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Advancing Residency Training for Future Academic Physicians: A Comprehensive Approach

This presentation by Dr. Leila Mei Pang discusses innovative residency training models for academic physicians at Columbia University, focusing on pathways that integrate research and clinical training. Key models include the ABIM Research Pathway, ABP Integrated Research Pathway, and ABA Clinical Scientist Track, each designed to allow MD/PhD graduates to continue research during residency. The presentation highlights outcomes, such as NIH funding disparities among specialties, and outlines strategies for enhancing resident engagement in research and academic careers.

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Advancing Residency Training for Future Academic Physicians: A Comprehensive Approach

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  1. Developing an Improved Residency Training Continuum for Future Academic Physicians Presented by Leila Mei Pang, M.D. Associate Professor of Anesthesiology & Pediatrics Associate Vice-Chairman, Resident Education College of Physicians & Surgeons of Columbia University New York, New York

  2. Models Already in Existence • ABIM Research Pathway • ABP Integrated Research Pathway • ABA Clinical Scientist Track

  3. ABIM Research Pathway~ 1% of residents

  4. ABP Integrated Research Pathway • Designed to accommodate MD/PhD graduates to continue ongoing research during their pediatric residency • During the 3 years of general pediatric training, a max. of 11 months may be in research with no more than 1 month in PL-1 and at least 5 months in PL-3 year • Must apply before entering or during the first 9 months of the PL-1 year • 12 months of additional clinical experience must be completed to be eligible for general pediatric boards

  5. ABA Clinical Scientist Track • Option A: 6 months of clinical or laboratory research during 48 months of training (12 mos CB + 30 mos Clinical Anesthesia) • Option B: At least 18 months of clinical or laboratory research during 60 months of training (12 mos CB + 30 mos Clinical Anesthesia)

  6. Informal Model - Surgical Research Track @ Columbia • Resident candidates are informed that if they want to do a year of research, it is allowed; department’s commitment - time and money • Residents are exposed to research in the department during an August Research Symposium • During PGY 1 year competitive applications are submitted for start-up funds from the Department, naming a specific faculty as mentor • Research year usually occurs between their PGY 2 and PGY 3 year with night call duties only so GME slot is preserved • Progress report is expected; may extend by l year

  7. What Happens to these Residents? • ABIM - Most remain in academic practices with about 30% continuing with research • ABP - <1% elect this track; usually remain in academic practices • ABA • Option A: Usually go to private practice or a staff position at a teaching hospital • Option B: Usually are staff in academic departments continuing research • Surgery • Most end up in academic departments but few continue research

  8. Why are the outcomes different? • ABIM expects the resident to obtain an advanced degree, if not already acquired, so commitment to research is emphasized. AS A RESULT: • Departments of Medicine over the past several years get the lion’s share of NIH funding awarded to medical school departments

  9. Outcomes - continued • Pediatrician Scientists already have MD/PhD degrees and are encouraged to continue research during their residency As a result • Pediatric departments received the 4th highest number of NIH grants but are 3rd highest in $ amount in 2001

  10. Awards to Medical School DepartmentsFiscal Year 2001

  11. Outcomes • Anesthesiologists make up 6% of the physician workforce but get only 0.7% of the NIH funding • Academic anesthesiologists fare better in terms of percentage funding in the Surgical/Anesthesia/Trauma study section

  12. Outcomes Academic anesthesiologists spend only 7% of their time in research/scholarly activity compared to 12% in other clinical departments

  13. What Is My Department Doing to Affect the Outcome? Apgar Research Scholar Fellowships are offered on a competitive bases to our CA-1 residents who commit to up to 24 months after training to research. Goal: Future Faculty • Clinical Scholars are involved in clinical training in a subspecialty area plus clinical research • Basic Science Scholars are involved in basic science research but spend 20% of their time clinically

  14. Univ. of Wisconsin Medical SchoolGuidelines for Protected time for Tenure-Track Assistant Professors • Hire on tenure track only those who have demonstrated commitment to research • Plan for adequate research start-up funds and space before arrival • Chairperson’s responsibility to provide for sufficient protected time for research • Protect from committee assignments and other diversions • Provide mentoring and clear annual feedback from senior faculty either locally or from other schools • Encourage attendance at University sponsored professional development seminars and meetings

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