Building capacity for research in family medicine: Is the blueprint faulty?

Background and Objectives: This study compared the training programs and career paths of family medicine graduates in the National Research Service Award (NRSA) Program for Research in Primary Medical Care with general internal medicine and general pediatric peers. Methods: We mailed a survey to NRSA fellows graduating from 23 programs nationally between 1988-1997. Personal characteristics, fellowship experience, current professional activities, and academic productivity were compared among primary care disciplines. Results: Of 215 NRSA participants, 146 (68%) completed the survey. Of the 131 primary care respondents, 25% were family physicians. During the fellowship, family physician trainees spent significantly less time in hands-on research activity (32% +/- 12%) than internists and pediatricians (39% +/- 17%). Family physician graduates also had less post-fellowship mentoring and were less likely to hold clinician/researcher faculty positions in academic centers. Family physician faculty spent far more time on clinical work and less time on research. Only 12.5% of family physician fellowship graduates published one or more articles per year, compared with 36.5% of their peers, and 30% had published nothing since graduation. Conclusions: Family physician graduates of this research training program did not achieve academic success comparable to their peers. Family physicians need more protected time for conducting research in their faculty positions and more sustained mentorship.