Training the Physician-Scientist in Emergency Medicine

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Emergency medicine (EM) residency training prepares graduates to practice acute care medicine in high-volume emergency departments. Graduates may seek additional subspecialty clinical training in critical care medicine, emergency medical services, hospice and palliative medicine, medical toxicology, neurocritical care, pain medicine, pediatric emergency medicine, or undersea and hyperbaric medicine. From research into the social determinants of health and health services research to basic or mechanistic science, EM has broad research focus. There are multiple pathways available to become an independent researcher:

Physician Scientist Training Pathways (PSTP) – PSTPs are mentored research programs that are integrated with clinical residency training.  PSTPs are generally best suited to trainees that have substantial prior research experience, such as graduation from an MSTP program, prior Ph.D. training, or other significant prior dedicated research training. The typical model prolongs EM residency, but some models function as a built-in fellowship after clinical residency.

The purpose of this pathway is to integrate substantial research experience with clinical practice, thereby promoting clinically relevant hypothesis-driven research.  The overall goal at completion of these programs is to create independent physician-scientists who will be 1) competitive for NIH or equivalent funding, 2) dedicated to a research career, 3) adept in clinical practice, and 4) current or future leaders in academic EM.

EM PSTPs are characterized by the following:

  1. Integrated research experience during clinical years, such as research rotations, grand rounds, seminars, and grant writing courses.
  2. Continued clinical experience during research years, if applicable.
  3. Dedicated mentorship from independently funded physician-scientists to guide trainees in independent project design throughout the duration of the entire PSTP experience.
  4. Funded by institutional training grants such as T32 grants (in emergency medicine or related disciplines).
  5. Material and financial support for research during residency.

Research Fellowships – Another common pathway for research training in EM is research fellowships. These provide 1-3 years of additional research training following EM residency. Research fellowships are diverse, many offer the opportunity to obtain a graduate degree (i.e., MS, MA, MPH, or MHS) and all provide a focused, mentored research experience that encompasses various aspects of experimental design, epidemiology, clinical trials, or other focused research areas. Those entering a research fellowship may be new to EM research, or applicants may have significant prior research experience. Similar to PSTPs, the goal of these fellowships is to produce independent EM researchers who will change the practice of EM, be competitive for career-level funding, mentor students and residents, and continue to work clinically.  

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