Jefferson Journal of Psychiatry

Volume 11 Issue 1 Article 6

January 1993

Entering Academic Psychiatry: A Resident's Perspective

Julio Licinio, M.D.
Veterans Affairs Medical Center, West Haven, Connecticut

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Recommended Citation
Licinio, M.D., Julio (1993) "Entering Academic Psychiatry: A Resident's Perspective," Jefferson Journal of
Psychiatry: Vol. 11 : Iss. 1 , Article 6.
DOI: https://doi.org/10.29046/JJP.011.1.003
Available at: https://jdc.jefferson.edu/jeffjpsychiatry/vol11/iss1/6

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 Entering Academic Psychiatry:
A Resident's Perspective
Julio Licinio, M.D.

Abstract

University-based psychiatry residencyprograms encourage thepursuit qfacademic careers, both

on admission, byfiworing applicants with evidence qf a commitment to investigation, and afler
residency training, by selecting asfa culty residents who have demonstrated academic and research
productivity. While attempting to achieve multiple goals, some residents may be discouraged to
pursue an academic career as a result of marked conflict between the clinical and academic
components oftraining. The substantial diffirences in priorities among psychiatry residents ought to
be explored early in residency training by devoting seminars to career planning and by facili tating
the pursuit qf academic activities under a preceptorship program. Furthermore, the option fo r
research track residencyprograms should be available to those with a strong commitment to academic
psychiatry.

In th e past 15 ye a rs m edi cal ed uc a to rs and research ers havc bee n incrcasin gly
co nce r ne d abo u t th e futur e of acad emic medi cin e ( 1-9) . Su ch conce rn st ems from
variou s threats to th e acad emic m edi cal es t a blishmen t, including fina ncial con-
st ra ints (I 0), litigation issu es (II) , insuffi cient fund s to suppo r t research ( 12, 13), a nd
a declin e of int erest by m edi cal students and resid ents to pu rsu e a clini cal resea rch
academic ca ree r (I,3,9,14,15) . The trend tow ards fewer ph ysician-investigato rs has
been identified in th e U .S. a nd worldwide (16).
Wyngaard en (I) addressed th e declining int erest in biom edi cal research on th c
part of young physicians. H e point ed out that ph ysician-investigat or s a re an e nda n-
ge re d species, basing this s ta te me n t on th e substantial declin e of th e pr op ort ion of
fed eral postdoctoral fellowships awarded to M.Do's (physician-scienti st s) co m pa re d
with those grant ed to Ph.Dv's (non-physicians biom edi cal scie nt ists ), fro m 46% in
1977 to 20% in 1986. By 1977, of 2800 postdoctoral fellowships in th e clini cal scie nces,
only 2304 were filled, and 500 positions were not us ed. The pr oportion of fed e ra l
res earch grants awarded to principal investigators wh o are physician-scientist s also
declined , from 43 % in 1966 to 32% in 1977. A more recent article in th e American
Journal of Medicine co m pa res academic physi cians to din osaurs, st r uggling to survive
(17) . In the 80's fed eral res earch support to M .D o's co n t inue d to decline; by 1987 68%
of all NIH grants were award ed to inv estigators with a Ph .D.
Strong recomm endations to correc t th e decline in number of t hose e n te ring
clinical inv estigation have been mad e, including eco no m ic incentives a nd reex a m ina-

20
ENTE RING ACADEMIC PSYCHIATRY 21

tion of Board ce r tifica tion requirem ents so th at a ppro p ria te cr edit be given to
research training in resid en cy training programs. A d ecad e a nd a ha lf aft er Wyn-
gaarde n's paper, th e sit uat ion has onl y worsened. H eal y, th e cu r rent NIH direct or ,
has published a rep ort o n th e manpower crisis in biom edi cal research (9). In 1987 th e
propo r t ion of ph ysicians who we re principal investigators on federal research g ra n ts
furt he r declin ed to 26%. Bo th Wyn gaarden ( I) a nd H eal y (9) point out th at
clini cian-investigators are declining by cho ice: for th e past 20 years M.Do's a nd
Ph .D o's principal inv esti gators on a pplica tio ns for fed eral research fu nds have had
vir t ua lly identical award rat es, th erefore th e ph ysician-scientist s increasingly smalle r
success in obtaining gra nts is du e to th e pro g ressive d eclin e in th e tot al number of
ph ysicians a pplying for gran ts, as a pe rce nt a ge of th e tot al. Their conclusion is th at
ph ysicians are "d ecid ing not to e nte r resea rch.
In spite of th e d eclining int erest in biom edi cal resea rch on th e part of m edi cal
st ude n ts and resid ents, th e need for qu al ified cli nicia n-inves t iga tors has be en quit e
sig nifica nt in th e last two d ecad es. Wyn gaard en state d th at in th e 70's t he numbers of
m edi cal- school g ra d ua tes and full-tim e fac ulty in U .S. m edi cal schoo ls have doubled ,
but between 1966 a nd 1975 th e num be r of America n ph ysicia ns report in g research as
t hei r prim a ry ac t ivity declin ed from 15,441 to 7,944 ( I) . According to th e Nation al
Research Cou ncil, th ere has been a d em and for a n "an nual incr em ent of approxi-
m at ely 1,800 person s to m eet th e requirem ents crea te d by expa nsion and attrition of
clinical fa cult ies in m edi cal scho ols over th e next few year" ( 18). In view of thi s fact ,
th ere has been in recent years cons ide ra ble di scu ssion in th e m edi ca l ed uca t ion
lit erature on th e facilit ation of th e form ation of clinicia n-inves t igators in medi cin e in
ge ne ra l ( 1-3,6,8), a nd in psychi a t ry in pa rticu la r ( 19-22). On th e o t he r hand , a
com pre hensive review of th e lite ratu re in t he last te n years did not show a ny wo rk
atte mpti ng to a nalyze th e transit ion fro m t ra ining to academia from th e point of
view of th e t rain ee. This pape r exa m ines issu es e nco u n te red in my own training in a
resea rc h-t rac k resid en cy program in psychi atry. My ex pe rie nce in t he tra nsition from
train ee to ind epend ent investigator will be exa m ine d, a nd sugges tions will be mad e
to facilitat e th e t ra ining of th ose int erested in pu rsuing a n acad em ic ca ree r in
psychi at ry.
Th e need for qu alifi ed clinician-inves t iga tors in med icin e in gen eral (6,8, I0) a nd
in psychi at ry in particul ar (20-22) is not new ( 1,2, 19). T he need for clini cian-
investigators is es pecia lly sig ni fica n t in psychi atry. In th e pas t t hirty years th ere has
been a trend in psychiatric research for g rowing sophist ication in resea rch design , as
docum ent ed by th e sig nifica n t inc re ases in percentages of cohort, clini ca l trials, and
cross-sec tional st ud ies publish ed in th e Archives of General Psychiatry and the American
J ournal qf Psychiatry. The quality of resea rc h designs in psychiatry for 1983 al so
co m pa red favo rabl y with research d esign s fou nd in a res pe ct ed m edi cin e journal (23) .
Th erefore, wh en publish ed dat a is a na lyzed th e re a ppea rs to be an ove rall improve-
m ent in th e qu ality of psychia tri c research in t he past t hir ty years. However, wh en th e
research productivity of academic departm ent s of psychiatry is exam ine d, it be com es
clear th at th e trend for incr easin gly sophisticat ed research in psyc hia try is du e to a
22 J EFFERSON JO URNAL O F PSYCHIAT RY

co re gro up of acade m ic d ep artm en ts. Abo u t 77% of gra n ts award ed by th e Na tio nal
In stitut es of Mental H ealth (NIM H) a re won by j ust 10% of th e dep art me nt s of
psychi at ry, a nd nearly hal f of a ll psychi a t ry d ep art m en ts in th e USA a re without a
single research gran t awa rde d by NI MH (20). Furtherm ore, wh en co m pa re d to a pool
of ge ne ral m edi cin e physicians (inte rnal m ed icine, fami ly practi ce, obs te trics-
gynecology, and derm atology, n = 14,090), only 12% of psych ia t ry faculty (n = 2429)
had research t raining, ve rs us 34% of th ose in gen eral medi cin e. In addition , in
acade m ic ge ne ral m edi cin e 13% of all ph ysicians are pri ncipal investi gat or s on
fede ral researc h gran ts co m pare d wit h only 5% in psych iat ry (20) .
T o stim ula te th e formation of clinicia n-inves tiga tors t he Am erican Associa tion
of M edi cal Co llege s has recomm ended th at " me dica l schools shou ld e ncourage
pr ogra m di rect ors to pr ovid e flexibility in resid en cy sched ules for trainees d esirin g
research expe rie nce" (14) . A survey of resid en cy pro gr am s indica tes t hat research
track resid ency progr am s in psychi a t ry are ava ila ble a t several academic dep a rt -
m ent s of psychiatry, suc h as The Ne w York Hospit al-C ornell M edi cal C ent e r, Ya le
University, University of Mi chi gan , St anford U nivers it y, U niversit y of T exas-
Galv est on , and ot he rs.
I co m ple te d re side ncy training in th e research -t rack resid en cy program at T he
New York H ospit al- Cornell M edi cal Ce n te r, W est ch es te r Division. In th at progra m
th e core clinical training in psychi a try was supplemen ted with ex t ra elec tive ti m e to
d evelop a nd co nd uc t researc h. At t he begin ning of t he program I chose a resea rch
p recep tor wh o worked with m e throu ghout th e progra m . E lect ive co urses in biost at is-
tics a nd researc h d esign we re ava ila ble. I was t he first resid e n t to particip at e in t ha t
program, a nd my experience was very positi ve; the res earch elec t ive tim e a llowed me
to wo rk wit h my pr ecept or on th e design, im plem e n tation , a pprova l, a nd fund ing
a pp lica tion for my research. The ex pe rience was far mo re producti ve th an a nything
t hat wo uld have been possibl e in a tradit ion al cur riculum . On th e ot he r hand , my ro le
in t he clinica l rotation s was so m etimes un clea r. M a ny faculty supervi sors were aware
t hat t he re was a research-track pro gram in our hospi ta l, however did not kn ow I was
pa rt of it. In spite of this th e arrang e m e n t wo rked ve ry smoo t hly as I fully
particip at ed in all th e co re clinica l ro ta tions . In my fou rt h year of training, whe n th e
strong es t didactic cou rses a re offere d, I was cond ucting my studies a nd analyzing my
res ults . Therefore I felt a con flict between a tt e ndi ng core and electi ve did actic
cou rses, a nd doing th e required reading, and co nd uc ti ng my own resea rch st udies. At
tim es I qu esti on ed: do I read a pap er required for a n elective seminar or do I cond uct
a n ex perime nt? Using my own judgm ent to optimi ze both ex pe rie nces, I did not
a tte nd as m an y se m inars or read as m any pap ers as I wis h I could have, a nd I did not
cond uct as m any experim e n ts as possibl e; howeve r , overall I did particip at e in a
number of didacti c ac tivities a nd was also a ble to gain subs ta n tial ex pe rie nce
conducting clin ica l psychi atric research st udies. In my opinion, th e most import an t
skills I ga ine d result ed fr om thi s apparent tim e conflict: lea rn ing to m an age on e's
tim e effec tively, a nd negot iating tea ching, research , a nd clinical co m m it me n ts whic h
a re crucial to th ose in academic medicin e.
ENTERING ACADEMI C PSYCHIATRY 23

ISSUES RELATED TO THE TRAI NING OF ACADEMI C PSYCHIATRI STS

Train ing S tructure

In a research resid ency program, four options hav e been sugges ted to combine
research and patient ca re (8). I) Epidemiology research: resid en ts wou ld have
research training on e pide m iological d esign, with elec tives in epide m iology, biost a tis-
tics, and expe rimen tal d esign. 2) Clinical biomedical research: res idents wou ld be
intermediaries betwe en th e laboratory a nd th e clinic: th ey wou ld lea rn to be
ph ysicians who underst and research , translat e it into clinica l probl e m s, test hypothe-
ses, and bring idea s ba ck to th e lab oratory. 3) Basic biom edi cal research on a
dis ease-relat ed topic: residents would learn pr e-clinical research tech niq ues applied
to res earch on a sp ecific dis ease, and would have in -depth clini cal ex perience with
patients suffering from that dis ea se. 4) Basi c biom edi cal research wit h no concomi-
tant clinical responsibili ties.
From a structural point of view , Pincus , th e cu r re n t Direct or of th e O ffice of
Res earch, Am erican Psychiatric Association, has indicat ed th at to m eet th e cr itical,
ongoing ne ed for clinically trained investigators wh o ca n provid e a bri dge be tween
the ba sic and clinical sciences, th e followin g points have to be add ressed: recru it m en t,
preparation, retention , m entoring, cre a tion of soc ia l su ppo r t a nd reward systems,
a nd need for fed eral pr ograms. Pin cus furth er suggeste d t hat de part m e nts of
psychiatry should ac tively promot e research opportuniti es for resid en ts and medical
st ude n ts and dis cusses them ex te nsively (24) . It is import a nt t ha t ea rly in t heir
ca ree rs, inve stigators-to-b e acq uire fa m ilia rity with different psychi a t ric research
m ethodologies (25). A survey of 516 " successful" clinical investi gat or s showed t hat a
decision to follow a research ca reer is made in th e ea rly part of trainin g a nd is re lated
to early re search experien ces (26). Furthermore, ea rly research ex pe rie nce is high ly
correlat ed to following an acad emic caree r (27) . Learning resea rch pr oced ures is
important not only to motivat e trainees to sta r t a n academic ca ree r but also serves as
a foundation for furth er developm ent. Golst ein, in his presid ential ad dress de livered
before th e 78th Annual Meeting of th e Am erican Society for C linica l Investiga tion,
add ressed th e com mo n issu e of a mid-career invest igator suffe ri ng from PAID S
(paralyzed academic investigat or's disea se syndrom e), ca use d by insu fficien t research
training during th e ea rly phases of a res earch ca reer a nd lead ing to long-t er m
stagna tion in res earch productivity (7). As psychiatric research m ethodology has
evolved in recent decades (23,28-30) , th ere is a growing need for goo d psychi at ric
research training during m edical school a nd resid en cy so that both recruit m ent into
academic psychiatry and continu ed res earch excelle nce ca n be maint ained . Expe ri-
ence in several branch es of medicin e indicat es th at recruitm ent a nd ea rly t raining
are necessary but not sufficie nt; on ce th e transition to research is accomplished , ways
to retain you ng investiga tors ought to be developed (24,3 1).
The clinicall y trained ph ysician has th e insi ght to t ran sfer knowled ge gained
throu gh res earch to th e pati ent. Conversely, many res earch proj ects start from ideas
spa r ked by a ph ysician who e ncoun te rs a particul ar patient pr obl em. The advantage
24 J EFFERSON J O URNAL OF PSYCHIATRY

of clinician-investigators is th eir clinical t raining, whi ch rem a ins t he most import ant
co m pone n t of resid en cy program s, a llowing th em to bridge resea rch and pati ent ca re
( 14). In psychiatry, in particul a r, a d eep und erst anding of clinical issu es is esse n tia l in
th e formulation a nd e luc ida t io n of research qu estion s suc h as t he natu re of neurobi-
olog ica l d efect s in d epression o r sc hizo phre nia, d esi gn , mon itoring, a nd in te rpre ta-
tion of t echniqu es for m easurin g course a nd ou tco me (20) . T rying to an swer
q ues t io ns enco u nte re d in clini cal practi ce with goo d resea rch methodology is a
cha lle nge that has tradition all y a tt racte d ph ysician s to ca reers in clinical inves ti ga -
tion (33) . Int erestingly, a survey of a ll members of th e US med ical school clas ses of
1980 sho wed that se niors list ed as th e factors influ en cin g th e choice of a research
ca ree r in ord er of high est import an ce were: I) opportunity to work in th e acad emic
co m m u nity; 2) cha lle nge of se a rc h for new knowl ed ge; 3) resea rch experi ence whil e a
pr em edi cal or m edi cal st ude n t ; 4) ava ila bility of training research support. As a
wh ole th e 1980 seniors co ns ide re d of minor import an ce four fac tors generally
ass u me d to be det errents to a ca ree r in clini cal investi gation: I) t he uncertain
availability of research fund s a fte r com ple tion of training ; 2) th e fina ncial disadvan-
ta ges of a res earch ca ree r; 3) th e obliga tio n to pay back research training by
co n tin ue d res earch ac t ivity; 4) th e in cr easin g fru stration of invest igat ors in conduct-
in g clinical research. Th ese last four points may be of g rea te r import a nce a few years
lat er wh en st ude n ts as resid ent s or fell ows face th e reali ti es of a decision to pursu e a
research ca ree r (3).

Multiple R oles ofthe Academic Phy sician

In co m me rcial e nte r prises, m an a gem ent , producti on , and sa les are co nce n-
trat ed in di fferent d epartm ents; howeve r in acade m ia, th e physicia n has to to wear
sim ultaneo us ly th e hats of m an a ger, producer, a nd sa les pe rso n. T he d ifficulty of
co m bining those hat s is particul arly g reat for clinician-investigators. U.S. acad emic
ph ysician s a fte r th e post-World War II era tradit ion all y pu rs ue d research, t ea ching,
a nd patient ca re ( 17) . In th e last forty years t his tradition has bee n seen as the ideal
for th e university-hospital based ph ysician. In th e early 1990's th e trem endou s
expa ns io n of biomedical research and cha nges in th e eco no m ic a nd soc ia l rea lit ies of
clinical practi ce make it hardly possibl e for th e acad emic ph ysicia n to pu rsu e a
bal anced ca re e r of research , teaching, and patient ca re. Reimbu rsem en t for t hese
ac tivit ies is also a major probl em . Fed eral training g ra n ts to resid ency pro gra ms in
psychiatry no longer ex is t so th at t eaching is not ge ne ra lly reimbursed. Inco me is
ge ne ra te d for academic ph ysicians by clinical billing a nd resea rch gran ts. It is well
described that clinical reimbursem ent , especia lly for ment al health , is in a stat e of
cr isis. Psychiatric hospitalization is clos ely monitored by insuran ce companies and
reimbursem ent for need ed m ental health clinical se rvices is now closely managed by
most insurance plans. The effec ts of a possible health ca re reform , being o rches trat ed
by th e cu rre n t ad m inist ra t io n, o n th e ava ila bility and paym ent for clinical psychiatric
se rvices remain to be det ermin ed . On th e o t he r hand , res ea rc h funding is now
ex t rao rdina rily com pe t itive. Psychi at ry researc h has been predom inant ly fund ed by
ENTERING ACADEMI C PSYCHIATRY 2S

th e fed eral gove r n me n t. The m ent al health a nd substance a buse institut es are now
part of NIH . Mov sesi an report ed th at in 1990 of new, peer-reviewed and approved
investigator-initiat ed research g ran t a pplica t ions subm itted to NIH on ly one in seven
is fund ed (34). In th e last review cycle, only on e out of eve ry eleve n a pproved research
grants submitt ed to NIMH was fund ed. In this highl y st ress fu l climat e t he strain on
expe rie nce d acade m ic ph ysici ans is subs tan tia l. Fo r th ose in t ra ining the highly
pr essured e nviro n me n t of acade m ic medicin e, a nd acade m ic psych iatry, may be
experie nce d as ove rwhe lm ing .
H ealy has state d th at th e triple mission of academ ic medicin e, nam ely, research ,
t eaching, a nd patien t ca re, has act ually become a tripl e t hrea t : " as basi c research
becomes m or e so phist ica te d a nd m e t hodologica lly com plex, and practi ce more
spec ia lize d, a nd o rie n te d towards technology, th e ph ysicia n scientist who ca n do
justice to a ll three is becoming a va nis hing br eed " (9). A "t ug-of-war" among
researc h , teaching, a nd clinical pr acti ce will not solve th e cu r re n t manpower prob-
lems in acade m ic m edi cin e. H eal y reco m me nds removin g th e st ra in from th e
individual ph ysician to be sim u lt a neo us ly a great clinicia n, a g rea t researcher, and a
gre a t t each er. C areer d ifferentiation sho uld be em phasized a nd the burd en of th e
triple mi ssion sho u ld shift from th e individual facul ty member to th e acade m ic
departm ent as a wh ole.

H ospital Versus M edical School

Recent research indicat es that th e t raining of fu t ure clinical investi ga tors occurs
pr edominantly in university-ho spital se tt ings, expos u re to research during training
being a n import ant fact or th at motivat es st ude n ts a nd resid en ts to pursu e careers in
clini cal investigation (27,35- 37). A recently publish ed lon gitud inal co hort study of
ca ree r ac hieve me n t amon g ac ade m ic ph ysicians showed th at resea rch experi en ce in
me d ica l sc hoo l wa s ind ep endently associa te d wit h having chosen an acade m ic ca ree r
(27) . This findin g is co m pa rable to wh at had bee n found by pr evious st ud ies
cond uc te d in this co un try a nd a broad . A survey of a ll medica lly-qualified faculty
m embers in th e U .K. (pro fesso rs a nd read ers, n = 940) showe d t hat those with
und ergradu at e researc h ac hieve me n ts had a bett er publicati on reco rd over te n yea rs
(me d ian number of ori ginal publication s = 72) th an th ose wit ho ut such a record
(m edian = 46) (37) . In Au stralia, gradu at es of th e Universit y of Q uee ns la nd Bache-
lor of M edi cal Scien ces program , whi ch provides m edi cal s t ude n ts with la bora tory
ba sed research t ra ining, we re sig nifica n t ly m or e lik ely to e nte r fu ll-t im e acad emic
m edi cin e or res earch th an o t he r m edi cal g ra d ua tes (20% ve rs us 0.9%, p < 0.00 I)
(38) . In th e US, 76% of th e g ra d ua tes of Duk e U niversity Sc hoo l of Medi cine M edi cal
Scie n tis t T raining Program (M .D .-Ph.D .) (n = 75) followe d care ers in acad emic
m edi cin e o r in research , co m pa re d to 8-9% of th e tot al nu m be r of physicians in th e
US (n = 570,00) wh o a re m embers of full-ti me clin ica l faculties (39) . In a survey of all
departm ents of int ernal m edi cin e in th e US, 71.6% of a ll medicall y-qu al ified faculty
(n = 6749) had had m or e than one year of research training, a nd 75% of facult y with
26 J EFFERSON JOURNAL OF PSYCHIATRY

only a m edi cal degree (n = 6237) re port ed r esearch activity in th e academ ic year
1982-1 983 (35).
For those in universit y-b ased post graduat e t raining pr ograms th ere may be a
co nflict between th e m edi cal schoo l a nd th e hospital. Resid e nt s a re hospital employ-
ees, pa id and penali zed acco rd ing to hospit al r ules a nd regul a t ions. Increased
cost-co ntain me n t meas ures (10), an d th e problems rela t ed to lit iga tion ha ve led
hospital s and eve n th e Ne w York State Legislatu re to be very st rict in relation to
resid ent activities (I I) . Failure t o fu lfill incr easingly st ringe n t bureau cratic require-
m ents may lead to penalties. As a result hou sest aff t end to have as a priori ty th e
fulfillm ent of hospit al requirem ent s.
Tim e spe n t dealing with m edi cal records, quality ass uran ce, a nd docu men tatio n
of need for a nd delivery of ca re m ay prevent penal ti es bu t it will not lead to academic
promotion (6) . Promotion is reco m mend ed accord ing to th e requirem en ts of th e
m edi cal sc hoo l, whi ch a re relat ed to research pr oductivity. Youn g invest iga tors are
cons tan t ly pr essured to publish in orde r to advance t h eir acad e mi c ca ree rs (40).
Faculty m embers supe rvising residents a re not awa re in m a ny inst an ces t hat th e
co nflict between th e requ irem ents of th e hospit al a nd th ose of th e m edi cal schoo l are
already a problem for th e hou sest aff, especia lly for t hose int e rest ed in pu rsui ng a
clinical research ca re e r. Those issu es, if di scussed a t a ll, te nd to be left fo r faculty
m eetings from which resid ent s a r e excl ud ed .

CO NCLUSION S

The early acq uisit ion of research skills is impor tant in mo tiva tin g train ees to
pursu e ca re e rs in clinical investigation a nd a lso to ensu re continu ed excellence in
re sea rch throu gh out a n acad e m ic ca reer in psychi at ry. Residency programs need
se m inars devot ed to ca ree r planning in ord er to explore different ca reers pa ths for
trainees. Those se m inars sho uld add ress th e followi ng fo ur poin ts relat ed to ca reers
th at com bine research a nd clinical ca re (8) : I. Wha t will com pose basic me dica l
research in th e futu re? 2. What ca re ers a re feasible for a physician who wa nts to
co m bine research and patient ca re? 3. Wha t training pa t hways for such ca ree rs are
ava ila ble or need ed ? 4. H ow a re these ca reers displayed an d supported? Those who
have po tential for a nd int erest in pursui ng a ca re e r in cli nica l investiga tion would
benefit fr om a resea rc h pr eceptorship program , in whi ch a se nio r inves tiga tor
su pervises th e residen t throu gh out hi s training. Fu rt hermore, th e opt ion of alte rn a-
t ive progra m s, such as a five-yea r research -t rack residency, sh ould be avai la ble for
those with a stro ng com m it me n t to acade m ic psychi at ry . Acad emic departm en ts of
psychi atry could a lso facilit at e early research experie nce by providin g init ial fu nding
for those pilot st udies , secre taria l, a nd da t a processing suppo r t systems, fac ulty
su pe rvisio n, a nd d efin ed cur ricular ti m e for res earch du ri ng resid en cy t rai ning (42) .
The degree of ava ilability of th ose resou rces could t he n vary between th e t rad it ional
cu rriculu m a nd research -t rack resid e ncy tra ini ng pr ogra ms.
ENTERI NG ACADEMI C PSYCHIATRY 27

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