Life-cycle health effects of compulsory schooling.

The physician-scientist workforce has declined for four decades, and in 2020, only 1.3% of psychiatrists identified research as their primary activity, down from 1.6% in 2011 []. From 2013 to 2022, the number of National Institutes of Health (NIH) career development awards to physicians was stagnant []. Barriers to a physician-scientist career are mounting, as the age at first R01 increases and the future of NIH funding is unclear. The obstacles to physician-scientist training are well established, and there have been many attempts to bolster research training in residency to grow the physician-scientist population []. In 2001, the National Institute of Mental Health (NIMH) commissioned a report from the Institute of Medicine (IOM) on obstacles and solutions to physician-scientist training in residency []. One obstacle was fragmented research training throughout residency. As a result, residency research tracks were developed to provide formalized research training in residency [–]. Psychiatry residency research tracks provide substantial protected research time, mentorship, and funding during the earliest stages of building a research career []. Many research tracks are funded through the NIH R25 mechanism, which was established over 20 years ago to support educational initiatives intended to enhance the pipeline of well-trained researchers and to diversify the biomedical workforce. The NIMH began funding R25s to ensure continued engagement in research through residency research tracks. Rather than stepping away from research during residency training, the R25 provided protected time so residents could stay engaged in research, improving retention of physician scientists and reducing the time to a K award and first R01. Despite the R25 programs, the number of psychiatrists engaging in research continues to decline. Of the over 350 psychiatry residency programs in the USA, there are currently 17 NIMH-funded R25 research tracks. There are also many non-R25-funded research tracks, which must find alternative ways to support research, including leveraging departmental support and/or funding from graduate medical education. Thus, for many programs, the hurdles to support residents engaging in research remain high.