Research & Rounds

Choosing a research-focused residency is about more than finding the right track or acronym. It's about finding an environment where your clinical and scientific ambitions can grow together.

In this episode of Research & Rounds, host Evan Noch, MD, PhD, shares five practical questions to help medical students and future physician-scientists look beyond program promises, assess mentorship and protected research time, and find a training pathway that fits the career—and life—they want to build.

From understanding the differences between physician-scientist training programs (PSTPs) and research-intensive categorical residencies to knowing what to ask current trainees, Evan offers advice for making a more informed decision.

Press play before your next residency interview.

Quote of the Episode

“You are choosing an ecosystem, not an acronym.”

— Evan Noch, MD, PhD

Key Takeaways

• Define the career you want to build. Before comparing residency programs, consider your research interests, long-term goals, specialty, and how much structure or flexibility you need. A formal research track isn't necessarily the best or only route to a successful physician-scientist career.
• Understand what the pathway actually offers. PSTPs, research-in-residency programs, and other research-focused pathways vary considerably. Ask about training length, research requirements, funding, board-certification requirements, and whether fellowship opportunities are guaranteed or simply anticipated.
• Find out whether research time is truly protected. A promise of protected time means little without a clear plan. Ask when research blocks occur, which clinical responsibilities continue, and who ensures that research time remains protected when clinical demands increase.
• Evaluate the people and culture, not just the program's reputation. Look for accessible mentors, a supportive research community, and leadership that values physician-scientist training. Consider whether mentors understand the demands of residency and whether trainees receive the resources and flexibility they need to succeed.
• Talk to trainees and look for evidence of outcomes. Ask current residents, fellows, and graduates about their experiences. Established programs should be able to describe where trainees went next, while newer pathways should demonstrate concrete commitments to funding, mentorship, and support. Remember that location, family responsibilities, finances, and quality of life also matter when choosing a sustainable career path.

Five Questions to Ask During Residency Interviews

As you evaluate residency programs, ask program leadership, current trainees, and recent graduates these questions to better understand what each pathway offers in practice.

• What happens to graduates of the pathway? If this is an established pathway, can you walk me through what happened to the last two or three residents who completed it? If it is new, what time, funding, mentors, and leadership commitments are already in place, and how will trainee feedback lead to changes?
• Is research time truly protected? When does protected research time occur, which clinical responsibilities continue, and what happens if service needs increase?
• How does mentorship work? How are residents connected with mentors, and what support is available if the first match is not a good fit?
• What are the expectations for fellowship? If residency and fellowship are linked, what is guaranteed, what is expected, and how much flexibility is there if my interests change?
• What challenges do trainees actually face? What do current or recent trainees say is the hardest part of making this pathway work?

Sources & Resources

Resources for Residency Applicants

• AAMC Physician-Scientist Training Program Resources — An overview of physician-scientist training pathways, including research-in-residency programs and specialty-specific options.
• AAMC Physician-Scientist Training Program Webinars — Recorded discussions with program directors and trainees covering training pathways, applications, and interviews.
• APSA Residency and PSTP Program Database — A searchable directory of formal PSTPs and related research pathways. Verify program details directly with individual institutions.
• APSA Resources for Residents and Fellows — Career-development, networking, and professional support for physician-scientists in training.
• APSA Mentorship Programs — Mentorship opportunities for trainees pursuing physician-scientist careers.
• APSA Residents and Fellows Funding Database — Funding opportunities for physician-scientists during residency and fellowship.
• AAMC Residency Interview Resources — Guidance to help applicants prepare for interviews and evaluate program fit.

Selected Specialty-Specific Pathways

• Internal Medicine: ABIM Research Pathway
• Surgery: American College of Surgeons Surgeon-Scientist Training Pathway
• Neurological Specialties: NINDS Research Education Programs

Selected Research and Guidance Referenced in the Episode

• AAMC: Training the Physician-Scientist in Internal Medicine — Explains differences in training structures and terminology.
• NIH: Stimulating Access to Research in Residency (StARR) — Describes institutional expectations for research time, mentorship, funding, and training support.
• Overcoming Barriers to Resident Scholarly Productivity and Research at a Large Academic Institution — Examines barriers residents encounter when pursuing research.
• Emergency Medicine Residency Pathways for MD/PhD Trainees — A national study examining the availability of research pathways in emergency medicine.
• Evaluating Factors Impacting Early Career Physician-Scientists' Decisions to Continue Research Careers in the United States of America — A national survey coauthored by Evan Noch examining career challenges, including balancing clinical and scientific responsibilities, work-family balance, and research funding.

Research & Rounds: The Physician-Scientist Career is produced by the National Academy of Medicine in collaboration with the American Physician Scientists Association and the American Junior Investigator Association.

In “Why the Physician-Scientist Career Pathway Still Matters,” host Evan Noch, MD, PhD, talks with Elizabeth “Betsy” Nabel, MD, chair of the Lasker Foundation Board of Directors and advisor to ModeX Therapeutics/OPKO Health, and Rochelle P. Walensky, MD, MPH, professor of medicine at Harvard Medical School and former director of the Centers for Disease Control and Prevention.

Their careers began with very different questions. For Nabel, it was why patients experienced recurrent narrowing of their arteries after angioplasty. For Walensky, it was why lifesaving HIV treatments remained financially out of reach for so many patients. Those questions would lead them into laboratory research, health economics, biotechnology, and leadership at some of the nation's most influential health institutions.

Together, they discuss the mentors and unexpected opportunities that shaped their careers, what it means to be a physician-scientist beyond the traditional academic model, and how to navigate an increasingly uncertain research environment. They also offer candid advice about finding support, reconsidering how physician-scientists are trained, and recognizing the small victories along the way.

— Elizabeth “Betsy” Nabel, MD

• Let clinical questions guide your research. Nabel recalls how observing high rates of restenosis after coronary angioplasty inspired her to investigate the underlying molecular mechanisms. With support from her department chair, she established a small research laboratory and secured her first NIH R01 grant within 18 months. Walensky's experiences treating patients with HIV similarly led her to study the costs and accessibility of lifesaving therapies.
• There's more than one way to be a physician-scientist. Neither Nabel nor Walensky followed the traditional MD-PhD pathway. Their experiences demonstrate how research careers can extend beyond the laboratory into decision science, public health, government, biotechnology, and health care leadership. Nabel encourages early-career investigators to explore opportunities in biopharma and other settings, even when their mentors' careers have remained entirely in academia.
• Research training prepares you to navigate uncertainty. Walensky explains how her background in mathematical modeling and decision science became invaluable during her leadership of the CDC, particularly when making consequential public health decisions with incomplete information. The ability to evaluate risk, anticipate outcomes, and revise decisions as evidence changes is a skill that extends far beyond research.
• The physician-scientist pathway needs to become more sustainable. Both guests question the length of traditional training programs and the institutional structures that make it difficult to pursue research careers. Nabel advocates for shorter training pathways and stronger institutional support, while Walensky emphasizes the need to account for family responsibilities, financial pressures, and the personal demands of prolonged training.
• Be willing to explore unconventional opportunities. With research funding increasingly uncertain, Nabel encourages physician-scientists to broaden their networks and consider collaborations, patient advocacy organizations, philanthropy, and industry partnerships. An unexpected opportunity or temporary shift in research direction may provide the support needed to continue pursuing longer-term goals.
• Celebrate progress, not just major achievements. Walensky recalls applying for eight small grants during her first postdoctoral research year, hoping someone would recognize the potential of her work. She reminds listeners that CVs capture successes but rarely show the rejected papers, unsuccessful applications, and uncertainty behind them. Both guests encourage early-career researchers to recognize smaller milestones and find satisfaction throughout the different chapters of their careers.

Elizabeth “Betsy” Nabel, MD

Elizabeth “Betsy” Nabel, MD, is a cardiologist, physician-scientist, and leader in biomedical research and academic medicine. She serves as chair of the Lasker Foundation Board of Directors and advisor to ModeX Therapeutics/OPKO Health. Previously, she served as president of Brigham Health and Brigham and Women's Hospital from 2010 to 2021 and director of the National Heart, Lung, and Blood Institute at the National Institutes of Health from 2005 to 2009. Her research on the molecular genetics of cardiovascular disease has resulted in more than 250 scientific publications, 17 patents, and two start-up companies. She is an elected member of the National Academy of Medicine.

Read Dr. Nabel's official biography.

Rochelle P. Walensky, MD, MPH

Rochelle P. Walensky, MD, MPH, is an infectious disease physician, researcher, and public health leader. She is a professor of medicine at Harvard Medical School and professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health. She served as the 19th director of the Centers for Disease Control and Prevention from 2021 to 2023 and previously led the Division of Infectious Diseases at Massachusetts General Hospital. Her research has focused on HIV prevention, screening, and treatment, using mathematical modeling and health economics to inform clinical practice and health policy. She has authored more than 300 scientific publications and is an elected member of the National Academy of Medicine.

Read Dr. Walensky's official biography.

Research & Rounds: The Physician-Scientist Career is produced by the National Academy of Medicine in collaboration with the American Physician Scientists Association and the American Junior Investigator Association.

Introducing Research & Rounds: The Physician-Scientist Career, a new podcast from the National Academy of Medicine hosted by Evan Noch, MD, PhD.

Through conversations with physician-scientists, program leaders, and funders, along with shorter episodes addressing common career questions, the podcast offers practical guidance on the opportunities, challenges, and decisions that shape a physician-scientist's career.

The first two episodes launch October 29, 2026, with new episodes every other week.

Follow Research & Rounds on your favorite podcast platform so you don't miss an episode.

Created by the National Academy of Medicine in collaboration with the American Physician Scientists Association and the American Junior Investigator Association as part of NAM's Sustaining the Physician-Scientist Workforce initiative.