Navigating physician-scientist careers: insights from American Board of Internal Medicine Research Pathway graduates.

The American Board of Internal Medicine Research Pathway (ABIM RP) is designed to train physician-scientists by shortening postgraduate clinical training and increasing research time. We surveyed ABIM RP graduates to understand career trajectories, research engagement, and barriers to physician-scientist retention in academic research careers. We performed an anonymous, structured, web-based survey of 700 ABIM RP current and former trainees (2011-2022). We received 105 survey responses (97 RP graduates). The survey queried about demographics, training background, career outcomes, research involvement, and perceived barriers to retention in physician-scientist careers. Responses were stratified by trainee status, gender, and Medical Scientist Training Program (MSTP) participation, and select results were compared to test for statistical associations. Most respondents (79%) remained in academia, with 61% engaged in research-dominant roles. More MSTP graduates held research-focused academic positions than non-MSTP graduates. The most commonly reported barriers to sustaining research careers were funding instability, financial concerns, and lack of protected research time. Although many of the trainees in the ABIM RP who completed the survey remained in academia, systemic barriers such as funding instability and gaps in institutional support persist. Strategies to enhance financial stability, protected research time, and mentorship appear to be necessary to enhance physician-scientist career retention.