Background

Research is an important component of the mission of SGIM and its members, and we are in an exciting time of opportunities for general medicine researchers. The Agency for Healthcare Research and Quality (AHRQ) has established the National Center for Excellence in Primary Care¹ as its home for primary care research, and it recently announced several research funding priorities and Special Emphasis Notices focused on primary care²; these include an interest in supporting career development awards for early investigators seeking to develop careers in primary care research. Many National Institutes of Health (NIH) funding priorities, such as developing the behavioral research workforce, reducing health disparities, disease prevention and health promotion, and dementia research, are relevant to general medicine researchers.³

There are also many opportunities for training in general medicine research: The Health Resources & Services Administration (HRSA) recently renewed its National Research Service Award (NRSA) institutional research training grant (T32) that focuses on training in primary care research—19 programs are funded across the country. Additionally, the National Clinical Scholars Program (NCSP) has evolved and is flourishing with six sites across the country,⁴ and the Department of Veterans Affairs continues to be a dedicated partner in funding generalist research through the NCSP and through its own training programs for post-doctoral trainees.

While there is increasing recognition of the importance of primary care in solving today’s healthcare problems, we also recognize the challenges of pursuing a career as a clinician investigator in general internal medicine. Receipt of an R01 as Principal Investigator is often thought of as the time that “independence” as an investigator is achieved, and the age of receipt of first R01 for MDs increased from 40 to 44 years between 1995 and 2020.⁵ Many generalists do not do disease-specific research and therefore may have a more difficult time obtaining NIH funding. Frequently, we meet trainees who are interested in generalist research, but anecdotally they often do not pursue long-term research careers. We may hypothesize that difficulty obtaining funding for research and having a career based on “soft money” in combination with other factors, such as lower salaries of academic research jobs, are among the reasons that fewer early career general internists choose to stay in research careers.

What SGIM Is Doing

To understand the challenges trainees and early investigators face in pursuing research careers, SGIM will implement two surveys to current and former fellows and program directors.

Currently, about one in five SGIM members consider themselves clinician investigators. SGIM’s Research Committee includes 18 geographically diverse clinician investigators who serve for at least three years and work to foster the career development of generalist investigators. The Research Committee develops research related content for the annual and regional SGIM meetings, helps organize selection committees for SGIM’s major research awards, maintains SGIM’s dataset compendium, and serves as SGIM’s go-to committee for issues and projects that affect generalist researchers. To ensure the Research Committee is meeting the needs of generalist researchers through its many initiatives, SGIM is taking a systematic approach to evaluating and improving or adding to these resources for researchers. In December 2020, SGIM’s Research Committee appointed the SGIM Fellows Survey Sub-Committee of 10 academic general internists from across the United States (80% of whom are not members of the Research Committee) to focus on how SGIM can better serve researchers.

Over the past year, the sub-committee has designed the following two surveys:

1. Fellows’ Survey—for persons currently in or who have completed (in the past 10 years) a general medicine research fellowship;
2. Program Directors’ Survey—for program directors of active general medicine research fellowships.

These surveys will provide us with the necessary data on the career outcomes of current and former general medicine research fellows and will identify barriers and facilitators to developing and maintaining a research career. SGIM will use the results of these surveys to enhance and add to its existing resources for researchers.

How You Can Help

Thank you if you already completed one or both of our surveys. If you have not yet done so, please act on the following:

• Fellows’ Survey: If you completed a general medicine research fellowship in the past 10 years, please furnish Dr. Mara Schonberg (mschonbe@bidmc.harvard.edu) with your name and e-mail address. She will provide a unique, secure survey link via REDCap. This research study has been approved by Beth Israel Deaconess Medical Center’s Committee on Clinical Investigation (IRB protocol #: 2021P000995).
• Program Directors’ Survey: If you are the program director of a general medicine research fellowship, please furnish Dr. Michael Paasche-Orlow (michael.paasche-orlow@bmc.org) also with your name and e-mail address. He will provide a unique, secure survey link via REDCap. This research study has been approved by Boston University Medical Campus Institutional Review Board (IRB protocol #: H-42364).

Please complete both surveys if you are eligible!

Next Steps

We plan to complete data collection for these surveys in March 2022 and to share preliminary findings at the SGIM National Meeting in April 2022.