Physician Scientist Training Pathway

Overview

The University of Iowa Pathology Physician Scientist Training Pathway (PSTP) seeks to facilitate outstanding biomedical research opportunities balanced with a strong tradition of excellence in anatomic and clinical pathology training, for those trainees who plan to include a significant research component in their career. The training pathway is designed to be flexible in order to accommodate the individual needs and training goals of its members, and to be well integrated within the University of Iowa College of Medicine PSTP. This site provides programmatic structure and guidelines that coordinate the admission and residency/postdoctoral fellowship training of physician scientists under the auspices of the University of Iowa Department of Pathology.

Why Iowa PSTP?

UI Health Care and the Department of Pathology have a rich research environment with great opportunities for physician-scientists. Our program is committed to support physician-scientists at every stage of their career, from providing a robust clinical experience in residency training, assuring protected time and support for research training, receiving high priority for fellowship positions as well as mentorship toward obtaining funding such as K08 awards.

The Department of Pathology has significantly increased the research opportunities under the leadership of our current chair, Nitin Karandikar, MD, PhD. This enhanced focus on research has yielded a number of improvements:

  • We have expanded to over 20 laboratory-based principal investigators in the department, 10 of whom are physicians and 6 of those physician-scientists were recruited in the last 4 years.
  • Pathology maintains a rolling advertisement for physician-scientist investigators interested in clinical work in any area of clinical/anatomic pathology. We are committed to mentoring our residents and fellows to be well prepared for academic positions.
  • Beyond laboratory-based investigation, the majority of our clinical faculty are involved in basic, clinical or translational research projects as both collaborators and primary investigators.
  • Almost our entire clinical pathology faculty and a sizable proportion of our anatomic pathology faculty have PhDs, providing a very large mentoring community for PSTP trainees and junior physician-scientist faculty.
  • All PSTP trainees are provided a $4000/year stipend from the institutional PSTP program for academic expenses. This is in addition to developmental funds as well as funding for small projects available through the department.

A physician-scientist coming to the UIHC Department of Pathology will be joining a cohort of experienced researchers that contribute to our department’s research strengths in immunology and cancer biology, as well as supporting departmental and institutional pockets of excellence in the neurosciences, cardiovascular and pulmonary research, genetics, and metabolism.  The Pathology department’s national ranking in Blue Ridge NIH funding has increased over 30 places in the last 5 years.

Admission Process

Interested individuals apply to the University of Iowa College of Medicine PSTP, and to the University of Iowa residency program through ERAS. The candidate then interviews for PSTP and Anatomic Pathology (AP), or Clinical Pathology (CP), or both AP/CP, if undecided. Nationally, the trend is for research pathway candidates to pick either AP only or CP only tracks. It is anticipated that the undecided candidate would eventually pick AP or CP during their first year of residency. However, in keeping with the flexible and individualized nature of this program, the UI Pathology PSTP does not mandate this choice.

The successful candidate generally will have both an MD and PhD in a field of biological or physical science. Those applicants with an MD and significant prior research training (but not a PhD) will also be considered.

Training Overview

Each PSTP trainee receives individualized guidance and mentoring from two committees. In the first 12-18 months in the program, the Pathology PSTP Oversight Committee provides mentoring. After a research laboratory has been chosen, a customized PSTP Advisory Committee (PAC) provides continued guidance.

A general training sequence is outlined below as a starting point for trainees and their mentoring committees to discuss. Trainee interests and discussions with residency program/postdoctoral laboratory mentors may result in a different superior pathway for a specific trainee.

  • Residency training is initiated at beginning of PSTP training.
  • The placement of clinical and research rotations is flexible. One of the recommended sequences for an AP or CP only candidate (30 months of clinical rotations + 6 months research) may look as follows:
    • 12 months clinical rotations – 6 months research – 18 months clinical rotations.
    • 18 months clinical rotations – 6 months research – 12 months clinical rotations.
  • Research during residency is done in the post-doctoral training lab. Ideally, this lab should be selected in first six to nine months in the PSTP.
  • The trainee sits for AP or CP or AP/CP board exam within one year of completing clinical training.
  • The trainee will complete activities needed to maintain board certification (MOC) thereafter, as required by the American Board of Pathology.
  • Post-doctoral research training - the trainee will typically participate in 3-4 years of Post-doctoral research. The mentor is encouraged (but not required) to be Pathology faculty.
  • Clinical involvement during the postdoctoral research period is determined by the stipulations of the training grant and the nature of the clinical specialty; but will not exceed 25% of the trainee’s effort and may allow for a fellow- or faculty-level clinical involvement, dependent on other details. Clinical opportunities during this phase include (but are not limited to):
    • attendance at conferences pertinent to clinical specialty
    • limited on-call duties
    • limited on service duties
    • workup of consult cases related to clinical specialty
    • tumor boards
  • Teaching experience requirement:
    • The trainee will prepare and present of at least two formal lectures.
    • The trainee will preferably lecture as part of a formal course to medical, graduate, or allied health students is preferred, but the requirement can also be met by a formal lecture to residents.
    • Research seminar presentations do not fulfill this requirement.
    • The trainee will also participate in the usual small group teaching experience during residency.
    • The trainee will present research seminars at least three times during training.
      • One presentation must be Pathology Grand Rounds.
      • Other possible venues include:
        • Pathology research day
        • Seminar series sponsored by trainee’s research department/program
        • Regional or national meeting
  • Trainee participation in College of Medicine PSTP seminars and other activities is encouraged.

Research Training Funding

  • Pathology guarantees salary/benefits support during 2-3 years of research training. This will be a combination of departmental funds, training grants and funds available to the research mentor.
  • Salary/benefits will generally be supplemented at least up to PGY level throughout the training period.
  • The trainee will also apply for funding to sources determined by consultation with the research mentor, PSTP Oversight Committee and/or PSTP Advisory Committee. The trainee should qualify to apply for transitional funding (e.g., K08 award) during postdoctoral training.

Pathology PSTP Advisory Committee

The PSTP Advisory Committee (PAC) is typically formed during PGY2. This group assumes mentoring responsibility from the PSTP Oversight Committee in a coordinated manner.

  • PAC membership
    • One faculty member in Pathology with active clinical and research roles. This member serves as PAC Chairperson.
    • Trainee’s research laboratory principal investigator.
    • One faculty clinical advisor, chosen from specialized field of interest.
    • One faculty member outside of Pathology (encouraged).
      • Choice may include faculty member with secondary appointment in Pathology.
      • This individual's role is to provide expertise relevant to the trainee’s scientific or clinical development and may help the trainee negotiate their first employment contract without bias.
    • Other individuals may be included at the PAC chair or trainee’s request.
  • PAC duties
    • Oversight of the trainee’s overall progress, including:
      • Research, including estimates of length of research training phase.
      • Funding applications (proposal guidelines, critical review).
      • Publications.
      • Oral Presentations on research.
      • Attendance at national meetings.
      • Clinical skills maintenance during post-doctoral training.
      • Potential clinical fellowship training.
      • Residency rotation scheduling (in consultation with residency program director).
      • Job placement/application.
      • Other concerns of the trainee.
    • Meeting schedule:
      • Once towards the end of the 6 month research block in PGY2 (assuming PAC has been assembled at this time).
      • At least once per year during post-doctoral training (more often if necessary or desired).
    • Reports to PSTP Oversight Committee after every meeting using a PAC Progress Assessment Form completed by the PAC Chair.

Pathology PSTP Oversight Committee

This committee provides orientation and early mentoring as outlined below.

1st meeting (orientation meeting) -- first month of residency training.

  • Overview of the training pathway individualized to the trainee's needs.
  • Research lab selection.
  • Exploration of potential career paths, potential mentors and related resources.
  • Residency rotation scheduling preferences.

2nd meeting -- third month of PGY1.

  • Monitor and/or facilitate the process of identifying a research laboratory and mentor.
  • Assist in AP vs. CP residency decision for undecided trainees.

3rd meeting -- sixth months of PGY1.

  • Review short list of research laboratory options (if necessary).
  • Select 12/6/18 month or 18/6/12 month track for sequencing of clinical-research-clinical training during residency.
  • Discuss options, deadlines, requirements, and application process for postdoctoral funding to support research.

4th meeting -- two months into the six month research block (PGY2).

  • Monitor early progress in the laboratory.
  • Discuss suitability of the chosen mentor for the trainee.
  • Monitor progress on identifying/pursuing research funding.
  • Determine if mentoring responsibility can be transferred to customized PSTP Advisory Committee (PAC).
    • If yes: review of PAC responsibilities and trainee progress with PAC Chairperson.
    • If no: develop a timeline for transfer of mentorship to PAC.