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

BACKGROUND: 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. OBJECTIVE: To survey (1) GM research fellows and recent graduates and (2) program directors to learn about the opportunities and challenges facing GM research fellowships. DESIGN: Cross-sectional retrospective survey study. PARTICIPANTS: 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. MAIN MEASURES: 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. KEY RESULTS: 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. CONCLUSIONS: 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.