The Experience of General Internal Medicine Research Fellows and Program Directors: Results from a National Survey.

Abstract

General medicine (GM) research fellowships facilitate health care professionals to obtain the skills and mentored research experience needed for a research career. Yet, little is known about the experience and outcomes of recent graduates of GM fellowships. To survey (1) GM research fellows and recent graduates and (2) program directors to learn about the opportunities and challenges facing GM research fellowships. Cross-sectional retrospective survey study. Individuals who were enrolled in or completed a GM research fellowship (identified through prior fellow lists, advertising from the Society of General Internal Medicine, and fellowship program directors) between 2012 and 2022 in which ≥ 50% of effort was devoted to training and conducting research; 2022 program directors were recruited separately. Respondents were asked to rate factors motivating them to pursue a research fellowship and their experiences during fellowship and to report their professional outcomes. Program directors were asked to rate how challenging different fellowship activities were to them. A total of 160 (42.2%) current/former fellows and 27 (67.5%) program directors completed surveys. Fellowship training was considered essential to obtain the skills necessary to become a GM researcher. Fellows were highly productive (median of 4 papers [IQR 3-6] published from fellowship work); the majority obtained research faculty positions. Gaps in training included negotiation skills, team management, and grant writing. Trainees and graduates sought more cross-institutional collaboration during fellowship. Approximately 1/3 reported at least one symptom of burnout. Fellowship outcomes generally did not vary by gender or under-represented in medicine status. Program directors (88%) found fellowship recruitment challenging. Research fellowships play a critical role in cultivating GM investigators. Consistent investment in GM research fellowships is needed to ensure a pipeline of researchers with the skills necessary to improve general medicine, especially during an ongoing crisis in primary care.