Fostering Research Mentorship and Training During Psychiatry Residency

Massachusetts General Hospital, Boston MA

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Abstract

ABSTRACT: Despite tremendous advances in all areas of neuroscience, computational biology, and approaches to health disparities, and the advent of digital phenotyping and precision medicine, progress has been very limited in the translation and implementation of these areas to clinical practice. The participation of physician-scientists in the biomedical research enterprise is critical, as they bridge the gap between basic science and clinical practice to address the healthcare needs of the public through translation and implementation of research findings. In recent years, however, the number of physicians engaged in research careers has declined by more than half, as have the number of research psychiatrists and research fellowships for psychiatrists. A recent study investigating success rates of MDs, compared to PhDs, in obtaining federal funding showed physicians have lower rates of success with first-time R01 applications and they are less likely to obtain subsequent R01 grant funding. Ley and Rosenberg noted that a secure future for the physician-scientist workforce must begin early in professional development, as they represent the pool from which the next generation of physician-scientists will be drawn. One of their encouraging findings is that a progressively larger proportion of matriculating and graduating medical students indicate serious interest in research careers. Furthermore, Ward et al note that research training programs during residency can be critical in supporting research careers of women and URM physician-scientists. Therefore, continued support for programs that expose health professional students and trainees to research is critically needed. Several barriers make it difficult for residents to have meaningful research training during residency. With the exception of well-established MD/PhD programs and recently established research-residency tracks, residencies typically offer fragmented research experiences across years of training due to the array of clinical experiences required of the typical psychiatric resident. In addition, faculty have limited time to provide mentorship and funding for early career researchers. Studies have shown that the presence of at least one mentor is associated with the development of successful investigators and is instrumental in acquiring skills in grant writing, project implementation, and manuscript preparation. Finally, many students with high education debt burdens favor higher paying clinical salaries, instead of choosing to extend the length of their training. The IOM convened a panel to study research training among psychiatrists in response to the shortage of physician-scientists. The panel noted that residency-based research training might help solidify research career interests for greater numbers of psychiatrists. They recommended that “departments of psychiatry should organize optional research experiences and mandatory research didactics in residency as early steps in research career development”. In response to the critical shortage of physician-scientists in Psychiatry, the MGH/McLean Psychiatry Residency developed the Physician-Scientist Training Program (PSTP) in 2010, with continual NIMH funding from 2011 to 2022. The PSTP aims to mitigate the institutional, financial, and regulatory barriers to research training during psychiatry residency for residents with and without formal graduate-level training. We aim to improve and expand our program to continue to address the shortage of Physician-Scientists in Psychiatry in the US.