Numerous mechanisms exist to pursue a career as a physician scientist during medical school,. including MD/PhD training, residency (i.e., combined residency/fellowship research pathways), and fellowship (i.e., fellowship research pathways). Thus, it is critical to discuss available options and funding sources with a program director(s) and division leadership to see what options are available at various institutions. While there are many possible pathways to a career as a physician scientist, the ASH Trainee Council has developed a rough career-development timeline for MD or MD/PhD trainees interested in research-oriented careers in hematology based on established "Research Pathways" established by the American Board of Internal Medicine (ABIM) and American Board of Pediatrics (ABP). Generally, applicants are considered prior to starting residency or during their first post-graduate year (i.e., internship).

• Communicate with your mentor/mentorship committee
• Present your research as early and as often as possible
• Become increasingly independent

Residency Training (Year 1-2)

• Build your clinical foundation, develop research plan

General Fellowship Training (Year 3+)

• Focus on clinic
• Seek physician scientist mentors

Clinical Fellowship Training

• Hone clinical skills
• Research Fellowship Training
• Develop research plan (with mentor)
• Publish
• Obtain grant support
• Transitioning from Fellowship Training
• Start job search early
• Present your research (talks, meeting abstracts)

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Throughout Your Training:

• Establish a mentorship committee (3-4 faculty including your primary research mentor) early in your training and meet with them several times a year to review plans, progress, career goals, timeline.
• Meet with your program director(s) and division chief regularly (>2 times per year). They can help to ensure you make good progress in training. Along with your mentorship committee, they can also help create a career development plan as you plan your transition toward a junior faculty position.
• Attend a mix of clinical and research conferences throughout your trainingto continue to keep up with clinical skills and hone your research interests.
• Attend at least one national or international research meeting each year of training, such as theASH annual meeting. This provides an excellent venue to explore the latest research in your area of interest and network with peers and experts in your field(s) of interest.TheASH Calendar of Eventsis a good resource for identifying potential conferences.

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Residency Training (PGY 1 & 2):

• Be sure to meet with your residency and fellowship program directors early and often to ensure that you fulfill all requirements for ABIM or ABP Research Pathways.
• Develop strong clinical skills. Part of being a good specialist is having a strong foundation in clinical medicine.
• Meet with potential research mentors early. When possible talk with current and/or past trainees to get an idea about mentorship style. Review publication record to assess productivity of lab and past fellows. Ask about funding sources that support the lab and trainees. Be sure to prepare a list of questions to ask potential mentors ahead of time. Discuss your ideas with your program director(s). Select a primary research mentor as early as possible during your training (i.e. prior to starting fellowship or shortly thereafter).
• Meet with your primary research mentor often (every 1-2 months) during clinical residency and fellowship training to discuss potential projects and start laying the groundwork for your research. Attend lab meetings and relevant research seminars as possible. Develop a plan to transition into your protected research time to maximize productivity.
• Consider establishing a clinical or lab-based project to during residency. Present your data at meetings (i.e. ASH Annual Meeting), and/or carry this project forward to fellowship.
• Attend the ASH Annual Meeting in December of years 1 & 2 if possible, and visit the ASH trainee website frequently.

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General Fellowship Training (PGY 3+)

• Become a member of ASH to take advantage of invaluable trainee resources including member-only training grants and programs. Applications for Associate membership are processed throughout the year.
• Discuss the breakdown of clinical and research training at your institution, and how much protected research you can expect. It is nice to have something in writing in case the leadership in your division changes during your training.
• Seek out physician scientists at various stages of career development in your department and division to serve as role models and mentors. It can be quite helpful to have someone to talk to that does not have a direct stake in your training.
• Anticipate requisite regulatory steps to initiate your research project (i.e. HIPPA, ethics, responsible conduct or research, animal use, radiation and lab safety training, animal protocols, IRB approval). Work on getting these out of the way early. Many may be able to be completed on-line on your own time.

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Clinical Fellowship Training

• Continue to hone your clinical skills. Attend and present at clinical conferences and tumor boards. Expand your knowledge base through clinical conferences your fellowship core curriculum.
• Use your half-day per week of required continuity clinic to continue to develop a broad clinical knowledge base.
• Use your clinical experiences and knowledge to develop clinically relevant research questions.
• Consider spending time in clinic with experts in your area of research.

Research Fellowship Training

• Discuss your research plans early with your primary mentor and mentorship committee. Consider balancing a safer short-term project that might yield abstracts and publications in the first year with more risky longer term project(s) that may yield more transformative findings down the line. Try to publish findings along the way. Having a few projects going helps to ensure that something is working, and that you generate data for abstracts, publications, and grants.
• Explicitly discuss your research plans and goals for mentored and independent funding with your primary research mentor. In particular, what portions of your work you can take with you to launch an independent research career.
• Attend the ASH Annual Meeting in December, network with leaders in your field, establish collaborations, and present your research.
• Consider including mentors from outside your institution on your mentoring committee.
• Meet with you mentoring committee at least twice yearly. Review your research progress and goals. Use this as an opportunity to refocus or redirect your project(s). Propose where and when you plan to publish your research.
• Publish your research in high-impact, peer-reviewed journals. Consider helping with reviews and book chapters if the opportunity arises, but do not let this detract from you primary research project.
• Visit the ASH trainee website frequently, and consider applying for trainee awards such as the ASH Research Training Award for Fellows (RTAF) ASH Clinical Research Training Institute (CRTI), EHA-ASH Translational Research Training in Hematology (TRTH), as well as awards from ASCO and AACR.
• Take a course of workshop on grant writing. Consider applying for training support during fellowship even if you have an institutionally funded position. An individual training grant provides excellent practice and looks good on your CV.
• Attend the Career Development Activities at the ASH Annual Meeting.
• As your research matures - Identify and apply for grant opportunities. Strongly consider a mentored research award or transitional research award from the NIH (K series, K99/R00). Review requirements and application with your mentors and past-award recipients. Make sure to balance the research plan with a strong career development plan. Visit the ASH Grants Clearinghouse for additional funding opportunities available to trainees and helpful tips. Visit the Grants & Funding section on the Training Page of the ASH web site for additional resources on trainee grant opportunities.

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Transitioning from Fellowship Training

• As you start your job search - take advantage of research contacts and collaborators, division chiefs, program director(s). Visit the ASH Job Center, and "How to Write a Resume, Curriculum Vitae, and Cover Letter" from the American College of Physicians. Review the classifieds in high-ranking journals.
• Even if your preference is to stay at the same institution, seriously consider looking elsewhere. You never know what might be out there.
• If you decide to stay at the same institution, discuss how you will establish independence from your primary research mentor. Establish an ongoing mentoring committee. Devise a plan for funding and publications that do not involve your fellowship research mentor.
• Strive to give talks at other institutions and present abstracts at meetings. Use discussions about your work to explore the potential for a position at other institutions.

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