Table 1 Reasons not all trainees should learn to insert CVC’s

1)

Not all have the skills to safely learn to do it

2)

Most are intellectually oriented, and are not seeking to perform lots of procedures

3)

Other physicians perform CVC insertions using real time ultrasound guidance frequently, and offer timely, safer, and better service to patients

4)

Most trainees will not enter practice settings where CVC insertion ability is required

5)

Otherwise excellent future trainees may be denied a nephrology certificate of special competence only because they are unable to insert a CVC

6)

Academic nephrology training programs that cannot provide adequate CVC insertion experience to fellows may lose their status as training centres