Background
The cooperative venture Council of Academic Family Medicine (CAFM) Educational Research Alliance, commonly known as CERA, has been one of the most—if not the most—successful research infrastructure programs in academic family medicine.1–3 In medicine, research is often equated with large, externally funded grants. Unfortunately, few grant programs support educational research, and many clinician educators, who do not view research as a primary focus of their job, would not pursue such grants. Fifteen years ago, CERA was founded with the mission to support clinician educators to perform rigorous educational scholarship. Moreover, it was specifically designed to help clinician educators in environments with few research resources and mentors do meaningful research.
CERA was built on an innovative idea to provide research and mentorship infrastructure on a national level. It would be relatively inexpensive and funded by the academic family medicine organizations, but in a more revolutionary fashion. The initiative would be built and sustained by voluntarism throughout the academic family medicine community. By design, the CERA steering committee rotates regularly, allowing new volunteer leaders to oversee each of the surveys (eg, program director survey; general membership survey) while the research infrastructure would remain stable. Further, all the mentors are volunteers. The reviewers of CERA proposals are volunteers. The payoff to this volunteer-led structure is it benefits both the discipline and individual scholars: it strengthens the evidence base of family medicine while helping clinician educators engage in research and advance professionally. Additionally, people’s level of involvement can fluctuate, allowing others to step in.
Over time, the CERA “staff” has grown from an original 6 to more than 150 volunteers. People who want to help have been welcomed as reviewers, mentors, survey leaders, and steering committee members. The idea of CERA may have grown out of the vision of a few people, but was always conceptualized on building from the contributions of the community and would be sustained by the community. After 15 years of existence, it is clear that this voluntarism-based model embracing the community has been exceptionally successful.
Successes
The scholarly production that has come out of the CERA infrastructure has often been cited because it is so impressive. As of May 1, 2026, nearly 250 peer-reviewed manuscripts have been published in the medical literature and over 250 presentations have been delivered internationally.4 Over 650 individual authors contributed to the publications.5
Beyond the sheer numbers, the most lasting success of CERA is likely the fact that it significantly lowers the bar to participation in research. A large proportion of CERA authors were early-career faculty at the time of participation, with some projects led by medical students and residents. Facilitating research by removing many of the more onerous barriers for less experienced individuals has been a catalyst to continued participation in the research realm for many. In this regard, “opening doors” may be CERA’s greatest legacy. This is most true for individuals working at institutions with less research infrastructure and few, or no, mentors.
Alongside its volume and reach, CERA has made measurable progress toward gender equity in education scholarship. In contrast to prior literature demonstrating lower proportions of women authorship in family medicine journals,6 a bibliometric analysis of CERA’s authors revealed women submitted two-thirds of the survey proposals and there was no significant difference in acceptance rates by gender.7 Moreover, the proportion of women authors exceeded the proportion of women members within family medicine organizations. CERA’s unique infrastructure, including volunteer-led mentors, may help reduce gender-based inequities in scholarly participation.
Challenges/Missed Opportunities
CERA has had many successes, but there are also challenges and areas that could benefit from increased focus. Some submitters have been frustrated by the CERA process itself; the fact that it is a competitive submission process means that not all survey ideas are accepted, the limitation to 10 closed-ended questions (in order to decrease mental load and survey fatigue on survey responders), and the timeline of the CERA process are common concerns.8 These limitations lead some researchers to use other methods of survey outreach, such as snowball sampling or registry surveys; however, these methods don’t lead to samples that are representative of the target population, and also don’t include CERA’s focus on the quality of the survey questions.
Because CERA conducts an open call for proposals among CAFM members and has a low bar to participation, it attracts early career faculty and newer researchers. This does result in proposals that are more descriptive or exploratory rather than hypothesis driven. To support authors regardless of research experience, all accepted teams are assigned a CERA mentor. CERA has also started offering mentorship for research proposals that were initially rejected and are planned for resubmission. In addition, all proposals receive feedback from 3 reviewers and the survey chair. The CERA Steering Committee continues to develop resources on how to create stronger research proposals through conference presentations, website links, and published articles focused on survey design.9
One of the most common requests of CERA is to directly survey residents and medical students. In 2022, CERA partnered with the American Academy of Family Physicians (AAFP) to pilot these surveys using an adaptation of the CERA process. Although a high number of proposals were received for both audiences, response rates were consistently low (~2.5-5.7% for residents and 1.9-2.9% for medical student surveys) despite trialing multiple strategies. As a result, the resident and student surveys have been paused while the CERA Steering Committee explores alternative methods to more effectively and representatively reach these highly sought populations. Although potential solutions such as a new sampling framework and partnership with specific family medicine organizations have been proposed, they would require additional resources and coordination beyond CERA’s current capacity.
Another missed opportunity is CERA’s Data Clearinghouse and its incredible potential for scholarship. CERA has generated a substantial body of data through more than 70 surveys over the past 15 years. Survey data is available to CAFM members to use for secondary and longitudinal analysis. The Data Clearinghouse is a great venue for resident scholarly activity, as the timeline to complete a project is more realistic than developing an original survey proposal. The past survey data is an important opportunity for future growth.
Future Goals
As the current and prior CERA Steering Committee Chairs reflect on the past 15 years of CERA, we are also looking for the next steps for this primarily volunteer-led program. While we remain committed to improving the quality of CERA questions, by expanding support and resources for authors, reviewers, mentors, and survey directors, we are also exploring how CERA might evolve beyond serving as a survey infrastructure. After all, CERA is the CAFM Educational Research Alliance, not simply a survey alliance. Identifying and prioritizing opportunities to further elevate CERA will therefore remain an ongoing and intentional discussion within the Steering Committee.
The Steering Committee is deliberately structured with regular member rotation to ensure fresh perspectives and to create opportunities for broader involvement across the community. We encourage interested faculty to watch for future calls for director positions, typically announced in the winter. Finally, CERA would not be possible without the extraordinary commitment of its volunteer reviewers, mentors, and contributing authors. We are also deeply grateful to the STFM staff and extend a special thank you to Ray Biggs for his many years of service as he enters retirement.
- © 2026 Annals of Family Medicine, Inc.
