Training the Physician-Scientist in Internal Medicine
The need for this complex level of training has led to development models that can be generally categorized as physician-scientist training programs (PSTP), research in residency (RiR) programs, or umbrella PSTPs. These sorts of programs are generally distinct from “categorical” programs. Whether a program is described as a PSTP or RiR is largely at the discretion of the program. Individual programs vary considerably in how they divide clinical and research efforts and which clinical specialty rotations or de-emphasized in order to make room for research activities. Internal Medicine programs may also be a part of umbrella PSTPs that are broad programs seeking to develop an institutional culture that promotes the growth and diversity of the physician scientist workforce at all levels of education and training ranging from undergraduate and medical school to trainees transitioning into faculty positions.
The PSTP model most commonly integrates clinical training in Internal Medicine and a subspecialty with research activities over a six- to seven-year period of training time. Internal Medicine PSTP trainees complete two or three years of residency, and most pursue clinical fellowship training in medicine sub-specialties lasting 12-24 months depending on the subspecialty. The clinical training phase is followed by three years of either basic or clinical research training (80% effort) to qualify for board eligibility in Internal Medicine through the ABIM Research Pathway. Training is often enhanced by educational programming specific to the development of the physician-scientist. Trainees in such programs often designate clinical fellowships of interest prior to enrollment, with an understanding that they are likely to proceed in this specialty at the conclusion of the residency phase.
The RiR model allows categorical residents in traditional three-year training programs to simultaneously engage in activities from a coexisting PSTP or a unique research curriculum dedicated to residents training in internal medicine.
Internal Medicine programs may also be a part of umbrella PSTPs that are broad programs seeking to develop an institutional culture that promotes the growth and diversity of the physician scientist workforce at all levels of education and training ranging from undergraduate and medical school to trainees transitioning into faculty positions.
Additionally, many institutions offer Stimulating Access to Research in Residency (StARR) to address the growing need for the physician-scientist workforce. These programs offer Resident-Investigators dedicated time during residency for a mentored research experience while fostering their ability to transition to individual career development research awards. Support is provided for up to two years of research conducted by Resident-Investigators in structured programs with defined program milestones.
The Physician-Scientist Training Program in Internal Medicine utilizes the American Board of Internal Medicine (ABIM) Research Pathway to facilitate combined clinical and research training of individuals who are committed to careers in academic medicine.
