Michael E. Whitcomb, MD; Deborah L. Walter, MPA
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.
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.
National Study of Graduate Education in Internal Medicine questionnaires from 1996–1997 and 1997–1998.
Programs in internal medicine subspecialties accredited by the Accreditation Council for Graduate Medical Education.
1163 (84%) and 1094 (79%) directors of internal medicine subspecialty programs in 1996–1997 and 1997–1998, respectively.
Survey questions on the amount of time fellows usually spend conducting research and available opportunities to pursue course work leading to an advanced degree.
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%).
Few internal medicine subspecialty programs are currently designed to provide adequate research training as defined by the Institute of Medicine and the ABIM.
Comparison of the Number of Internal Medicine Subspecialty Training Programs and Fellows in 1996–1997 and 1997–1998, by Sponsorship Category
Internal Medicine Subspecialty Training Programs in 1996–1997 and 1997–1998
Considerably more programs sponsored by academic medical center hospitals planned to accept persons interested in pursuing the new ABIM Research Pathway and to provide opportunities for fellows to obtain an advanced degree. Each key at the bottom of the figure corresponds to the two bar graphs above it.
Programs That Planned To Accept Persons Interested in Pursuing the ABIM Research Pathway during 1998–1999 and 1999–2000
The average percentage of time that first-year, second-year, and third-year fellows in programs that did not have separate clinical or research tracks spent doing research is shown. The horizontal line shows the average percentage of time that fellows spent conducting research in their last year.
The average time that first-year ( ), second-year ( ), and third-year ( ) fellows spent conducting research is shown for programs that did ( ) and those that did not ( ) have separate clinical or research tracks in 1997–1998. The number of programs with separate tracks was as follows: cardiology, 33; endocrinology, 18; gastroenterology, 27; infectious disease, 33; nephrology, 44; rheumatology, 17.
From the Association of American Medical Colleges and Medicare Payment Advisory Commission, Washington, D.C.
Acknowledgments: The authors thank Lynn Langdon, Senior Vice President, ABIM, for sharing insight about the Research Pathway and providing data about programs and trainees enrolled in the ABIM Research Pathway Program.
Grant Support: The 1996–1997 and 1997–1998 National Study of Graduate Education in Internal Medicine was funded by the Association of American Medical Colleges in collaboration with the Federated Council for Internal Medicine.
Requests for Single Reprints: Deborah L. Walter, MPA, Medicare Payment Advisory Commission, 1730 K Street NW, Suite 800, Washington, DC 20006; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Whitcomb: Division of Medical Education, Association of American Medical Colleges, 2450 N Street NW, Washington, DC 20037.
Ms. Walter: Medicare Payment Advisory Commission, 1730 K Street NW, Suite 800, Washington, DC 20006.
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Whitcomb ME, Walter DL. Research Training in Six Selected Internal Medicine Fellowship Programs. Ann Intern Med. ;133:800–807. doi: 10.7326/0003-4819-133-10-200011210-00013
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Published: Ann Intern Med. 2000;133(10):800-807.
Cardiology, Education and Training, Gastroenterology/Hepatology, Hospital Medicine, Infectious Disease.
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