CHALLENGES AND STRATEGIES FOR TRAINING AND RETAINING THE NEXT GENERATION OF PHYSICIAN SCIENTISTS IN PSYCHIATRY DURING RESIDENCY AND FELLOWSHIP

Background

While neuroscience funding and discoveries have grown exponentially in the past decades, the physician-scientist workforce to translate these research findings to the bedside has remained stagnant, with only under10% of MD/PhD graduates entering psychiatry residency training. This has contributed to an enormous practice gap (i.e., it can take many years before critical findings from research are implemented in psychiatric practice and improve patient outcomes). Residency training is a “critical period” of high attrition for physician scientists, in which protected research time and mentoring (or lack thereof) can “make or break” a research career. Providing support and individualized training and mentorship through structured programs in residency and fellowship is instrumental to train and retain psychiatristsscientists.

Methods

At the Icahn School of Medicine at Mount Sinai, over the past 17 years we have developed a pipeline of programs to train physicians (MDs and MD/PhDs) in psychiatry research during residency and fellowship. These include the NIMH-funded R25 program “Combined Psychiatry Residency and PhD Training at Mount Sinai” (2013-2024), the R25 program “Training the Next Generation of Psychiatrists-Scientists for Translational Research” (20222027), and the T32 program “Training the next generation of clinical neuroscientists” (20202025). Our programs aim to train the next generation of Clinician-Scientists equipped to perform translational research in psychiatry. To accelerate their research independence, our programs are designed to acquire research skills and pilot data during residency for a career development (K) award application to launch productive, independent careers in translational psychiatry research. One key goal is to increase the pool of psychiatrists-scientists who remain involved in research, as there is high attrition after completion of clinical residency training. Our programs provide ample protected research time, individually-tailored training and targeted coursework based on an Individualized Development Plan, outstanding mentoring and networking opportunities, pilot project funding, grant writing seminars and an internal K award review process.

Results

Our programs have been highly successful in achieving the goals. The majority of our trainees have obtained faculty appointments and have remained in academia; > 50% have been retained as faculty at Mount Sinai. The majority of our trainees have obtained external grant funding (9 K awards and multiple R level grants to date), and have published numerous highquality and high-impact publications. 100% of the graduates from our T32 program have joined the faculty at academic institutions (75%) or industry (25%) immediately after graduation. Trainees who have graduated to date each have an average of 49 publications (range 31-76), with an average of 11 publications each from work conducted during the T32 program.

Conclusions

Structured training programs are needed to train physician-scientists during psychiatry residency and fellowship. These programs can help minimize attrition by providing research protected time and coursework organized based on an Individual Development Plan. This training, coupled with outstanding mentoring, networking opportunities, grant writing seminars and an internal K award review process, will prepare promising clinician scientists and help accelerate the launch of productive, independent careers in translational psychiatry research.