Early Outcomes of a New NIH Program to Support Research in Residency

Abstract

The work of physician–investigators has historically led to key discoveries and developments in modern medicine, but recent decades have seen significant declines in the number of U.S. physician–investigators. One of the barriers to physicians participating in research is the lack of mentored research opportunities during clinical training, especially during residency training. In response to this identified barrier and to expand the physician–investigator workforce, the National Institutes of Health initiated the R38 program, known as Stimulating Access to Research in Residency, to support mentored research opportunities for residents. This article reports on the early outcomes of the recipients of the initial round of R38 awards, granted in 2018. Early positive outcomes include increases in the reported likelihood of resident–investigators pursuing physician–investigator careers, greater reported clarity in resident–investigators’ research directions, the commitment of additional institutional resources to support the R38-awarded programs, and the approval of resident–investigators as having met training requirements for certification by multiple medical boards.

Rethinking the Physician–Scientist Pathway

“…In our view, such programs should ideally expand to cross-departmental efforts, such that residents in scientifically underrepresented fields could access peers and mentors in departments with more established research programs. Residency programs should offer interested trainees structured mentorship, coursework, and research immersion (as outlined in the program described by Rapoza and colleagues) 2 to position them competitively for NIH and private “transition awards” that support mentored independence.…”

“…Indeed, every individual who applied to be part of the NIH program described by Rapoza and colleagues reported preexisting research experience. 2 The implication is that, for a realistic chance at a physician-scientist career, early exposure to research may be critical. Moreover, in our view, the ever-increasing pace of clinically relevant biomedical advances (see, for example, the rapid deployment of mRNA-based vaccines for SARS-CoV-2) means that even physicians who choose a purely clinical career would be well served by a solid foundation not just in the substance of basic science, but in the methods by which such knowledge is generated.…”

“…When undergraduates ask us for advice, we hope we can tell them that there are multiple paths to becoming a successful physician–scientist, and that the risks of pursuing this career are matched or eclipsed by its rewards. Programs like the one described by Rapoza and colleagues 2 are an important step in the right direction, but it will take much more sustained effort by funding agencies and training institutions to fully clear the path to a physician–scientist career.…”

“…In this issue, Rapoza and colleagues report initial results from a National Institutes of Health (NIH) pilot program that funds 1 to 2 years of dedicated research time during clinical residency. 2 Preliminary data reveal that the program helped clarify individuals’ research directions and strengthened their intentions to pursue physician–scientist careers. The outcomes are early but promising.…”

Making the Match or Breaking it? Values, Perceptions, and Obstacles of Trainees Applying into Physician-Scientist Training Programs

“…1 Institutions have therefore begun implementing specialized postgraduate tracks to promote retention of physician-scientist trainees, using research-integrated residency programs, or physician-scientist training programs (PSTPs), to interweave research mentoring and experiences alongside residency training. 2 Although no studies have yet empirically shown their worth as retention tools, PSTPs offer many aspects of training support that are likely to benefit the long-term success of trainees, including structured mentorship and protected research time.…”