This survey highlights both a low exposure to, and a lack of knowledge about, the field of renal transplantation amongst medical students. This is cause for concern as it has implications for the future recruitment of trainees to the speciality and, potentially, to the procurement of organs.
Previous work has highlighted the multiple factors that deter surgical trainees from this speciality . These include the on-call commitment, unpredictable workload and a lack of exposure to the speciality, at an early stage in training. Based on this information, calls have been made to increase the exposure of surgical trainees by the inclusion of transplantation within basic surgical training (BST) rotation programmes . However, as there are only 23 surgical centres performing renal transplantation within the UK it is unlikely that all trainees would be exposed to the field. In order to gain exposure to the maximum number of doctors, early in their careers, targeting medical students may yield the best results. Indeed, a recent crisis meeting regarding recruitment to renal transplant surgery identified that early positive exposure to the field is vital, and should begin at the undergraduate level . This survey highlights that the potential for the promotion of renal transplantation within the undergraduate course is currently relatively unexplored.
The lack of knowledge regarding sources of organs commonly used within the UK is also of concern. In order to increase the number of kidneys available UK Transplant funds a number of non-heart beating programmes. Such initiatives can potentially increase the transplant rate by 20–40% . Identifying all potential heart beating and non-heart beating donors is fundamental to providing a successful service, and reducing the gap between donors and patients on the waiting list. However, if future doctors are unaware of the existence of these programmes then such schemes are unlikely to reach their full potential.
One of the limitations of this study is the selection bias from a 54% response rate. From talking to some of the students who did not complete the questionnaire it became apparent that those who had no experience or knowledge of the speciality were less likely to participate. This means that the results are probably over reporting the exposure to and knowledge of renal transplantation. A further limitation is that this work only represents the situation at one medical school. We believe that this situation is not unique to Bristol University and recommend that a national study be performed to assess the true extent of the situation.
If transplantation rates are to be maximised and recruitment into the speciality improved, then ideally, all doctors should have some exposure to renal transplantation during the early stages of their career. Indeed a recent study has demonstrated that increased knowledge about organ donation is associated with higher levels of medical education, an increased likelihood of holding an organ donor card and feeling more comfortable in approaching relatives of potential organ donors . Whilst it is realised that teaching time is of a premium at medical school this would be the ideal opportunity to promote transplantation. We believe that conventional methods such as ward based teaching, lectures and tutorials could be supplemented with a more multidisciplinary exposure. For example, involving students in patient education open days or the production of information leaflets/web pages could allow students to see from themselves the improvement in quality of life brought about by transplantation; Such learning experiences may prove more memorable for some students than those of the operating theatre.