          "palabras" => array:1 [
            0 => "Nephrology"
          ]
        ]
        3 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441256"
          "palabras" => array:1 [
            0 => "Fellowship"
          ]
        ]
        4 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec441258"
          "palabras" => array:1 [
            0 => "Teaching"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "resumen" => "<p class="elsevierStylePara">This article reviews the trends in positions of internal medicine resident &#40;IMR&#41; assigned to nephrology in Spain from 1985 to 2008&#46; We analyse the number of positions&#44; the changes of average points received &#40;435 to 377&#41;&#44; and the average position for nephrology &#40;253 to 3457&#41;&#46; We also observed the distribution by sex for the candidates &#40;from 42&#37; to 72&#37; feminisation&#41; over the 24 years examined&#46; Nephrology is positioned 29th of the 47 specialities offered on Spanish IMR training programmes&#46; These data should be an indication to all nephrologists that change is needed&#46; We must examine which factors are involved in the lessening interest in Nephrology as a career among medical graduates and then strive to resolve the problems&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<p class="elsevierStylePara">Analizamos la evoluci&#243;n de&#160;las plazas asignadas a nefrolog&#237;a en la convocatoria MIR&#160;desde 1985 a 2008&#46; Se recoge el n&#250;mero de plazas y se calculan la calificaci&#243;n media anual y el n&#250;mero de orden promedio&#46; El n&#250;mero de plazas adjudicadas ha aumentado&#160;un 464&#37; &#40;de 17 a 96&#41;&#44; con una progresiva feminizaci&#243;n&#160;que llega al 72&#44;5&#37; en los &#250;ltimos a&#241;os&#46; La calificaci&#243;n media anual de los candidatos ha disminuido&#160;de 435 a 377 puntos&#160;y el puesto medio&#160; de elecci&#243;n se ha ido retrasando del 233 al 3&#46;457&#46;&#160;Los datos sugieren una p&#233;rdida de atractivo de la especialidad que debe llevar a examinar y corregir los factores implicados&#46;&#160;</p> <p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p>"
      ]
    ]
    "multimedia" => array:8 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14751_en_10829t1.jpg"
            "Alto" => 417
            "Ancho" => 600
            "Tamanyo" => 181459
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Trends related to IMR nephrology places assigned &#40;1985-2008&#41;"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig2"
        "etiqueta" => "Fig. 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14752_en_10829t2.jpg"
            "Alto" => 454
            "Ancho" => 600
            "Tamanyo" => 212880
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Summary of centres requested by the top five nephrology IMR trainees &#40;1985-2008&#41;"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig3"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14753_en_10829f1.jpg"
            "Alto" => 321
            "Ancho" => 600
            "Tamanyo" => 97162
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Trends related to IMR places assigned to nephrology &#40;1985-2008&#41;"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig4"
        "etiqueta" => "Fig. 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14754_en_10829f2.jpg"
            "Alto" => 282
            "Ancho" => 600
            "Tamanyo" => 118700
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Distribution by sex of IMR nephrology places assigned &#40;1985-2008&#41;"
        ]
      ]
      4 => array:8 [
        "identificador" => "fig5"
        "etiqueta" => "Fig. 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14755_en_10829f3.jpg"
            "Alto" => 334
            "Ancho" => 600
            "Tamanyo" => 103153
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Average number of points for IMR nephrology trainees &#40;1985-2008&#41;"
        ]
      ]
      5 => array:8 [
        "identificador" => "fig6"
        "etiqueta" => "Fig. 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14756_en_10829f4.jpg"
            "Alto" => 320
            "Ancho" => 600
            "Tamanyo" => 97219
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Average position for IMR nephrology trainees &#40;1985-2008&#41;"
        ]
      ]
      6 => array:8 [
        "identificador" => "fig7"
        "etiqueta" => "Fig. 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14757_en_10829f5.jpg"
            "Alto" => 333
            "Ancho" => 600
            "Tamanyo" => 105839
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Nephrology IMR&#58; trends related to first trainee to choose this speciality &#40;1985-2008&#41;"
        ]
      ]
      7 => array:8 [
        "identificador" => "fig8"
        "etiqueta" => "Fig. 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "10829_108_14758_en_10829f6.jpg"
            "Alto" => 313
            "Ancho" => 600
            "Tamanyo" => 101374
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Nephrology IMR&#58; trends related to last trainee to choose this speciality &#40;1985-2008&#41;"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:21 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Perazella MA. Nephrology fellowship training in the 21st century: where do we stand? Clin J Am Soc Nephrol 2010;5(3):387-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20093345" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Ortega Suárez F. Situación de la especialidad de Nefrología en relación a las necesidades de nefrólogos y a su formación. Nefrologia 2008;28(3):241-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18590486" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "3.\u{A0}Quereda C, por la Comisión Nacional de la Especialidad de Nefrología en España\u{A0}(Presidente: F. Ortega Suárez. Vicepresidente y Secretario: C. Quereda Rodríguez-Navarro. Vocales: A.L. Martín de Francisco Hernández, R. Matesanz Acedos, R. Alcázar Arroyo, A. Sanz Boix, C. Bernis Carro, P. Abaigar Luquin, A. Sánchez Casajús, E. Mérida Herrero, M.A. García Pérez). Algunos aspectos de la situación de la formación de especialistas en España.\u{A0}Nefrologia. 2008;28(3):263-71. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18590492" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Parker MG. Nephrology training in the 21st century: toward outcomes-based education. Am J Kidney Dis 2010;56(1):132-42. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20418002" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Rosenberg ME. Adult nephrology fellowship training in the United States: trends and issues. J Am Soc Nephrol 2007;18(4):1027-33. Epub 2007 Feb 28. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17329571" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Berns JS. A survey-based evaluation of self-perceived competency after nephrology fellowship training. Clin J Am Soc Nephrol 2010;5(3):490-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20089491" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "González López Valcárcel\u{A0}B,\u{A0}Barber P, del Grupo de Investigación de Economía de la Salud de la Universidad de Las Palmas de Gran Canaria «Oferta y necesidad de médicos especialistas en España 2006-2030», marzo 2007. Accesible en: http://www.mspsi.es/profesionales/formacion/docs/necesidadesEspecialistas06_30.pdf"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "8.\u{A0}González López Valcarcel B,\u{A0}Barber P,\u{A0}del Grupo de Investigación de Economía de la Salud de la Universidad de Las Palmas de Gran Canaria «Oferta y necesidad de médicos especialistas\u{A0}en España\u{A0}2008-2025», marzo 2009. Accesible en: http://www.mspsi.es/profesionales/formacion/docs/necesidadesEspecialistas2008_2025.pdf"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Matesanz R. Las necesidades de especialistas: el hilo de Ariadna. Nefrologia 2005;25:589-90 <a href="http://www.ncbi.nlm.nih.gov/pubmed/16514896" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Bernis Carro C, Cámara González C. Liberación y utopía. En: Durán MA (ed.). La mujer y la medicina. Akal, 1982.\u{A0}"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Levinson W, Lurie N. When\u{A0}most doctors are women: What lies ahead? Ann Intern Med 2004;141:471-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15381521" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Arrizabalaga P, Bruguera M. Feminización y ejercicio de la medicina. Med Clin (Barc) 2009;133(5):184-6."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Arrizabalaga P. Feminización y ejercicio de la nefrología. Nefrologia\u{A0}2010;30:1010-3."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Palsson R, Kellett J, Lindgren S, Merino J, Semple C, Sereni D; For the EFIM/UEMS Working Group on Competencies in Internal Medicine in Europe. Core competencies of the European internist: A discussion paper. Eur J Intern Med 2007;18(2):104-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17338961" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Legmann M, Kahn Bensaude I, Romestaing P. Atlas de la démographie médicale en France. Situation au Javier\u{A0} 2009. Conseil National de l Ordre des Médicins. Accesible\u{A0}http:www.web.ordre.medecin.fr/demographie/atlas2009.pdf"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Kohan DE, Rosenberg ME. Nephrology training programs and applicants: a very good match. Clin J Am Soc Nephrol 2009;4(1):242-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19056616" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Barrio Lucia V, García López F, Quereda Rodríguez-Navarro C. Los suplementos de Nefrología basada en la evidencia como instrumento para la formación continuada. Nefrologia 2008;28(Suppl 2):1. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19018730" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Niyyar VD, Work J. Interventional nephrology: core curriculum 2009. Am J Kidney Dis 2009;54(1):169-82. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19481319" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Goh BL, Ganeshadeva Yudisthra M, Lim TO. Establishing learning curve for Tenckhoff catheter insertion by interventional nephrologist using CUSUM analysis: how many procedures and in which situation? Semin Dial 2009;22(2):199-203."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Haq NU, Sayeed S, Ali SA. Impact of training in interventional nephrology on hemodialysis vascular access types. Semin Dial 2009;22(1):90-2. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19000113" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Vachharajani TJ, Moossavi S, Salman L, Wu S, Maya ID, Yevzlin AS, et al.\u{A0}Successful models of interventional nephrology at academic medical centers. Clin J Am Soc Nephrol 2010;5(11):2130-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20930089" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003100000002/v0_201502091641/X2013251411051696/v0_201502091641/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35446"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Special Originals"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003100000002/v0_201502091641/X2013251411051696/v0_201502091641/en/P1-E518-S2900-A10829-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251411051696?idApp=UINPBA000064"
]
Article information
ISSN: 20132514
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 3 5 8
2024 October 43 41 84
2024 September 58 48 106
2024 August 58 55 113
2024 July 42 21 63
2024 June 55 27 82
2024 May 48 25 73
2024 April 52 31 83
2024 March 33 14 47
2024 February 44 40 84
2024 January 38 21 59
2023 December 31 18 49
2023 November 37 30 67
2023 October 27 32 59
2023 September 44 29 73
2023 August 35 20 55
2023 July 35 24 59
2023 June 46 26 72
2023 May 70 26 96
2023 April 68 16 84
2023 March 58 21 79
2023 February 31 19 50
2023 January 39 26 65
2022 December 52 23 75
2022 November 47 28 75
2022 October 99 29 128
2022 September 39 32 71
2022 August 37 51 88
2022 July 37 41 78
2022 June 39 25 64
2022 May 43 38 81
2022 April 34 44 78
2022 March 33 46 79
2022 February 52 33 85
2022 January 33 34 67
2021 December 37 37 74
2021 November 41 29 70
2021 October 32 48 80
2021 September 27 37 64
2021 August 33 33 66
2021 July 23 34 57
2021 June 23 18 41
2021 May 34 35 69
2021 April 67 45 112
2021 March 81 36 117
2021 February 61 22 83
2021 January 39 23 62
2020 December 34 16 50
2020 November 25 14 39
2020 October 17 20 37
2020 September 34 10 44
2020 August 25 12 37
2020 July 31 5 36
2020 June 19 6 25
2020 May 25 15 40
2020 April 28 18 46
2020 March 17 10 27
2020 February 28 23 51
2020 January 40 21 61
2019 December 20 18 38
2019 November 19 18 37
2019 October 9 10 19
2019 September 24 20 44
2019 August 13 12 25
2019 July 31 19 50
2019 June 37 5 42
2019 May 24 10 34
2019 April 61 21 82
2019 March 31 15 46
2019 February 19 14 33
2019 January 30 16 46
2018 December 90 35 125
2018 November 143 21 164
2018 October 98 18 116
2018 September 64 11 75
2018 August 34 18 52
2018 July 35 6 41
2018 June 47 11 58
2018 May 48 14 62
2018 April 61 4 65
2018 March 37 10 47
2018 February 45 3 48
2018 January 50 9 59
2017 December 66 13 79
2017 November 52 8 60
2017 October 32 14 46
2017 September 64 13 77
2017 August 25 10 35
2017 July 50 7 57
2017 June 39 5 44
2017 May 49 28 77
2017 April 42 21 63
2017 March 37 28 65
2017 February 46 13 59
2017 January 33 13 46
2016 December 78 17 95
2016 November 82 17 99
2016 October 111 14 125
2016 September 117 5 122
2016 August 232 9 241
2016 July 171 4 175
2016 June 140 0 140
2016 May 152 0 152
2016 April 111 0 111
2016 March 116 0 116
2016 February 121 0 121
2016 January 117 0 117
2015 December 110 0 110
2015 November 83 0 83
2015 October 78 0 78
2015 September 76 0 76
2015 August 64 0 64
2015 July 75 0 75
2015 June 44 0 44
2015 May 56 0 56
2015 April 7 0 7
Show all

Follow this link to access the full text of the article

Idiomas
Nefrología (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?