On the road to residency, for those interested in research, there comes a fork in the road when deciding between traditional residency programs and “fast-tracking.” Not to be confused with the bridge toll payment scanning system, fast-tracking in residency refers to research oriented residency programs which allow residents to substitute a year of clinical training for an extra year in the lab. The idea is that the path to becoming a physician scientist is long, and fast tracking can be a point to increase efficiency.
Each board certified specialty has its own twists on the fast-tracking process, and to make matters more complicated, each individual residency also structures their program differently. They can be called Physician Scientist Pathways (PSP), Clinician-Scientist Pathways (CSP), or Medical Research Tracks (MRT). All of this makes the system difficult to decipher, and most of my understanding of the process came from the helpful advice of former classmates, a few years ahead in the process.
To share some of what I’ve learned, to start with, some types of residencies have much more established track records and programs. For example, my specialty, internal medicine, has a long history of having its residents fast track, and as such there’s a fair amount about it on the American Board of Internal Medicine (ABIM) website. Other specialties, particularly those with smaller numbers of residents per class, have less established pathways. As someone who’s experimented with their medical education, not having to pave the way with a new track can save a lot of effort, though the path is certainly possible through other specialties as well.
Another difference between programs at different institutions is that some will guarantee a fellowship position upon acceptance to residency, while others will not. My program for instance, Mass General, does not, so I’ll need to apply again for fellowship. In fact, some residency programs won’t have an explicit fast-track program, rather they’ll just offer the option to do so to a resident in the general program.
If these assortments of pathways sound confusing, that’s because they are. And it’s part of a phenomenon that I’ve noticed in medical training, which is that the further along through the medical training pipeline I traverse, the less formalized the branch points become. This makes sense, because while early on everyone needs to learn the same fundamental curriculum, with more specialization the definition of “core content” for learning becomes less definable, and flexibility and adaptability become more important principles for our education.