title: Prevalence and cost of full-time research fellowships during general surgery residency: a national survey.
abstract: OBJECTIVE
  To quantify the prevalence, outcomes, and cost of surgical resident research.
  
  
  BACKGROUND
  General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1 to 3 years performing full-time research. No comprehensive data exists on the scope of this practice.
  
  
  METHODS
  Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program.
  
  
  RESULTS
  Response rate was 200 of 239 (84%). A total of 381 of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and postresidency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (P < 0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of Accreditation Council for Graduate Medical Education work hour regulations for clinical residents, whereas a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%).
  
  
  CONCLUSIONS
  Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. Although performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after postgraduate training.
authors.affiliation: Department of Surgery, Washington University School of Medicine, St Louis, MO 63110, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Robertson
authors.forename: Mary E
authors.initials: ME
authors.lastname: Klingensmith
authors.forename: Craig M
authors.initials: CM
authors.lastname: Coopersmith
mesh_terms: D035843:Biomedical Research / Q000191:economics* / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D003625:Data Collection; D005257:Fellowships and Scholarships / Q000191:economics* / Q000706:statistics & numerical data*; D013502:General Surgery / Q000193:education*; D007396:Internship and Residency; D014481:United States