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Sure. Plenty do this. Totally depends on what type of research you want to do. You'll want to be at an IM residency that will help you build your research cred. Academic spots tend to pay less than private practice, but the salary (usually) isn't horrible, Research salaries are complicated, because the NIH scale is not great.
Hospitalists being replaced by mid levels like in EM would be my main concern
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I'm interested in quality improvement, AI in healthcare, and equitable healthcare delivery. So quite broad right now. But more interested in the technology and management aspects of healthcare than traditional biomedical research.
Absolutely from a teaching perspective, though keep in mind an academic general internist salary isn't going to necessarily wow you. Keep in mind that many academic IM doctors "specialize" in a non-formal manner, e.g. I know people who "specialize" in the primary care of transgender patients, of athletes, or of the homeless - it's not like they did fellowships for that. If you are interested in QI or healthcare delivery, you don't necessarily need a fellowship for research. If you want a significant portion of your academic effort to come from research, that is a bit more complex, but again, a fellowship won't necessarily make it more simple.
Pay in academic general IM will make you among some of the lowest paid physicians (besides maybe the academic peds, which usually fare even worse). Grants can help boost your pay in academics (without adding additional clinical time) but would depend on the type of grant and what type of research it is. Besides that it's usually administrative responsibilities or other non-clinical work such as consulting revenue or expert witness work to boost your salary, but these shouldn't be counted on as a new grad joining academic medicine. Also, make academic institutions have strict rules about what type of non-clinical work is allowed outside work, and they tend be non-negotiable about it if there's a policy already in place.
General IM is usually not as competitive for basic science research grants since these tend to be favor specialists who are the experts in the specific niche, but of course there's always exceptions to the rule. They usually pursue more clinically oriented research and can definitely get grants to fund those.
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What kinds of rules?
Depends on what's written in your employment contract, but academic institutions are notorious for having some of the most restrictive covenants about what clinical and non-clinical work isn't allowed if you're employed full time with their institution. For example, most will significant limit or restrict moonlighting at outside competing institutions. Some will restrict payments from work like outside consulting or expert witness work; in many cases it would have to be approved first, or in some cases it's not allowed at all.
