Bibliographical noteFunding Information:
Psychiatric residency training in the USA typically consists of four postgraduate years (PGY1-4) of clinical training. Core training requirements are mandated by the Accreditation Council for Graduate Medical Education (ACGME), but residency programs retain significant autonomy in allocating time for additional training experiences and educational opportunities. Historically, psychiatry training programs have long acknowledged the importance of research as a component of a residency curriculum , and most psychiatry residencies offer practical research experience such as a small project which can be completed during an elective rotation. However, some programs offer formal and systematic training in research. This allows psychiatry residents to design and complete their own projects, often over several years, and usually in conjunction with specialist training in laboratory skills and/or clinical research assessments, data analysis, scientific writing, and grant applications. Such formal training is referred to in this article as a “research track.” Residents who complete a research track are frequently encouraged to pursue academic careers in psychiatry, which may include further training in a research fellowship, or pursuing an early career research grant such as a National Institutes of Health (NIH) Career Development Award (“K award”). Such competitive awards are highly desirable because they enable a clinician-scientist to continue research after residency by providing project funding and salary contributions, the latter of which releases clinicians from clinical duties linked to productivity reimbursement.
Psychiatric residents seeking research careers have other options besides research tracks. After residency, trainees could apply for research fellowships, either institutional or federal, and these typically give 1–3 years of dedicated research time. The advantages of research fellowships include the following: fellowships are funded and have successful track records; the fellow usually has no clinical responsibilities unrelated to the research project; the supervisors are experienced; and the fellow usually belongs to a team of researchers who can share ideas, work together, and co-author publications. However, research fellowships pay far less than full-time clinical positions, are competitive, and may be adversely affected by institutional or federal budget adjustments. A psychiatry resident could apply instead for a clinical position at an academic institution and try to “carve out” a research career by using their own time to write and apply for grants, subsequently using grant funding to exchange clinical time for research time. This process can take years and involves applying for multiple small grants, career development awards, and ultimately larger private and government grants. The advantages of this path include the following: academic institutions have IRBs readily available; a pool of patients is available for clinical research or samples; and the early career physician-scientist can continue expanding their clinical skills. This is an uncertain career path with no guarantee of successfully obtaining grants that demands a huge amount of time and effort on the part of the researcher to try to continue to meet clinical and financial targets for their institution. Given the demands, this path may provide less time for the psychiatrist to spend with family or pursue other interests.
Residency programs need to meet service requirements for safe patient care, and they may struggle to consistently give allocated time to research track trainees, especially if the number of residents in a class decreases. Programs may find it burdensome to financially support research trainees, whether through grants or private funding. Programs must be able to offer adequate facilities and experienced supervisors who can guide trainees successfully. These requirements may tax resources within a program.
Funding A number of funding questions arise in the immediate planning stages of a research project. The trainee and mentor should budget for their needs, which may include supplies, statistical or laboratory support, and even journal publication fees. Does the mentor already have adequate grant funding to finance the trainee’s proposed project? If not, does the residency have a successful record of helping trainees obtain funding? As mentioned earlier, many residencies and/or their institutions are recipients of federal or private funding, but residency programs must decide whether they have the budget to adequately finance a research track.
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