title: Performance of physicians trained through the research pathway in internal medicine.
abstract: OBJECTIVE
  Educators in internal medicine are concerned that reducing clinical training from three years to two could negatively affect physicians' ability to provide good patient care. Physician-scientists already follow a short-track research pathway that shortens clinical training to two years. The authors examine whether this shortened training affects ability.
  
  
  METHODS
  The authors use a national sample of 101,031 physicians who took their first internal medicine certification examination between 1993 and 2008 and trained in either a traditional or research pathway. They collected data, including demographics, exam information, and maintenance of certification (MOC) return rates. They used regression models to assess the relationship between training pathway and MOC exam scores and eventual certification status, adjusting for physician characteristics.
  
  
  RESULTS
  In this study, research pathway training did not adversely impact internal medicine certification status. Although the scores of physicians who followed the research pathway were slightly lower, the effect size was small. In a subset of research pathway physicians, 63% remained in academic medicine and 37% continued to spend a substantial portion of time in medical research 10 years later.
  
  
  CONCLUSIONS
  Different training pathways can lead to similar achievements in clinical judgment. The educational model, competency-based rather than time-dependent, that works for research pathway physicians could be extended to other talented trainees who would benefit by customizing training to meet career goals.
authors.affiliation: American Board of Internal Medicine, Philadelphia, Pennsylvania 19106, USA. rlipner@abim.org
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Lipner
authors.forename: Carola
authors.initials: C
authors.lastname: Lelieveld
authors.forename: Eric S
authors.initials: ES
authors.lastname: Holmboe
mesh_terms: D000124:Achievement; D000328:Adult; D035843:Biomedical Research / Q000193:education*; D002321:Career Choice; D002568:Certification; D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D013044:Specialty Boards