Research Pathway Policies and Requirements

The ABIM Research Pathway is an integrated program that combines training in research with training in clinical internal medicine and its subspecialties. This pathway is recommended only for physicians who intend to seriously pursue a career in basic science or clinical research. Physicians who are interested in teaching or practicing internal medicine should pursue the standard three years of internal medicine training.

Prospective planning for the research pathway by trainees and program directors is necessary. The training experience of all physicians in this pathway will be documented through ABIM's tracking program. Because this pathway integrates research and training in internal medicine, with or without subspecialty training, entry implies a commitment to its completion.

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Planning

Trainees interested in a research career should work with their residency program director and research mentor to design an appropriate training plan that will provide an adequate clinical experience and meet ABIM's requirements. Ideally, planning for this pathway should occur during PGY-1, and ABIM should be notified of a trainee's intention to pursue such training by spring of PGY-2.

Responsibility for Training

The internal medicine program director must be in support of a resident's request to pursue the research pathway.

ABIM requires that candidates for certification in internal medicine are competent in: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice for both the PGY-1 and PGY-2 years of training. Furthermore, the internal medicine program director must coordinate plans for the resident's training with a research mentor and, if appropriate, the subspecialty program director. It must be clear which program director is responsible for the resident's training after PGY-2. If the research experience is to be in a subspecialty, the subspecialty program director should become responsible for training through the research pathway beginning in PGY-3. If the research experience is to be in internal medicine, the internal medicine program director should continue to be responsible for training through the research pathway.

Training can occur at several institutions as long as the responsible program directors provide coherent, integrated, coordinated training.

Training

Internal Medicine Training

All trainees in the research pathway must satisfactorily complete 24 months of accredited categorical internal medicine training. A minimum of 20 months must involve direct patient care responsibility.

Clinical Subspecialty Training

The minimum full-time clinical training required for each subspecialty is also required for Certification through the research pathway. Specifically:

• 12 months in adolescent medicine; allergy and immunology; critical care medicine; endocrinology, diabetes, and metabolism; geriatric medicine; hematology; hospice and palliative medicine; infectious disease; nephrology; medical oncology; pulmonary disease; rheumatology; sleep medicine or sports medicine
• 18 months in gastroenterology, hematology/oncology, pulmonary/critical care medicine, or rheumatology/allergy and immunology
• 24 months in cardiology

Research Training

At least three years of research training at 80 percent commitment is required. ABIM defines research as scholarly activities intended to develop new scientific knowledge.

The research experience of trainees should be mentored and reviewed; training should include completion of work leading to a graduate degree (if not already acquired) or its equivalent. The last year of the research pathway may be undertaken in a full-time faculty position if the level of commitment to mentored research is maintained at 80 percent.

Clinical Experience During Research Year

During internal medicine research training, 20 percent of each year must be spent in clinical experiences, including continuity clinic experiences consistent with ACGME requirements for continuity clinic.

During subspecialty research training, at least one-half day per week must be spent in an ambulatory clinic, consistent with ACGME requirements for continuity clinic in the discipline.

Time spent in a continuity outpatient clinic during non-clinical training is in addition to the requirement for full-time clinical training.

Ratings of satisfactory clinical performance must be maintained annually for each trainee in the ABIM Research Pathway.

Examinations

Certification Examination in Internal Medicine

Trainees in the internal medicine research pathway may be admitted to the certification examination in internal medicine in the summer of PGY- 5 after successful completion of four years of training, which must include 24 months of accredited training in internal medicine and 24 months of research training. Documentation that the resident will be in full-time residency training or in a position with 80 percent involvement in mentored research during PGY-5 will be required at the time of application.

Trainees in the subspecialty research pathway must be certified in internal medicine at the time of application to be eligible to apply for certification in a subspecialty. Subspecialty research trainees may be admitted to the certification examination in internal medicine in the summer of PGY-4, as long as two required years of accredited training in internal medicine and one year of accredited subspecialty training have been completed satisfactorily.

The ABIM Board Certification examination and ABIM certificate are the same for all ABIM candidates whether they pursue the research pathway or standard internal medicine training.

Certification Examination in a Subspecialty

A subspecialty examination may be taken in the fall of PGY-6 (adolescent medicine; allergy and immunology; critical care medicine; endocrinology, diabetes, and metabolism; geriatric medicine; hematology; hospice and palliative medicine; infectious disease; nephrology; medical oncology; pulmonary disease; rheumatology; sleep medicine or sports medicine) or in the fall of PGY-7 (cardiology, gastroenterology, hematology/oncology, pulmonary/critical care, or rheumatology/allergy and immunology). At the time of application, documentation will be required that the resident will be in full-time fellowship training or in a position with 80 percent involvement in mentored research for the duration of the year.

To reiterate, the ABIM subspecialty examinations and ABIM certificates are the same for all ABIM candidates whether they pursue the research pathway or standard subspecialty training.

During internal medicine research training, 20 percent of each year must be spent in clinical experiences, including continuity clinic experiences consistent with ACGME requirements for continuity clinic.

During subspecialty research training, continuity clinic must be continued structured in a way consistent with ACGME requirements for continuity clinic in the discipline. Ratings of satisfactory clinical performance must be maintained annually for each trainee in the ABIM Research Pathway.

Impact of Changing from the Research Pathway

Internal Medicine

Trainees who change their career path from internal medicine researcher to internal medicine clinician will not be eligible for the ABIM Internal Medicine Certification Examination with less than three years of standard clinical training.

Subspecialties

Trainees who change their career path from subspecialty researcher to subspecialty clinician will not be eligible for the subspecialty certification examination with a shorter duration of training than that required for the standard clinical pathway. Such trainees are strongly encouraged to complete a third year of internal medicine training, and their total clinical training must be equivalent to the total required for standard training in internal medicine and the subspecialties. For example, a cardiology trainee who switches from the research pathway to the clinical pathway will be required to have at least six years of training, five of which are clinical training, three in internal medicine and two in cardiology.