Transition from ABIM research pathway to clinical practice

[sirrileydog]

I am a PGY5 completing my 3rd year of an IM subspecialty fellowship through the ABIM research pathway (ie fast tracker); I will soon complete the 3 year fellowship and all the clinical requirements required for the clinical fellow track. My fellowship says that I have achieved competency in the practice of my subspecialty. I am board certified in internal medicine and hold a PhD degree as well.

I am most passionate about clinical medicine. Over the past 1-2 years have decreasing interest/success/passion in research. Despite significant time and effort investments, my research projects have gone extremely poorly. I will "graduate" from my fellowship as a PGY5 but still have my PGY6 year left. I will be leaving academics as soon as I can clear my subspecialty board certification; I basically have a private practice job lined up pending a definite end date from my program.

ABIM says that I need to complete a 6th year with 80% research effort (https://www.abim.org/certification/policies/research-pathway/policies-requirements.aspx)--but this is no longer in my interest (and arguable not longer in my division's interest). Does anyone have experience with a transition to a non-academic career out of the research pathway? I am looking to negotiate with my division chief to achieve a mutually beneficial plan. Otherwise, it seems like the PGY6 year is just a year to moonlight, show up to a few Zoom meetings, and run out the clock. There are few if any deliverables beyond a weekly continuity clinic and on paper research effort. Appreciate any personal experiences about how to make this transition.

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[DrMetal]

I am a PGY5 completing my 3rd year of an IM subspecialty fellowship through the ABIM research pathway (ie fast tracker); I will soon complete the 3 year fellowship and all the clinical requirements required for the clinical fellow track. My fellowship says that I have achieved competency in the practice of my subspecialty. I am board certified in internal medicine and hold a PhD degree as well.

I am most passionate about clinical medicine. Over the past 1-2 years have decreasing interest/success/passion in research. Despite significant time and effort investments, my research projects have gone extremely poorly. I will "graduate" from my fellowship as a PGY5 but still have my PGY6 year left. I will be leaving academics as soon as I can clear my subspecialty board certification; I basically have a private practice job lined up pending a definite end date from my program.

ABIM says that I need to complete a 6th year with 80% research effort (https://www.abim.org/certification/policies/research-pathway/policies-requirements.aspx)--but this is no longer in my interest (and arguable not longer in my division's interest). Does anyone have experience with a transition to a non-academic career out of the research pathway? I am looking to negotiate with my division chief to achieve a mutually beneficial plan. Otherwise, it seems like the PGY6 year is just a year to moonlight, show up to a few Zoom meetings, and run out the clock. There are few if any deliverables beyond a weekly continuity clinic and on paper research effort. Appreciate any personal experiences about how to make this transition.

You need to complete the PGY6 year in order to sit for the subspec BC, right?

Just complete it. Come on you're almost done

Then you can do WTF you want.

 

[sirrileydog]

You need to complete the PGY6 year in order to sit for the subspec BC, right?

Just complete it. Come on you're almost done

Yes, Abim says you should complete PGY6 to sit for the test (I registered early).

Almost there and don't want to jeopardize it all. Any deviation would require the support of the division chief.

.....I guess it's a year of moonlighting, perhaps some subspecialty locums 1 week per month, and show up to research group meetings with as much data as I feel like....

 

[DrMetal]

Yes, Abim says you should complete PGY6 to sit for the test (I registered early).

Almost there and don't want to jeopardize it all. Any deviation would require the support of the division chief.

.....I guess it's a year of moonlighting, perhaps some subspecialty locums 1 week per month, and show up to research group meetings with as much data as I feel like....

Yes , 'fake it until you make it

What kind of research, basic science? Benchtop?

 

[Bobblehead]

Depending on what type of relationship you have with your PD and what type of person your PD is, one option may be to tell him that you are no longer passionate about research and that you will be transitioning to private practice at the end of your fellowship. However, in the upcoming year you will work hard on your existing commitments, no matter what but perhaps your PD has suggestions on how else to fill your time.

You will need the people from fellowship for references for future jobs. Subspecialties are small fields and lots of people know lots of other people. Lots of people leave research and go into practice. Lots of those people will have calls made on their behalf to open doors and calls will be placed to faculty in your fellowship program by future employers as well.

 

[NotAProgDirector]

Transitioning out of the research pathway basically means you need to get an IM PGY-3 year. That site you posted a link to? The last collapsable section:

Impact of Changing from the Research Pathway​

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.

As a three year fellowship, you'd need 5 clinical years and 1 research year, just like everyone else. Much then depends on how much of your 3 years of fellowship have been research already. And it's not clear that the ABIM would accept 2 IM + 3 Fellowship + 1 research as an option.

Unfortunately, I think I have more bad news for you. The ABIM research pathway for 3 year fellowships is not 6 years long. It's a minimum of 6.5 years, 7 for Cardiology. Your prior posts suggest GI. If so, it's 2 IM + 1.5 GI + 3 research = 6.5 years.

Last, just doing the minimum and trying to maximize your moonlighting may end badly for you. You need to pass this experience. Get kicked out of the lab and you'll have no specialty board certification.

 

[DrMetal]

Transitioning out of the research pathway basically means you need to get an IM PGY-3 year. That site you posted a link to? The last collapsable section:


As a three year fellowship, you'd need 5 clinical years and 1 research year, just like everyone else. Much then depends on how much of your 3 years of fellowship have been research already. And it's not clear that the ABIM would accept 2 IM + 3 Fellowship + 1 research as an option.

Unfortunately, I think I have more bad news for you. The ABIM research pathway for 3 year fellowships is not 6 years long. It's a minimum of 6.5 years, 7 for Cardiology. Your prior posts suggest GI. If so, it's 2 IM + 1.5 GI + 3 research = 6.5 years.

Last, just doing the minimum and trying to maximize your moonlighting may end badly for you. You need to pass this experience. Get kicked out of the lab and you'll have no specialty board certification.

Yikes!!! Then @sirrileydog , I suggest you continue your research like you're about to win the Nobel Prize! Or at least, the Ig Nobel Prize.

 

[aafisahar]

get a few residents, crank out some garbage retrospective stuff, submit an abstract or two to ACG, then walk away. You can pretty much get by doing zero work as the residents will do everything. Unless your department stipulates it needs to be a paper (sounds like it;s not), you can drum up a ****ty abstract to fulfill the requirement and be done.

 

[gutonc]

I will defer to @NotAProgDirector on the precise rules, but I happen to know 2 people (1 cards, 1 H/O) who decided to bail out of the research pathway after their first full research year. Both were required to complete the same number of full clinical years that the underlying IM+Sub required in order to graduate. Both were offered the option of an extra sub-specialty year vs an extra IM year.

In the case of the H/O fellow, he chose to do the extra year in H/O. As a 3rd year H/O fellow in our program, you basically do the equivalent of 2 clinic days a week, share call (with the other 13 fellows) and are expected to complete a "research project". Since he'd already submitted a couple of abstracts and a manuscript, he had that part done and basically just moonlighted 3-4 nights a week.

The cards fellow decided to go back and do a PGY3 IM year since the expectations for senior cards fellows in that program was essentially being the "pretending" on inpatient services and primary operator on the cath service (no interventional fellows at that time) so an R3 IM year was the easier choice since she'd already front-loaded her PGY2 IM year in order to get enough core rotations to do the research pathway. She however had pissed off the cards PD and was prohibited from moonlighting, which had originally been her plan as well.

 

[NotAProgDirector]

It can be done, but only if the program supports it.

These last research year(s) are probably paid using an R01 or T32 grant. So if the OP tries to go back to clinical, they will now need another funded position. Whether or not one exists is unknown.

Since the research year is likely grant funded, you can't just "fake it". I expect the person paying your salary may be very upset.

I wish the OP the best of luck. They just need to proceed carefully.

 

[sallyhasanidea]

Could we get an update from OP? Did he transition to private practice well?

 

[sallyhasanidea]

I am a PGY5 completing my 3rd year of an IM subspecialty fellowship through the ABIM research pathway (ie fast tracker); I will soon complete the 3 year fellowship and all the clinical requirements required for the clinical fellow track. My fellowship says that I have achieved competency in the practice of my subspecialty. I am board certified in internal medicine and hold a PhD degree as well.

I am most passionate about clinical medicine. Over the past 1-2 years have decreasing interest/success/passion in research. Despite significant time and effort investments, my research projects have gone extremely poorly. I will "graduate" from my fellowship as a PGY5 but still have my PGY6 year left. I will be leaving academics as soon as I can clear my subspecialty board certification; I basically have a private practice job lined up pending a definite end date from my program.

ABIM says that I need to complete a 6th year with 80% research effort (https://www.abim.org/certification/policies/research-pathway/policies-requirements.aspx)--but this is no longer in my interest (and arguable not longer in my division's interest). Does anyone have experience with a transition to a non-academic career out of the research pathway? I am looking to negotiate with my division chief to achieve a mutually beneficial plan. Otherwise, it seems like the PGY6 year is just a year to moonlight, show up to a few Zoom meetings, and run out the clock. There are few if any deliverables beyond a weekly continuity clinic and on paper research effort. Appreciate any personal experiences about how to make this transition.

Can you update for someone looking to do something similar?