Introduction. Switzerland, like most Western countries, faces a paradox: an ageing, multimorbid population needs general internal medicine (GIM) physicians more than ever, yet fewer young doctors choose - and stay in - the specialty. Career decisions during residency are intertwined with well-being, mental and physical health, and work-life balance, and distress in training has been associated with depression, burnout, attrition and poorer patient care. Longitudinal data following GIM residents across these domains, and linking them to actual career trajectories, are lacking. The COMET study establishes a multicentre prospective cohort of GIM residents to fill this gap. Methods and analysis. COMET is a prospective, open, multicentre cohort conducted in the departments of (general) internal medicine of Fribourg Hospital (HFR, four sites), Bern University Hospital (Inselspital) and Lausanne University Hospital (CHUV). All GIM residents providing direct patient care are eligible (≈334 residents; expected enrolment ≥267, assuming 80% participation). Participants complete an annual online survey (REDCap; French or German) at baseline and for at least four years, covering sociodemographics; job characteristics; career intentions and 24 factors for or against a GIM career; well-being (Physician Well-Being Index, Professional Fulfillment Index, quality of life, work-life balance); mental health (CES-D, Perceived Stress Scale, Maslach Burnout Inventory, Questionnaire of Cognitive and Affective Empathy); and physical health (step counts, physical activity, fatigue, sleep, healthcare utilisation). Primary endpoints are the longitudinal course of well-being and distress (PWBI, PFI, CES-D) and residents' career trajectory. Analyses combine descriptive statistics, mixed-effects and regression models, and comparisons with the population-based CoLaus\|PsyCoLaus cohort.
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Change from baseline in psychological distress measured by the Physician Well-Being Index (PWBI)
Timeframe: Baseline and annually at years 1, 2, 3, 4 and 5
Change from baseline in professional fulfilment measured by the Professional Fulfillment Index (PFI) - professional fulfilment subscale
Timeframe: Baseline and annually at years 1, 2, 3, 4 and 5
Change from baseline in burnout measured by the Professional Fulfillment Index (PFI) - burnout composite
Timeframe: Baseline and annually at years 1, 2, 3, 4 and 5
Change from baseline in depressive symptoms measured by the Center for Epidemiologic Studies-Depression scale (CES-D)
Timeframe: Baseline and annually at years 1, 2, 3, 4 and 5
Percentage of participants remaining in general internal medicine training or practice
Timeframe: Annually at years 1, 2, 3, 4 and 5
Intention to leave direct patient care, measured on a single-item 5-point scale
Timeframe: Baseline and annually at years 1, 2, 3, 4 and 5