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<p>The Korolev Crater on Mars. This picture from the ESA Mars Express mission shows there was a 2018 White Christmas somewhere in the solar system. &#8212;&#8212;&#8212;&#8212;&#8212;&#8212; I’m committed to a career in research. To succeed I need (above all!) two things: time and mentorship. That’s why in 2011 I enrolled in the IU MSTP, which shortened the time to obtain both [&hellip;]</p>

The ABIM Research Pathway: Fast-Tracking Residency to Become a Physician Scientist

Korolev Crater on Mars

https://www.esa.int/spaceinimages/Images/2018/12/Perspective_view_of_Korolev_crater

The Korolev Crater on Mars. This picture from the ESA Mars Express mission shows there was a 2018 White Christmas somewhere in the solar system.

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I’m committed to a career in research. To succeed I need (above all!) two things: time and mentorship. That’s why in 2011 I enrolled in the IU MSTP, which shortened the time to obtain both an MD and PhD and provided excellent oversight to smooth the transitions between different phases of my training.   

Now, as a MS4, my career goals are unchanged. But how should I pursue them?  Residency does not provide time to do basic research. And if I leave the lab to become one of the over 10,000+ American PGY1s in Internal Medicine, what are the odds that I’ll return to research after 3 years of residency and 1+ years of clinical fellowship? [Answer: Not very good.] If only there was an MSTP-like program to keep me focused and help me fast-track towards a research career… 

Fortunately, there is: the Research Track Pathway, Unlike the MSTP, the Research Track is not an NIH grant. Rather, it is a set of training guidelines, set by the American Board of Internal Medicine (ABIM), the same body that sets standards for residency training and administers board certification. The highlights of the program are: 

  • Compress residency training from 3 to 2 years. 
  • 36 months of protected research (max clinical time = 20% or 1 day a week) 
  • Trainees are eligible for all IM fellowships. 

Given my commitment to research, I find these features are very appealing. Initially, I worried that a shortened residency would undermine my clinical training. Indeed, the average IM board score of research track residents is marginally lower compared with those in the traditional pathway. However, research track trainees have a higher board pass rate and are deemed to have greater “medical knowledge” by their program directors. Further, research track trainees are placed in leadership roles on inpatient teams earlier to mitigate their shorter training. Most importantly, during my interviews I have not met a single research track graduate who felt unprepared to start fellowship in PGY3 and who desired a third year of residency. Some longed for the close-knit community of residency, but noted that leaving this camaraderie early was the price paid for hastening one’s return to the lab. 

The research track programs have various names. The most common is the PSTP (Physician Scientist Training Program), but you’ll also find variations on Medical Research Track (MRT, MERIT), Molecular Medicine, and others. Frequently, there is a separate NRMP code in ERAS, but not always. I recommend you contact each Residency program directly to ask if they have a ‘ABIM Research Pathway’ and how you apply to it. 

95% of the applicants I met during my interviews were dual MD/PhD trainees. A small subset were MD students who had significant (2+ years) research experience. There are other training programs available to those with less research experience, who nevertheless are committed to becoming physician scientists.  For instance, 9 programs have been awarded a new NIH grant — R38, Stimulating Access to Research in Residency (StARR) — which provides protected research time to residents. Notably, whereas the ABIM Research Track is only for Internal Medicine trainees, various specialties have been awarded the R38 grant.  

Internal Medicine, however, leads the way in providing dedicated training for prospective physician-scientists. A cursory search suggests that the American Board of Pediatrics is the only other specialty accreditation that provides a shortened residency track for research-minded trainees. Nevertheless, if you are a budding researcher applying to Neurology, Psychiatry, Surgery, etc. then know that certain institutions highly value physician-scientists and have residency programs and resources available to prepare you for a career that spans between the clinic and research.

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
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Stefan Tarnawsky

MS4 MD/PhD Student. Going into Internal Medicine; interested in Heme/Onc. Bread baker, bonsai artist, aspiring astronomer.