Jumpstarting Academic Careers with a Novel Intern Research Rotation: the AIMS Rotation

The Accreditation Council for Graduate Medical Education (ACGME). requirements for residency education in internal medicine specifically state that the program must advance residents’ knowledge of the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care.1 Further, residents should participate in scholarly activity and the sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities.1 The scholarly activity requirement may be satisfied with projects other than research, including journal clubs, presentation at grand rounds, and quality improvement projects. Some programs have developed structured research training experiences that prepare residents to present their research at professional or scientific meetings, write manuscripts in peer reviewed journals, and publish review articles or book chapters.2 Dedicated research activities advance the core competencies and are often highly rated aspects of residency training.3–5 In fact, most residents feel research should be required.6 A recent article suggests that residency program enhancements in patient care, education, community service, and research improve departments of internal medicine and teaching hospitals.7 Finally, research experiences may encourage some residents to consider a career in clinical investigation.8 Despite these potential benefits, implementing a structured research curriculum in a busy residency program remains a logistical challenge. In a meta-analysis, Hebert and colleagues9 identified four features of successful resident research programs: exposure to and guidance from mentors, training in basic research methods, protected time, and an environment supportive of research. The vast majority of internal medicine programs offer one to two months of protected research time during postgraduate year (PGY) two or three. An informal email survey of the Association of Program Directors in Internal Medicine (APDIM) listserver participants showed that 121 of 143 programs, or 85%, offered at least four weeks for research. However, successful resident research projects require much greater commitment of time, interest, and resources. Pursuit of research interests is often displaced by patient care demands.10 We previously described resident research as a three-year continuum of preparation, investigation, and synthesis phases in which early preparation is critical.11 Delaying bona fide research experiences to PGY-2 and compressing them into a one-month block, along with an often ad hoc search for mentors, limits the resident’s chances for success. Such frustrating research experiences may even deter residents from careers in clinical investigation. We recently implemented the four-week Academic Internal Medicine Scholarship (AIMS) rotation, which introduces all interns to the process of organized inquiry and research. Each intern designs a feasible, scientifically sound research project to be completed over the course of residency. They learn research methodology, cultivate mentoring relationships, and develop interdisciplinary collaborations. Since 2005, all interns in the categorical internal medicine residency program at University of California, Davis, School of Medicine (UC Davis) have completed this rotation. We describe the early success of this novel research curriculum. This project has been approved by the UC Davis Institutional Review Board (IRB).