Research training in six selected internal medicine fellowship programs.

BACKGROUND Effective July 1997, the American Board of Internal Medicine (ABIM) established a research pathway to certification to encourage research training of general internists and subspecialists. OBJECTIVE To document the current status of research training in six selected subspecialty programs, to examine opportunities available for trainees to undertake formal course work, and to report the percentage of subspecialty programs that might accept research pathway fellows. DESIGN National Study of Graduate Education in Internal Medicine questionnaires from 1996-1997 and 1997-1998. SETTING Programs in internal medicine subspecialties accredited by the Accreditation Council for Graduate Medical Education. PARTICIPANTS 1163 (84%) and 1094 (79%) directors of internal medicine subspecialty 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 leading to an advanced degree. RESULTS On average, during their last year of training, fellows enrolled in infectious disease, nephrology, endocrinology, and rheumatology programs spent 40% to 50% of their time conducting research, whereas fellows in gastroenterology and cardiology spent 25% to 30% of their time conducting research. Compared with programs sponsored by major teaching hospitals, a greater percentage of programs sponsored by academic medical center hospitals planned to accept persons interested in pursuing the new ABIM Research Pathway (28% vs. 8%) and to provide opportunities for fellows to obtain an advanced degree (60% vs. 14%). CONCLUSIONS Few internal medicine subspecialty programs are currently designed to provide adequate research training as defined by the Institute of Medicine and the ABIM.