Embedding research in practice: enablers, challenges and pathways to sustainability for embedded health researchers in Canada

BACKGROUND: Embedded fellowship programs provide PhD-trained researchers valuable opportunities to enhance their competencies in applied health settings. We explored the experiences of fellows in the Canadian Institutes of Health Research's Health System Impact Fellowship (HSIF) program. This study examined the enablers and challenges faced by HSIF doctoral and postdoctoral fellows and sustainable career pathways for PhD-trained researchers within health system organizations. METHODS: Focus groups conducted at two 2023 fellowship retreats were analysed using thematic analysis, mapping factors influencing sustainability onto the Program Sustainability Assessment Tool. RESULTS: Key enablers included collaboration with interprofessional teams, mentorship and alignment between research goals and health system priorities. Challenges included the short-term nature of fellowships, financial structures and limited career pathways post-fellowship. CONCLUSIONS: Insights from the HSIF program offer valuable guidance for other embedded research and learning health system initiatives, emphasizing the need for policy reforms to enhance funding structures and establish sustainable pathways for integrating PhD-trained researchers into health systems.