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Developing an Improved Residency Training Continuum for Future Academic Physicians

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.

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Developing an Improved Residency Training Continuum for Future Academic Physicians

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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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