The DART program provides a model to effectively integrate research training during residency without increasing the number of years of residency training. The program recruits and mentors physicians to help advance them toward becoming independent investigators, provides a consistent curriculum of research training that begins early on during residency, and provides summer research training for undergraduate and medical school students so they may be exposed to research early in their career trajectories.
Although the DART program helps overcome many obstacles to resident research, several important challenges exist. First, there is an insufficient “bridge” between completing residency and obtaining a faculty appointment. Most of the residents in the DART program are not ready to submit a Career Development Award during the PGY4 year. At MUSC, we have several fellowships that residents may enter into immediately following residency, which also gives them more time to prepare the grant application, but many universities are unable to offer fellowships. Furthermore, if junior researchers join the faculty without protected research time, the success of their long-term research career goals may be jeopardized. Secondly, financial challenges remain an obstacle. The Loan Repayment Program has been extremely beneficial in helping relieve resident debt load, however it has become increasingly more competitive to obtain. In addition, the financial considerations mentioned earlier may limit the exportability of this program.
Finally, more women and under-represented minorities (URM) need to be integrated into residency research training programs (16
). Thus far, 38.5% of DART residents have been women and 7.1% URM . These numbers are likely a direct reflection of the make-up of MUSC's residency training program (41% women, 9% URM). The women in the DART program have done as well as their male counterparts in all arenas (e.g., research productivity, grant submissions, obtaining post-DART fellowship and faculty positions). The DART program's success at attracting women physicians to clinical research may be attributed to the mentoring process, in which the quality of the mentoring relationship is emphasized and mentors are compensated for their efforts. Sakamoto and Dipple (18
) comment that one of the most important factors contributing to their success as women physician-scientists is supportive mentorship. Outreach efforts to URM and women coupled with careful attention to the mentoring process will be important in increasing diversity in the physician-scientist community.
In conclusion, the DART program has been successful in providing a clinical research experience for psychiatry residents, medical students and undergraduates. Most of the DART graduates have embarked on a career in academic medicine in which they are continuing their research activities. If financial barriers can be overcome, programs like this one may be of value in providing a much needed increase in the number of physicians involved in clinical research.