@Article{info:doi/10.2196/57157,
author="Miao, Jing
and Thongprayoon, Charat
and Garcia Valencia, Oscar
and Craici, Iasmina M
and Cheungpasitporn, Wisit",
title="Navigating Nephrology's Decline Through a GPT-4 Analysis of Internal Medicine Specialties in the United States: Qualitative Study",
journal="JMIR Med Educ",
year="2024",
month="Oct",
day="10",
volume="10",
pages="e57157",
keywords="artificial intelligence; ChatGPT; nephrology fellowship training; fellowship matching; medical education; AI; nephrology; fellowship; United States; factor; chatbots; intellectual; complexity; work-life balance; procedural involvement; opportunity; career demand; financial compensation",
abstract="Background: The 2024 Nephrology fellowship match data show the declining interest in nephrology in the United States, with an 11{\%} drop in candidates and a mere 66{\%} (321/488) of positions filled. Objective: The study aims to discern the factors influencing this trend using ChatGPT, a leading chatbot model, for insights into the comparative appeal of nephrology versus other internal medicine specialties. Methods: Using the GPT-4 model, the study compared nephrology with 13 other internal medicine specialties, evaluating each on 7 criteria including intellectual complexity, work-life balance, procedural involvement, research opportunities, patient relationships, career demand, and financial compensation. Each criterion was assigned scores from 1 to 10, with the cumulative score determining the ranking. The approach included counteracting potential bias by instructing GPT-4 to favor other specialties over nephrology in reverse scenarios. Results: GPT-4 ranked nephrology only above sleep medicine. While nephrology scored higher than hospice and palliative medicine, it fell short in key criteria such as work-life balance, patient relationships, and career demand. When examining the percentage of filled positions in the 2024 appointment year match, nephrology's filled rate was 66{\%}, only higher than the 45{\%} (155/348) filled rate of geriatric medicine. Nephrology's score decreased by 4{\%}‐14{\%} in 5 criteria including intellectual challenge and complexity, procedural involvement, career opportunity and demand, research and academic opportunities, and financial compensation. Conclusions: ChatGPT does not favor nephrology over most internal medicine specialties, highlighting its diminishing appeal as a career choice. This trend raises significant concerns, especially considering the overall physician shortage, and prompts a reevaluation of factors affecting specialty choice among medical residents. ",
issn="2369-3762",
doi="10.2196/57157",
url="https://mededu.jmir.org/2024/1/e57157",
url="https://doi.org/10.2196/57157"
}