Research training in six selected internal medicine fellowship programs

Background: Effective July 1997, the American Board of Internal Medicine (A BIM) established a research pathway to certification to encourage research training of general intemists and subspecialists. Objective: To document the current status of research training in six selec ted subspecialty programs, to examine opportunities available for trainees to undertake formal course work, and to report the percentage of subspecial ty programs that might accept research pathway fellows. Design: National Study of Graduate Education in Internal Medicine questionn aires from 1996-1997 and 1997-1998. Setting: Programs in internal medicine subspecialties accredited by the Acc reditation Council for Graduate Medical Education. Participants: 1163 (84%) and 1094 (79%) directors of internal medicine subs pecialty programs in 1996-1997 and 1997-1998, respectively. Measurements: survey questions on the amount of time fellows usually spend conducting research and available opportunities to pursue course work leadi ng to an advanced degree. Results: On average, during their last year of training, fellows enrolled i n infectious disease, nephrology, endocrinology, and rheumatology programs spent 40% to 50% of their time conducting research, whereas fellows in gast roenterology and cardiology spent 25% to 30% of their time conducting resea rch. Compared with programs sponsored by major teaching hospitals, a greate r percentage of programs sponsored by academic medical center hospitals pla nned to accept persons interested in pursuing the new ABIM Research Pathway (28% vs. 8%) and to provide opportunities for fellows to obtain an advance d degree (60% vs. 14%). Conclusions: Few internal medicine subspecialty programs are currently desi gned to provide adequate research training as defined by the Institute of M edicine and the ABIM.