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JAMA Internal Medicine —The Year in Review, 2023

• 1 Editor, JAMA Internal Medicine
• 2 Department of Medicine, Harvard Medical School, Boston, Massachusetts
• 3 Aging Brain Center at the Hinda and Arthur Marcus Institute of Aging Research, Hebrew SeniorLife, Boston, Massachusetts
• Peer Reviewers List JAMA Internal Medicine Peer Reviewers in 2023 JAMA Internal Medicine

We live in a tumultuous time of increased health care challenges within a milieu of ongoing COVID-19, climate change, war, gun violence, racial and ethnic discrimination, political divisions, and ongoing financial challenges to health care systems and financing. Amidst this background, the JAMA Internal Medicine editors came together to renew our commitment to publishing evidence to inform and improve health and health care. Our commitment is captured in our new mission statement: “To advance the equitable, person-centered, and evidence-based practice of internal medicine through publication of scientifically rigorous, innovative, and inclusive research, review, and commentary that informs dialogue and action with clinical, public health, and policy impact.” 1

In direct alignment with this mission, published articles have addressed meaningful themes, such as the treatment and outcomes of COVID-19, benefits and challenges of artificial intelligence in health care, importance of prevention in health care, association of social determinants of health and violence with health, and lack of equity in health care. Our articles, such as those featured in the Table , 2 - 6 have informed, raised awareness, and proposed solutions. We prioritize articles that have strong clinical relevance and the potential to change clinical practice. 7

Our year-end statistics reflect the broad global effect and reach of JAMA Internal Medicine . Despite the anticipated decrease in COVID-19 articles and the associated deflation in the Journal Impact Factor, the journal performance has remained robust. Submissions remain steady at 3419 received in 2023, with acceptance rates of 13% overall and 6% for original research articles. Our review times remain expeditious, with time to initial decision without peer review at a median of 2 days and time to first decision with peer review at a median of 39 days. Approximately 350 000 receive our weekly electronic Table of Contents, and there were more than 15 million article views and downloads in 2023. The 2022 Journal Impact Factor was 39, placing JAMA Internal Medicine among the leading journals in internal medicine worldwide.

During the 6 months since I took the helm at JAMA Internal Medicine , we have introduced new themes, series, and article types. We have already published articles in our new theme of Climate Change and Health. We will soon be issuing 2 new calls for papers in 2024. Our first call on the theme of Women’s Health 8 (led by Deborah Grady, MD, MPH) highlights a relatively neglected scientific area of fundamental importance to health worldwide. Our second call on Innovations in Clinical Trials (led by Tracy Wang, MD, MHS, MSc, and Giselle Corbie, MD, MSc) will highlight our interest in rigorous clinical trials relevant to internal medicine, with particular emphasis on nonpharmacologic and behavioral interventions, innovative trial designs, and pragmatic trials that promote equity.

We are deeply committed to addressing racism and ageism in medicine, health care, and public health globally. Raegan W. Durant, MD, MPH, serves as our Diversity, Equity, and Inclusion Associate Editor, collaborating with the rest of the JAMA Network to implement the plan to increase equity, diversity, and inclusion at our journal and the entire network. We are working to increase diversity of our editors, authors, commentators, and reviewers. We prioritized publishing the highest-quality studies regarding diversity, equity, and inclusion, resulting in more than 25 publications on this topic in 2023.

We have expanded the Clinical Review and Education series (led by Michael Incze, MD, joined by Kenneth Covinsky, MD, MPH) to include narrative reviews and Clinical Insights, 9 along with continuation of our successful Teachable Moments and Challenges in Clinical Electrocardiography sections. Our new Inside Story section (led by Deborah Grady, MD, MPH) features personal stories and experiences relevant to internal medicine. 10 The Guide to Statistics and Methods series (led by Heather Gwynn Allore, MS, PhD, joined by Yorghos Tripodis, PhD) provides accessible guidance to the methodologic details in our published research articles. 11 Under the coleadership of Michael Incze, MD, and Kenneth Covinsky, MD, MPH, we will be launching a new 1-year JAMA Internal Medicine Editorial Fellowship this year, targeted toward junior faculty and intended to provide an immersive experience in editing and publishing at a medical journal. The first round of applications is due April 15, with 3 fellows starting July 1, 2024. 12

All of this would not have been possible without the hard work of an amazing team of editors. My deepest gratitude goes to deputy editors Deborah Grady, MD, MPH, and Mitchell H. Katz, MD, and our team of 7 associate editors (Giselle Corbie, MD, MSc; Kenneth Covinsky, MD, MPH; Raegan W. Durant, MD, MPH; Ishani Ganguli, MD, MPH; Cary P. Gross, MD; Lona Mody, MD, MSc; and Tracy Wang, , MD, MHS, MSc) who handle research manuscripts and work tirelessly to ensure that we publish high-quality work in every issue. Our weekly manuscript meetings allow for a lively and in-depth discussion of all manuscripts under consideration for publication. Our statistical editors, Heather Gwynn Allore, MS, PhD, and Yorghos Tripodis, PhD, have developed a stellar system to ensure each accepted manuscript receives statistical review and input. I thank Lona Mody and Tracy Wang, who have joined me in triaging all submitted manuscripts for the past 6 months. Our success would not be possible without the day-to-day work of our extremely dedicated and capable editorial manager, Marian Weidner, assisted by editorial assistant Terri Carter. Our distinguished editorial board has contributed to reviews and commentaries and provided ongoing guidance and advice on improving our journal. I want to extend a special thanks for dedicated and continuous support of the JAMA and JAMA Network leadership from Kirsten Bibbins-Domingo, PhD, MD, MAS, editor in chief; Annette Flanagin, RN, MA, executive managing editor; Gregory Curfman, MD, executive editor; and the entire staff of JAMA and the JAMA Network. We could not do this without you.

On behalf of all the editors, I sincerely thank our peer reviewers in 2023, who are listed elsewhere in the journal. 13 We are so grateful for your knowledge, expertise, and insights, which are so critical to our review process. We realize that these reviews take time and effort, and we acknowledge and thank our reviewers for their invaluable contributions. To further recognize and build our pool of peer reviewers we have created a group of Distinguished Reviewers who have contributed high-quality and timely reviews during the past year and who intend to continue at this level of contribution and will be listed on the journal’s online masthead. We have also created a group of Distinguished Reviewers in Women’s Health, who will provide high-quality and timely reviews for our new Women’s Health series and will be listed on the journal’s online masthead.

Finally, our deepest thanks go to our authors and readers. To our authors, thank you for entrusting us with your important work. To our readers, thank you for giving us your input and viewing our articles and commentary. Your support is a testimony to the ongoing importance and value of the peer-reviewed scientific process and the validity of our work. Looking forward to 2024, we hope to continue to innovate and provide a home for cutting-edge, high-quality articles that will improve health and health care worldwide.

Corresponding Author: Sharon K. Inouye, MD, MPH, Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre St, Boston, MA 02131 ( [email protected] ).

Published Online: March 18, 2024. doi:10.1001/jamainternmed.2024.0252

Conflict of Interest Disclosures: None reported.

See More About

Inouye SK. JAMA Internal Medicine —The Year in Review, 2023. JAMA Intern Med. Published online March 18, 2024. doi:10.1001/jamainternmed.2024.0252

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Main Content

Internal medicine - research topics.

The following Research Topics are led by experts in their field and contribute to the scientific understanding of internal-medicine. These Research topics are published in a variety of our peer-reviewed journals, such as Frontiers in Cardiovascular Medicine , Frontiers in Nutrition , Frontiers in Neurology and Frontiers in Medicine , as open access articles .

Challenges of Multi-morbidity in the Era of Personalized Medicine

Globally the number of people with multiple long-term conditions (MLTCs) is on the rise. For people over the age of 60, living with multiple complex disorders is becoming commonplace, with some conditions tending to form consistent clusters, whereas ...

The Newer Paradigms in Hypertension Research and Management

Hypertension is a significant risk factor for cardiovascular disease and premature death worldwide. Of the estimated 1.13 billion people suffering from hypertension, approximately a third are undiagnosed, and of those diagnosed, around half are non-a...

The Increasing Relevance of Traditional Medicine Systems for the Primary Health Care Sector and General Practice: Global Research Perspectives

Traditional medical (TM) systems continue to have relevance in healthcare worldwide, particularly in family medicine and primary care. The WHO explicitly promotes traditional medicine by issuing recommendations in this field and establishing correspo...

Future Prospects of Learning in the Clinical Environment: Exploring the Technological Revolution

Enhancing the quality of clinical education and training for medical students, residents, and practicing physicians is the goal of research in clinical learning. New teaching strategies such as team-based learning, learning by concordance, and inter...

High-Tech in Ophthalmology: Progress and Controversy

High-tech innovations have revolutionized the field of Ophthalmology, delivering unparalleled diagnostic accuracy and surgical precision while minimizing patient risk. Cutting-edge technology such as Artificial Intelligence (AI), Big Data, and Machin...

Translational Approaches in Deciphering the Gut Microbiome's Role in Non-Communicable Diseases

The intricate relationship between the human intestinal microbiome and its host holds a pivotal role in maintaining overall physiological health. With its remarkable capacity to produce a diverse array of bioactive molecules, the gut microbiome exert...

Current Status, Challenges and Future Scope of Stem Cells in Cardiovascular Regenerative Medicine

Stem cell therapy is a promising approach for the treatment of various diseases, including cardiovascular diseases. Stem cells possess embryonic cell-like characteristics and can self-renew, proliferate, differentiate into target cell types, and prod...

New Drugs in Lipid Lowering Therapy

Over the past decades, treatment of lipid disorders has evolved significantly. This is not only limited to the management of hypercholesterolemia, but also hipertriglicerydemia, atherogenic dyslipidemia, and hiperlipoproteinemia(a). Moreover, the per...

Target Organ Damage in Fabry Disease

Anderson Fabry disease is a rare genetic disease characterized by a defect in a X-Linked gene, the alpha galactosidase. Due to the sexual chromosome localization of the gene, men patients present a more severe phenotype, characterized by an early occ...

Insights in Thrombosis and Haemostasis: From a Biological, Clinical and Genetic Perspective

Thrombosis and haemostasis are two complex pathophysiological processes which may affect both,<br/>arteries and veins, subsequently leading to morphological and functional changes in the tributary territories. The clinical picture can sometimes, sugg...

Autonomic Involvement in Arrhythmias: Translating Mechanisms to Therapy

Arrhythmias, ranging from atrial fibrillation to ventricular tachycardia, pose a substantial burden on global healthcare systems. While structural heart disease is a well-established trigger for arrhythmias, emerging research indicates that the auton...

Imaging for the Assessment of Infective Endocarditis

Endocarditis is a rare group of diseases characterized by the presence of inflammation of the endocardium and they usually involve the cardiac valves. In this setting, the most frequent form of endocarditis is infective endocarditis (IE), which is ca...

Effects of Probiotics, Prebiotics, and Postbiotics on Microbiota-Gut-Brain Axis

Probiotics, prebiotics, and postbiotics are presently the primary constituents of targeted dietary intervention approaches for the regulation of intestinal microbiota. These components assume a pivotal role in maintaining health by modulating metabol...

Journal of General Internal Medicine

• Official Journal of the Society of General internal Medicine (SGIM)
• Focused on topics in clinical general medicine, epidemiology, disease prevention, equity in health care delivery, advancing medical education and curriculum development in internal medicine
• An efficient and rigorous peer review ensures content quality and provides expert guidance for clinicians, educators and researchers in internal medicine
• Explores numerous other non-traditional themes, narrative medicine, and innovative methods as they apply to GIM

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A toolkit for delirium identification and promoting partnerships between carers and nurses: a pilot pre–post feasibility study.

• Christina Aggar
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Letter to the Editor: Inpatient Understanding of Their Care Team and Receipt of Mixed Messages: A Two-Site Cross-Sectional Study

• Sruthi Selvakumar
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Dihydropyridine Calcium Channel Blockers and Kidney Outcomes

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Impact of SARS-CoV-2 Infection on Long-Term Depression Symptoms among Veterans

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• for the V. A. HSRDSARS-C.O.V.-2 Observational Research Collaboratory (CORC)

Similarities and Differences Between Pragmatic Trials and Hybrid Effectiveness-Implementation Trials

• John C. Fortney
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Journal updates

Themed issue on the science of electronic health record transitions: call for submissions.

JGIM is launching a themed issue on The Science of Electronic Health Record Transitions, edited by Michael Weiner, Seppo Rinne, Elizabeth Yano.  

The deadline for submissions is 1 November 2022.

The Editors are looking for submissions that are related to current issues on electronic health record transitions.

More detail of the scope, topics of special interest and articles considered is available here .

 Manuscript submissions should follow JGIM submission guidelines and be made in the usual way through the submission system by 1 November 2022.

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COVID-19 and impact on peer review

As a result of the significant disruption that is being caused by the COVID-19 pandemic we are very aware that many researchers will have difficulty in meeting the timelines associated with our peer review process during normal times.  Please do let us know if you need additional time. Our systems will continue to remind you of the original timelines but we intend to be highly flexible at this time.

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50 Studies Every Internist Should Know

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This online resource presents key studies that have shaped the practice of internal medicine. Selected using a rigorous methodology, the studies cover various specialty areas, including preventative medicine, endocrinology, hematology and oncology, musculoskeletal diseases, nephrology, gastroenterology, infectious diseases, cardiology, pulmonology, geriatrics and palliative care, and mental health. For each study, a concise summary is presented with an emphasis on the results and limitations of the study, and its implications for practice. An illustrative clinical case concludes each review, followed by brief information on other relevant studies.

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Researching medical equipment is one way that general internal medicine clinician-scientists help provide advanced treatment options.

Mayo Clinic Division of General Internal Medicine clinician-scientists and researchers study many aspects of medical care, including those in the areas of quality, integrative medicine and health, menopause and women's sexual health, and consultative practice. Our scientists are committed to contributing to the science and are highly involved with publishing and professional societies.

Their goal is to improve how care is delivered and to build on a foundation of scientific evidence that supports the team-based model of care.

See a list of publications about general internal medicine by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine.

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Research@EmoryGIM fosters a collaborative environment that supports emerging, new, and established faculty to initiate, grow, and sustain successful and impactful research and scholarly activity that positively impacts our patients and our learners. Our faculty engage in a wide variety of research topics that fit our mission to improve the health of adults in the US and worldwide. GIM Faculty have a rich portfolio of funded projects that provide opportunities for collaboration within the division, across departments, and across schools at Emory. We invite you to look through our specific research areas below and get a flavor of the rich diversity of scholarly activity happening in our division.

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Welcome to the subject guide for the Department of Medicine. This guide is designed to help you find and select appropriate resources and tools for teaching, research, and patient care. 

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Provides fulltext access to Lane's resources. Contains coverage of over 5000 journals and more than 35.5 million citations for biomedical articles, including, but not limited to, clinical trials, systematic reviews, case reports, and clinical practice guidelines.

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• AccessMedicine Repository of medical knowledge from internal medicine, cardiology, genetics, pharmacy, diagnosis and management, basic sciences, patient care, and more. Continuously expanding, all databases in the repository contain the latest editions of selected medical titles. Access Instructions. . . less... You must register and log in to access some features. To maintain your personal accounts, log in via the Stanford network every 90 days.

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Mayo Clinic School of Continuous Professional Development

You are here, 36th annual selected topics in internal medicine 2024.

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This course offers Live (in-person) and Livestream (virtual) attendance options

Course Directors:  John B. Bundrick, M.D. , and  Christopher (Chris) R. Stephenson, M.D .

January 22 - 26, 2024 - Hyatt Regency Maui Resort and Spa - Lahaina, Maui, Hawaii

Mayo Clinic's Selected Topics in Internal Medicine (STIM) is a postgraduate course designed to update general internists, internist-subspecialists, family medicine specialists, and other primary healthcare professionals on selected internal medicine topics. Some of the most common problems encountered in clinical practice are represented. Course focus is clinical pearls and practice updates. Presentations are made by experts from various disciplines in internal medicine and faculty members are available during breaks to answer questions and to discuss cases with course participants.

Target Audience

This course is designed for general internists, internal medicine subspecialists, family medicine physicians, and other primary healthcare professionals.

Learning Objectives

Upon completion of this activity, participants should be able to:

• Summarize recent updates, clinical studies, and new guidelines that impact practice in general medicine.
• Review updates and clinical practice strategies in the areas of general internal medicine, gastroenterology, infectious diseases, endocrinology, rheumatology, dermatology, cardiology, pulmonology, hematology, geriatrics, perioperative medicine, psychiatry and neurology.
• Describe management options for diabetes and evidence for new diabetic agents.

Attendance at any Mayo Clinic course does not indicate or guarantee competence or proficiency in the skills, knowledge or performance of any care or procedure(s) which may be discussed or taught in this course.

• 27.25 AAFP Prescribed
• 31.25 AAPA Category 1
• 31.25 AMA PRA Category 1 Credit ™
• 31.25 Attendance

The 2024 Selected Topics in Internal Medicine program will be held at: 

Hyatt Regency Maui Resort and Spa  200 Nohea Kai Dr.  Lahaina, HI 96761  United States 

Hyatt Regency Maui Resort and Spa – Guest Room Block  In an effort to provide continued support for Maui’s disaster relief efforts the Hyatt Regency Maui Resort and Spa has been required to make adjustments to our original room block and standing reservations.  A subset of guest reservations are being relocated to adjacent resorts.  Our planning team has been in contact with customers impacted by this change.  If your reservation has been impacted, a message was sent to the email address in our system (ce.mayo.edu).  If you have not received a message from our planning team your reservation at the Hyatt Regency is intact.   Adjacent resorts include the Westin Maui Resort and Spa or Sheraton Maui Resort and Spa.  Both resorts are a short walk to the Hyatt Regency – where the program will be held.  In addition, our planning team has secured convenient daily shuttle transportation between the hotels.  If you choose to drive yourself instead of taking the shuttle, complimentary parking is included.  

Hyatt Regency Maui – Luau Experience exciting entertainment at Hyatt Regency Maui’s “Drums of the Pacific” Luau! The sound of the conch shell and beating of the drums signal the start of the most exciting Maui luau. “Drums of the Pacific” Polynesian Spectacular (a Tihati Production) takes you on a journey through the islands of Polynesia, complete with a traditional imu ceremony and the exotic flavors of native Hawaiian cuisine.  Tickets available  HERE   20% Discount Promo code: MAYO2024 

Ritz-Carlton Maui - Overflow Hotel Block:   An additional room block is now available at The Ritz-Carlton Maui. The conference rate for a Deluxe room is $449 including the $10 resort fee or $599 for Deluxe Ocean View inclusive of the $10 resort fee. Reservations must be made before the room block is filled or by December 22, 2023, whichever comes first. After December 22, 2023, reservations will be taken on space and rate availability. 

Book your group rate for Mayo Clinic STIM Overflow Block  

* PLEASE NOTE : The $40 Resort Fee at the time of booking will be adjusted to an exclusive Mayo Resort Fee rate of $10 plus tax, per room, per night, upon check-in.* 

All travel and lodging expenses are the sole responsibility of the individual registrant. 

Credit Statement(s):

AMA  Mayo Clinic College of Medicine and Science designates this live activity for a maximum of 31.25  AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity

AAFP Prescribed The AAFP has reviewed 36th Annual Selected Topics in Internal Medicine 2024 and deemed it acceptable for up to 27.25 Live AAFP Prescribed credits. Term of Approval is from 01/22/2024 to 01/26/2024. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ANCC  Mayo Clinic College of Medicine and Science designates this activity for a maximum of 31.25 ANCC contact hours. Nurses should claim only the credit commensurate with the extent of their participation in the activity. 

American Board of Internal Medicine (ABIM)  Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 27.25 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

American Board of Surgery (ABS)  Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and Self-Assessment requirements of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

Royal College of Physicians and Surgeons of Canada  Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

This continuing education activity satisfies the new one-time, eight-hour training requirement for all Drug Enforcement Administration (DEA)-registered practitioners. Learners should claim only the credit commensurate with the extent of their participation in the activity.

Other Healthcare Professionals:  A record of attendance will be provided to all registrants for requesting credits in accordance with state nursing boards, specialty societies or other professional associations

For disclosure information regarding Mayo Clinic School of Continuous Professional Development accreditation review committee member(s) and staff, please go here to review disclosures .

Available Credit

Please  update your profile  to let us know if you have dietary restrictions or access requirements.  

To claim credit for livestream participation in this course, learners must view the content during the hours posted for the live activity.  This course is not approved for on-demand delivery. 

Commitment to Equity, Diversity and Inclusion​ 

Mayo Clinic School of Continuous Professional Development (MCSCPD) strives to foster a learning environment in which individual differences are valued, allowing all to achieve their fullest potential.  ​ 

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Annals of internal medicine presents breaking scientific news at acp's internal medicine meeting 2024.

Authors discuss evidence-based research on obesity, antibiotic resistance, and type 2 diabetes

BOSTON , April 19, 2024 /PRNewswire/ -- Today at ACP's annual meeting, Internal Medicine Meeting 2024, Annals of Internal Medicine presented three breaking scientific research articles during a live scientific plenary session that featured the authors of those articles. The articles were published in ACP's flagship journal concurrent with the live meeting presentation. During the session, New in Annals of Internal Medicine: Hear it First from the Authors, the authors of two research studies addressing the topics of obesity, antibiotic resistance, and an ACP clinical guideline on type 2 diabetes presented their work to meeting attendees.

Christine Laine , M.D., MPH, Annals of Internal Medicine Editor-in-Chief and ACP Senior Vice President, introduced the authors and facilitated a discussion to gain further insights into their work. The articles and presentations included:

The Effect of Time-Restricted Eating on Body Weight: A Randomized Controlled Isocaloric Feeding Trial in Adults with Diabetes . Nisa Maruthur , M.D., MHS, Associate Professor of Medicine and Director of the General Internal Medicine Fellowship Program at Johns Hopkins discussed findings of a randomized controlled trial of adults with obesity and prediabetes comparing time-restricted eating and basic calorie control for weight loss. Dr. Maruthur explained that when calories were held constant in both groups, it did not seem to matter whether participants consumed most of their calories early in the day or in the evening. Her findings suggest that overall calories may be more important than meal timing when it comes to weight loss.

Assessing Clinical Utilization of Next Generation Antibiotics Against Resistant Gram-negative Infections in US Hospitals: A Retrospective Cohort Study . Sameer Kadri , M.D., MS, Tenure Track Investigator in the National Institute of Health (NIH) Clinical Center's Critical Care Medicine Department at the NIH Clinical Center, explained that despite approval by the U.S. Food and Drug Administration (FDA) for seven new gram-negative antibiotics between 2014 and 2019, clinicians in U.S. hospitals still treated more than 40 percent of patients battling highly resistant pathogens exclusively with older, generic agents, even when these older agents are already known to be highly toxic or sub-optimally effective. Dr. Kadri told attendees that this sluggish uptake is an important issue because it threatens future development and supply of new antibiotics for patients.

Newer Pharmacological Treatments in Adults with Type 2 Diabetes: A Clinical Guideline from the American College of Physicians . Carolyn Crandall , M.D. Professor of Medicine at the David Geffen School of Medicine at UCLA and Chair of ACP's Clinical Guidelines Committee, provided context and rationale for the recommendations detailed in ACP's new diabetes guideline. Dr. Crandall explained that ACP's guidelines are based on a systematic review of the effectiveness and harms of newer pharmacological treatments. The ACP guidelines committee prioritized clinical benefit outcomes, such as reduced risk for mortality, stroke, and myocardial infarction, over glycemic control, as all eligible interventions, like sulfonylureas, GLP-1s, SGLT-2, DPP-4, and long-acting insulins, are known to improve glycemic control in adults with type 2 diabetes. This is a key difference between ACP guidelines and those of other organizations. With this goal in mind, ACP recommends adding a sodium-glucose cotransporter-2 (SGLT-2) inhibitor or glucagon-like peptide-1 (GLP-1) agonist to metformin and lifestyle interventions in adults with type 2 diabetes and inadequate glycemic control, she said. GLP-1 should be considered when weight loss is an important treatment goal for the patient.

"While this scientific plenary session marks a 'first' for ACP's annual meeting, the topics discussed today are central to our work as internal medicine physicians and on par with the high caliber of research ACP members and Annals of Internal Medicine readers have come to expect and anticipate every week," said Dr. Laine.

About the American College of Physicians The American College of Physicians  is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 161,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on  X , Facebook , Instagram  and LinkedIn .

About Annals of Internal Medicine Annals of Internal Medicine   is the flagship journal of the American College of Physicians (ACP).  Annals  is the most widely read and cited general internal medicine journal and one of the most influential peer-reviewed clinical journals in the world.  Annals' mission is to promote excellence in medicine, enable physicians and other health care professionals to be well-informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. New content is published every Tuesday at  Annals.org . Follow Annals  on  X  and  Instagram   and on  Facebook .

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Alternative routes into clinical research: a guide for early career doctors

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• Phillip LR Nicolson , consultant haematologist and associate professor of cardiovascular science 1 2 3 ,
• Martha Belete , registrar in anaesthetics 4 5 ,
• Rebecca Hawes , clinical fellow in anaesthetics 5 6 ,
• Nicole Fowler , haematology clinical research fellow 7 ,
• Cheng Hock Toh , professor of haematology and consultant haematologist 8 9
• 1 Institute of Cardiovascular Sciences, University of Birmingham, UK
• 2 Department of Haemostasis, Liaison Haematology and Transfusion, University Hospitals Birmingham NHS Foundation Trust, Birmingham
• 3 HaemSTAR, UK
• 4 Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth, UK
• 5 Research and Audit Federation of Trainees, UK
• 6 Department of Anaesthesia, The Rotherham NHS Foundation Trust, Rotherham Hospital, Rotherham
• 7 Department of Haematology, Royal Cornwall Hospitals NHS Trust, Treliske, Truro
• 8 Liverpool University Hospitals NHS Foundation Trust, Prescott Street, Liverpool
• 9 Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool
• Correspondence to P Nicolson, C H Toh p.nicolson{at}bham.ac.uk ; c.h.toh{at}liverpool.ac.uk

Working in clinical research alongside clinical practice can make for a rewarding and worthwhile career. 1 2 3 Building research into a clinical career starts with research training for early and mid-career doctors. Traditional research training typically involves a dedicated period within an integrated clinical academic training programme or as part of an externally funded MD or PhD degree. Informal training opportunities, such as journal clubs and principal investigator (PI)-mentorship are available ( box 1 ), but in recent years several other initiatives have launched in the UK, meaning there are more ways to obtain research experience and embark on a career in clinical research.

Examples of in-person and online research training opportunities

These are available either informally or formally, free of charge or paid, and via local employing hospital trusts, allied health organisations, royal colleges, or universities

Research training opportunities

Mentorship by PIs at local hospital

Taking on formal role as sub-investigator

Journal clubs

Trainee representation on regional/national NIHR specialty group

API Scheme: https://www.nihr.ac.uk/health-and-care-professionals/training/associate-principal-investigator-scheme.htm .

eLearning courses available at https://learn.nihr.ac.uk (free): Good clinical practice, fundamentals of clinical research delivery, informed consent, leadership, future of health, central portfolio management system.

eLearning courses available from the Royal College of Physicians. Research in Practice programme (free). www.rcplondon.ac.uk

eLearning courses available from the Medical Research Council (free). https://bygsystems.net/mrcrsc-lms/

eLearning courses available from Nature (both free and for variable cost via employing institution): many and varied including research integrity and publication ethics, persuasive grant writing, publishing a research paper. https://masterclasses.nature.com

University courses. Examples include novel clinical trial design in translational medicine from the University of Cambridge ( https://advanceonline.cam.ac.uk/courses/ ) or introduction to randomised controlled trials in healthcare from the University of Birmingham ( https://www.birmingham.ac.uk/university/colleges/mds/cpd/ )

This article outlines these formal but “non-traditional” routes available to early and mid-career doctors that can successfully increase research involvement and enable research-active careers.

Trainee research networks

Trainee research networks are a recent phenomenon within most medical specialties. They are formalised regional or national groups led by early and mid-career doctors who work together to perform clinical research and create research training opportunities. The first of these groups started in the early 2010s within anaesthetics but now represent nearly every specialty ( box 2 ). 4 Trainee research networks provide research training with the aim of increasing doctors’ future research involvement. 5

A non-exhaustive list of UK national trainee led research networks*

Acute medicine.

No national trainee research network

Anaesthesia

Research and Audit Federation of Trainees (RAFT). www.raftrainees.org

Cardiothoracic surgery

No national trainee-specific research network. National research network does exist: Cardiothoracic Interdisciplinary Research Network (CIRN). www.scts.org/professionals/research/cirn.aspx

Emergency medicine

Trainee Emergency Medicine Research Network (TERN). www.ternresearch.co.uk

Ear, nose, and throat

UK ENT Trainee Research Network (INTEGRATE). www.entintegrate.co.uk

Gastroenterology

No national trainee research network. Many regional trainee research networks

General practice

No national trainee-specific research network, although national research networks exist: Society for Academic Primary Care (SAPC) and Primary Care Academic Collaborative (PACT). www.sapc.ac.uk ; www.gppact.org

General surgery

Student Audit and Research in Surgery (STARSurg). www.starsurg.org . Many regional trainee research networks

Geriatric Medicine Research Collaborative (GeMRC). www.gemresearchuk.com

Haematology (non-malignant)

Haematology Specialty Training Audit and Research (HaemSTAR). www.haemstar.org

Haematology (malignant)

Trainee Collaborative for Research and Audit in Hepatology UK (ToRcH-UK). www.twitter.com/uk_torch

Histopathology

Pathsoc Research Trainee Initiative (PARTI). www.pathsoc.org/parti.aspx

Intensive care medicine

Trainee Research in Intensive Care Network (TRIC). www.tricnetwork.co.uk

Internal medicine

No national trainee-led research network. www.rcp.ac.uk/trainee-research-collaboratives

Interventional radiology

UK National Interventional Radiology Trainee Research (UNITE) Collaborative. https://www.unitecollaborative.com

Maxillofacial surgery

Maxillofacial Trainee Research Collaborative (MTReC). www.maxfaxtrainee.co.uk/

UK & Ireland Renal Trainee Network (NEPHwork). www.ukkidney.org/audit-research/projects/nephwork

No national trainee-led research network

Neurosurgery

British Neurosurgical Trainee Research Collaborative (BNTRC). www.bntrc.org.uk

Obstetrics and gynaecology

UK Audit and Research Collaborative in Obstetrics and Gynaecology (UKAROG). www.ukarcog.org

The National Oncology Trainee Collaborative for Healthcare Research (NOTCH). www.uknotch.com

Breast Cancer Trainee Research Collaborative Group (BCTRCG). https://bctrcguk.wixsite.com/bctrcg

Ophthalmology

The Ophthalmology Clinical Trials Network (OCTN). www.ophthalmologytrials.net

Paediatrics

RCPCH Trainee Research Network. www.rcpch.ac.uk/resources/rcpch-trainee-research-network

Paediatric anaesthesia

Paediatric Anaesthesia Trainee Research Network (PATRN). www.apagbi.org.uk/education-and-training/trainee-information/research-network-patrn

Paediatric haematology

Paediatric Haematology Trainee Research Network (PHTN). https://b-s-h.org.uk/about-us/special-interest-groups/paediatric-sig/phtn

Paediatric surgery

Paediatric Surgical Trainees Research Network (PSTRN). www.pstrnuk.org

Pain medicine

Network of Pain Trainees Interested in Research & Audit (PAIN-TRAIN). www.paintrainuk.com

Palliative care

UK Palliative Care Trainee Research Collaborative (UKPRC). www.twitter.com/uk_prc

Plastic surgery

Reconstructive Surgery Trials Network (RSTN). www.reconstructivesurgerytrials.net/trainees/

Pre-hospital medicine

Pre-Hospital Trainee Operated Research Network (PHOTON). www.facebook.com/PHOTONPHEM

Information from Royal College of Psychiatrists. www.rcpsych.ac.uk/members/your-faculties/academic-psychiatry/research

Radiology Academic Network for Trainees (RADIANT). www.radiantuk.com

Respiratory

Integrated Respiratory Research collaborative (INSPIRE). www.inspirerespiratory.co.uk

British Urology Researchers in Surgical Training (BURST). www.bursturology.com

Vascular surgery

Vascular & Endovascular Research Network (VERN). www.vascular-research.net

*limited to those with formal websites and/or active twitter accounts. Correct as of 5 January 2024. For regional trainee-led specialty research networks, see www.rcp.ac.uk/trainee-research-collaboratives for medical specialties, www.asit.org/resources/trainee-research-collaboratives/national-trainee-research-collaboratives/res1137 for surgical specialties, and www.rcoa.ac.uk/research/research-bodies/trainee-research-networks for anaesthetics.

Networks vary widely in structure and function. Most have senior mentorship to guide personal development and career trajectory. Projects are usually highly collaborative and include doctors and allied healthcare professionals working together.

Observational studies and large scale audits are common projects as their feasibility makes them deliverable rapidly with minimal funding. Some networks do, however, carry out interventional research. The benefits of increasing interventional research studies are self-evident, but observational projects are also important as they provide data useful for hypothesis generation and defining clinical equipoise and incidence/event rates, all of which are necessary steps in the development of randomised controlled studies.

These networks offer a supportive learning environment and research experience, and can match experience with expectations and responsibilities. Early and mid-career doctors are given opportunities to be involved and receive training in research at every phase from inception to publication. This develops experience in research methodology such as statistics, scientific writing, and peer review. As well as research skills training, an important reward for involvement in a study is manuscript authorship. Many groups give “citable collaborator” status to all project contributors, whatever their input. 6 7 This recognises the essential role everyone plays in the delivery of whole projects, counts towards publication metrics, and is important for future job applications.

Case study—Pip Nicolson (HaemSTAR)

Haematology Specialty Training, Audit and Research (HaemSTAR) is a trainee research network founded because of a lack of principal investigator training and clinical trial activity in non-malignant haematology. It has led and supported national audits and research projects in various subspecialty areas such as immune thrombocytopenia, thrombotic thrombocytopenic purpura, venous thrombosis, and transfusion. 8 9 10 Through involvement in this network as a registrar, I have acted as a sub-investigator and supported the principal investigator on observational and interventional portfolio-adopted studies by the National Institute for Health and Care Research (NIHR). These experiences gave me valuable insight into the national and local processes involved in research delivery. I was introduced to national leaders in non-malignant haematology who not only provided mentorship and advice on career development, but also gave me opportunities to lead national audits and become involved in HaemSTAR’s committee. 10 11 These experiences in leadership have increased my confidence in management situations as I have transitioned to being a consultant, and have given me skills in balancing clinical and academic roles. Importantly, I have also developed long term friendships with peers across the country as a result of my involvement in HaemSTAR.

Associate Principal Investigator scheme

The Associate Principal Investigator (API) scheme is a training programme run by NIHR to develop research skills and contribute to clinical study delivery at a local level. It is available throughout England, Scotland, Wales, and Northern Ireland for NIHR portfolio-adopted studies. The programme runs for six months and, upon completion, APIs receive formal recognition endorsed by the NIHR and a large number of royal colleges. The scheme is free and open to medical and allied healthcare professionals at all career grades. It is designed to allow those who would not normally take part in clinical research to do so under the mentorship of a local PI. Currently there are more than 1500 accredited APIs and over 600 affiliated studies across 28 specialties. 12 It is a good way to show evidence of training and involvement in research and get more involved in research conduct. APIs have been shown to increase patient recruitment and most people completing the scheme continue to be involved in research. 12 13

Case study—Rebecca Hawes

I completed the API scheme as a senior house officer in 2021. A local PI introduced me to the Quality of Recovery after Obstetric Anaesthesia NIHR portfolio study, 14 which I saw as a training opportunity and useful experience ahead of specialist training applications. It was easy to apply for and straightforward to navigate. I was guided through the six month process in a step-by-step manner and completed eLearning modules and video based training on fundamental aspects of running research projects. All this training was evidenced on the online API platform and I had monthly supervision meetings with the PI and wider research team. As well as the experience of patient recruitment and data collection, other important aspects of training were study set-up and sponsor communications. Key to my successful API scheme was having a supportive and enthusiastic PI and developing good organisational skills. I really enjoyed the experience, and I have since done more research and have become a committee member on a national trainee research network in anaesthesia called RAFT (Research and Audit Federation of Trainees). I’ve seen great enthusiasm among anaesthetists to take part in the API scheme, with over 150 signing up to the most recent RAFT national research project.

Clinical research posts

Dedicated clinical research posts (sometimes termed “clinical research fellow” posts) allow clinicians to explore and develop research skills without committing to a formal academic pathway. They can be undertaken at any stage during a medical career but are generally performed between training posts, or during them by receiving permission from local training committees to temporarily go “out of programme.” These positions are extremely varied in how they are advertised, funded, and the balance between research and clinical time. Look out for opportunities with royal colleges, local and national research networks, and on the NHS Jobs website. Research fellowships are a good way to broaden skills that will have long term impact across one’s clinical career.

Case study—Nicole Fowler

After completing the Foundation Programme, I took up a 12 month clinical trials fellow position. This gave me early career exposure to clinical research and allowed me to act as a sub-investigator in a range of clinical trials. I received practical experience in all stages of clinical research while retaining a patient facing role, which included obtaining consent and reviewing patients at all subsequent visits until study completion. Many of the skills I developed in this post, such as good organisation and effective teamwork, are transferable to all areas of medicine. I have thoroughly enjoyed the experience and it is something I hope to talk about at interview as it is an effective way of showing commitment to a specialty. Furthermore, having a dedicated research doctor has been beneficial to my department in increasing patient involvement in research.

Acknowledgments

We would like to thank Holly Speight and Clare Shaw from the NIHR for information on the API scheme.

*These authors contributed equally to this work

Patient and public involvement: No patients were directly involved in the creation of this article.

PLRN, MB, and CHT conceived the article and are guarantors. All authors wrote and edited the manuscript.

Competing interests: PLRN was the chair of HaemSTAR from 2017 to 2023. MB is the current chair of the Research and Audit Federation of Trainees (RAFT). RH is the current secretary of RAFT. CHT conceived HaemSTAR.

Provenance and peer review: Commissioned; externally peer reviewed.

• Downing A ,
• Morris EJ ,
• Corrigan N ,
• Bracewell M ,
• Medical Academic Staff Committee of the British Medical Association
• ↵ RAFT. The start of RAFT. https://www.raftrainees.org/about
• Jamjoom AAB ,
• Hutchinson PJ ,
• Bradbury CA ,
• HaemSTAR Collaborators
• ↵ National Institute for Health and Care Research. Associate Principal Investigator (PI) Scheme. 2023. https://www.nihr.ac.uk/health-and-care-professionals/career-development/associate-principal-investigator-scheme.htm
• Fairhurst C ,
• Torgerson D
• O’Carroll JE ,
• Warwick E ,
• ObsQoR Collaborators

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Firearm violence risk score may help tailor, disseminate prevention efforts in emergency departments

by American College of Physicians

A four-item score designed to predict those at risk for future firearm violence may serve as an important tool for emergency department clinicians to tailor interventions to young persons at risk for firearm violence and disseminating those interventions effectively. A new cross-sectional analysis of the association between the risk score and self-reported firearm violence is published in Annals of Internal Medicine.

Researchers from the University of Michigan, University of Pennsylvania, and University of Washington conducted a cross-sectional study of persons aged 18 to 24 years appearing in emergency departments in Flint, Michigan; Philadelphia, Pennsylvania; and Seattle, Washington between 2021 and 2023 to estimate the association between the SaFETy score and past 6-month self-reported firearm violence.

The SaFETy score was derived and internally validated in a previous sample of substance-using youth, and is the only clinical screening tool specific to firearm violence. This ten-point score includes four items: fighting; friends' weapon-carrying; hearing gunshots in one's neighborhood; and receiving firearm threats. The authors found that persons with higher SaFETy scores showed a higher prevalence for firearm violence within the most recent six months than participants with low scores.

According to the authors, their findings indicate that the score may be important for preventive resource allocation and to ascertain persons with firearm violence history.

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What the data says about gun deaths in the U.S.

More Americans died of gun-related injuries in 2021 than in any other year on record, according to the latest available statistics from the Centers for Disease Control and Prevention (CDC). That included record numbers of both gun murders and gun suicides. Despite the increase in such fatalities, the rate of gun deaths – a statistic that accounts for the nation’s growing population – remained below the levels of earlier decades.

Here’s a closer look at gun deaths in the United States, based on a Pew Research Center analysis of data from the CDC, the FBI and other sources. You can also read key public opinion findings about U.S. gun violence and gun policy .

This Pew Research Center analysis examines the changing number and rate of gun deaths in the United States. It is based primarily on data from the Centers for Disease Control and Prevention (CDC) and the Federal Bureau of Investigation (FBI). The CDC’s statistics are based on information contained in official death certificates, while the FBI’s figures are based on information voluntarily submitted by thousands of police departments around the country.

For the number and rate of gun deaths over time, we relied on mortality statistics in the CDC’s WONDER database covering four distinct time periods:  1968 to 1978 ,  1979 to 1998 ,  1999 to 2020 , and 2021 . While these statistics are mostly comparable for the full 1968-2021 period, gun murders and suicides between 1968 and 1978 are classified by the CDC as involving firearms  and  explosives; those between 1979 and 2021 are classified as involving firearms only. Similarly, gun deaths involving law enforcement between 1968 and 1978 exclude those caused by “operations of war”; those between 1979 and 2021 include that category, which refers to gun deaths among military personnel or civilians  due to war or civil insurrection in the U.S . All CDC gun death estimates in this analysis are adjusted to account for age differences over time and across states.

The FBI’s statistics about the types of firearms used in gun murders in 2020 come from the bureau’s  Crime Data Explorer website . Specifically, they are drawn from the expanded homicide tables of the agency’s  2020 Crime in the United States report . The FBI’s statistics include murders and non-negligent manslaughters involving firearms.

How many people die from gun-related injuries in the U.S. each year?

In 2021, the most recent year for which complete data is available, 48,830 people died from gun-related injuries in the U.S., according to the CDC. That figure includes gun murders and gun suicides, along with three less common types of gun-related deaths tracked by the CDC: those that were accidental, those that involved law enforcement and those whose circumstances could not be determined. The total excludes deaths in which gunshot injuries played a contributing, but not principal, role. (CDC fatality statistics are based on information contained in official death certificates, which identify a single cause of death.)

What share of U.S. gun deaths are murders and what share are suicides?

Though they tend to get less public attention than gun-related murders, suicides have long accounted for the majority of U.S. gun deaths . In 2021, 54% of all gun-related deaths in the U.S. were suicides (26,328), while 43% were murders (20,958), according to the CDC. The remaining gun deaths that year were accidental (549), involved law enforcement (537) or had undetermined circumstances (458).

What share of all murders and suicides in the U.S. involve a gun?

About eight-in-ten U.S. murders in 2021 – 20,958 out of 26,031, or 81% – involved a firearm. That marked the highest percentage since at least 1968, the earliest year for which the CDC has online records. More than half of all suicides in 2021 – 26,328 out of 48,183, or 55% – also involved a gun, the highest percentage since 2001.

How has the number of U.S. gun deaths changed over time?

The record 48,830 total gun deaths in 2021 reflect a 23% increase since 2019, before the onset of the coronavirus pandemic .

Gun murders, in particular, have climbed sharply during the pandemic, increasing 45% between 2019 and 2021, while the number of gun suicides rose 10% during that span.

The overall increase in U.S. gun deaths since the beginning of the pandemic includes an especially stark rise in such fatalities among children and teens under the age of 18. Gun deaths among children and teens rose 50% in just two years , from 1,732 in 2019 to 2,590 in 2021.

How has the rate of U.S. gun deaths changed over time?

While 2021 saw the highest total number of gun deaths in the U.S., this statistic does not take into account the nation’s growing population. On a per capita basis, there were 14.6 gun deaths per 100,000 people in 2021 – the highest rate since the early 1990s, but still well below the peak of 16.3 gun deaths per 100,000 people in 1974.

The gun murder rate in the U.S. remains below its peak level despite rising sharply during the pandemic. There were 6.7 gun murders per 100,000 people in 2021, below the 7.2 recorded in 1974.

The gun suicide rate, on the other hand, is now on par with its historical peak. There were 7.5 gun suicides per 100,000 people in 2021, statistically similar to the 7.7 measured in 1977. (One caveat when considering the 1970s figures: In the CDC’s database, gun murders and gun suicides between 1968 and 1978 are classified as those caused by firearms and explosives. In subsequent years, they are classified as deaths involving firearms only.)

Which states have the highest and lowest gun death rates in the U.S.?

The rate of gun fatalities varies widely from state to state. In 2021, the states with the highest total rates of gun-related deaths – counting murders, suicides and all other categories tracked by the CDC – included Mississippi (33.9 per 100,000 people), Louisiana (29.1), New Mexico (27.8), Alabama (26.4) and Wyoming (26.1). The states with the lowest total rates included Massachusetts (3.4), Hawaii (4.8), New Jersey (5.2), New York (5.4) and Rhode Island (5.6).

The results are somewhat different when looking at gun murder and gun suicide rates separately. The places with the highest gun murder rates in 2021 included the District of Columbia (22.3 per 100,000 people), Mississippi (21.2), Louisiana (18.4), Alabama (13.9) and New Mexico (11.7). Those with the lowest gun murder rates included Massachusetts (1.5), Idaho (1.5), Hawaii (1.6), Utah (2.1) and Iowa (2.2). Rate estimates are not available for Maine, New Hampshire, Vermont or Wyoming.

The states with the highest gun suicide rates in 2021 included Wyoming (22.8 per 100,000 people), Montana (21.1), Alaska (19.9), New Mexico (13.9) and Oklahoma (13.7). The states with the lowest gun suicide rates were Massachusetts (1.7), New Jersey (1.9), New York (2.0), Hawaii (2.8) and Connecticut (2.9). Rate estimates are not available for the District of Columbia.

How does the gun death rate in the U.S. compare with other countries?

The gun death rate in the U.S. is much higher than in most other nations, particularly developed nations. But it is still far below the rates in several Latin American countries, according to a 2018 study of 195 countries and territories by researchers at the Institute for Health Metrics and Evaluation at the University of Washington.

The U.S. gun death rate was 10.6 per 100,000 people in 2016, the most recent year in the study, which used a somewhat different methodology from the CDC. That was far higher than in countries such as Canada (2.1 per 100,000) and Australia (1.0), as well as European nations such as France (2.7), Germany (0.9) and Spain (0.6). But the rate in the U.S. was much lower than in El Salvador (39.2 per 100,000 people), Venezuela (38.7), Guatemala (32.3), Colombia (25.9) and Honduras (22.5), the study found. Overall, the U.S. ranked 20th in its gun fatality rate that year .

How many people are killed in mass shootings in the U.S. every year?

This is a difficult question to answer because there is no single, agreed-upon definition of the term “mass shooting.” Definitions can vary depending on factors including the number of victims and the circumstances of the shooting.

The FBI collects data on “active shooter incidents,” which it defines as “one or more individuals actively engaged in killing or attempting to kill people in a populated area.” Using the FBI’s definition, 103 people – excluding the shooters – died in such incidents in 2021 .

The Gun Violence Archive, an online database of gun violence incidents in the U.S., defines mass shootings as incidents in which four or more people are shot, even if no one was killed (again excluding the shooters). Using this definition, 706 people died in these incidents in 2021 .

Regardless of the definition being used, fatalities in mass shooting incidents in the U.S. account for a small fraction of all gun murders that occur nationwide each year.

How has the number of mass shootings in the U.S. changed over time?

The same definitional issue that makes it challenging to calculate mass shooting fatalities comes into play when trying to determine the frequency of U.S. mass shootings over time. The unpredictability of these incidents also complicates matters: As Rand Corp. noted in a research brief , “Chance variability in the annual number of mass shooting incidents makes it challenging to discern a clear trend, and trend estimates will be sensitive to outliers and to the time frame chosen for analysis.”

The FBI found an increase in active shooter incidents between 2000 and 2021. There were three such incidents in 2000. By 2021, that figure had increased to 61.

Which types of firearms are most commonly used in gun murders in the U.S.?

In 2020, the most recent year for which the FBI has published data, handguns were involved in 59% of the 13,620 U.S. gun murders and non-negligent manslaughters for which data is available. Rifles – the category that includes guns sometimes referred to as “assault weapons” – were involved in 3% of firearm murders. Shotguns were involved in 1%. The remainder of gun homicides and non-negligent manslaughters (36%) involved other kinds of firearms or those classified as “type not stated.”

It’s important to note that the FBI’s statistics do not capture the details on all gun murders in the U.S. each year. The FBI’s data is based on information voluntarily submitted by police departments around the country, and not all agencies participate or provide complete information each year.

Note: This is an update of a post originally published on Aug. 16, 2019.

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