Impact of scholarly activities on early postgraduate medical trainees: a cross-sectional study

While scholarly activities are considered essential for medical advancement and improved patient outcomes, the educational value and potential impact on postgraduate medical trainees' well-being has not been well studied. We examined whether clinical research experience and scholarly activity requirements during early postgraduate medical training affect trainees' competency and well-being.

We conducted a cross-sectional study of Japanese early postgraduate medical trainees (postgraduate year [PGY]1-2) recruited from hospitals participating in the General Medicine In-Training Examination (GM-ITE) in January 2024 and from teaching hospitals with scholarly activity requirements that did not participate in GM-ITE. Participants were classified into three groups based on scholarly activity experience: no scholarly activity, scholarly activity without clinical research, and scholarly activity with clinical research. The primary outcome was evidence-based medicine (EBM) competency assessed using the Japanese version of the Assessing Competency in EBM (ACE) tool. Secondary outcomes included GM-ITE scores, future scholarly activity intentions, depression symptoms, and well-being measures. Associations between scholarly activity experience and outcomes were examined using multiple regression analysis for continuous outcomes and logistic regression analysis for binary outcomes, adjusting for potential confounders; missing data were addressed using multiple imputation.

Among 1,152 participants (1,150 from GM-ITE-participating hospitals and 2 from non-participating hospitals), 656 (57.0%) reported engaging in scholarly activities during early postgraduate medical training, with 60 (9.1%) conducting clinical research. After adjusting for potential confounders, compared to trainees without scholarly activity, the difference in ACE tool scores was 0.22 points (95% confidence interval [CI]: 0.02 to 0.41) for those who engaged in scholarly activities without clinical research and 0.40 points (95% CI: -0.02 to 0.83) for those who conducted clinical research. Stratification by program requirements revealed differences of 0.34 points (95% CI: 0.09 to 0.58) for voluntary scholarly activities and 0.09 points (95% CI: -0.19 to 0.37) for required activities. Trainees who conducted clinical research or engaged in required scholarly activities showed higher odds of future academic interest (adjusted odds ratio [OR]: 2.68 [95% CI: 1.33-5.37] and 1.52 [1.02-2.25], respectively), while those who engaged in scholarly activities without clinical research or without requirements showed similar odds to the reference group (adjusted OR: 1.27 [0.97-1.68] and 1.24 [0.88-1.74], respectively) Well-being measures showed minimal differences across groups.

Scholarly activities during early postgraduate medical training, whether required by programs or not, had little impact on trainees' competency and well-being. However, trainees who engaged in clinical research showed increased interest in future academic activities, suggesting the importance of establishing supportive environments for interested trainees.