While I was in residency training, my chairman (in the Department of Pediatrics), co-authored the Institute of Medicine's report titled “Research Training in Psychiatry: Strategies for Reform” (1). Although I had some cursory basic science research experience in college, I did not engage in research during medical school, and was doubtful I would have the time to do research during my residency. I was applying for a triple board program in Pediatrics, Psychiatry, and Child and Adolescent Psychiatry, and from the moment I met my chairman, he encouraged me to consider pursuing a career in academic medicine. The dean of my medical school also envisioned this potential in my future, suggesting that there might be some early predictors for eventual choice of an academic career.

When I embarked on my residency, I was faced with the practical challenge of how to incorporate research into my clinical training. I would have to identify a mentor in an area of research that interested me, get some training in how to conduct research, learn how to write scientifically, attend scientific meetings where I was able to present my research findings, and find ways to financially support the questions I wanted to research. All of these compulsory steps seemed impossible, particularly for someone trying to gain clinical competency in not one but three subspecialties. Intern year was about getting used to being called “Doctor” while working like a dog. Nevertheless, it fueled my passion for finding an evidence-base for everything. During my second year, I “scoped out” potential mentors, many who, like me, were skeptical that I would accomplish anything related to research during my residency training, much less get published. With some persistence, I convinced one faculty member who was already rapidly climbing the academic ladder to take me under her wing. I wrote reviews and original articles with her, and when I recognized that a more in-depth foundation in research methodology was needed, I pursued a Masters of Science in Clinical Research Design and Statistical Analysis.

This program provided me with state-of-the-art training in research design and analysis during the last 2 years of my residency while I maintained my clinical and administrative responsibilities as a chief resident. By the end of residency, I had published 10 articles based on my mentor's archival data and was eager to submit grants to fund my own research. Looking ahead, I wanted the research I was doing “extracurricularly” to be the “main course,” rather than just “dessert.”

This issue of Academic Psychiatry features an article exploring factors that have influenced motivation to conduct research among senior residents in psychiatry (2). Using a survey method, senior residents across 16 large (10-or-more residents/class) psychiatry residency programs were asked to report on their interest level in research, give demographic information, and report on research experiences and factors influencing their motivation to do research. After dividing residents into three groups with High (N=37), Moderate (N=37), or Low (N=53) stated interest in research, comparisons among these groups suggested that residents in the High-Interest group differed in their research-intense post-residency plans and had greater tendency to have graduate degrees than did Low- and Moderate-Interest groups. Individuals in the High-Interest group expressed an interest in research well before residency, and, although a majority of residents had exposure to research in college, research involvement diverged on the basis of level of interest. The High-Interest group was composed mostly of men and had lower debt than those with less interest. This latter finding may be associated with graduate education, including medical school, being paid for by combined M.D.-Ph.D. programs. The article concluded that, for most residents, the decision on whether or not to pursue a research career is reached before the beginning of residency, and few residents with less than very high interest pursue research tracks. Thus, the best way to increase recruitment into research is to identify individuals with high interest very early in their careers, to eradicate barriers for women to pursue research, and to provide adequate financial support to talented young investigators.

There are many practical hurdles for inspiring young psychiatrists to choose a research career. The survey-based data may suggest that residency may not be the place to recruit clinician-researchers on the basis of motivation alone. However, depending on a resident's experience, it might be an excellent launching pad for an academic career. I am grateful that my residency-training program supported me wholeheartedly with a “can-do” attitude to cultivate my interests and made it financially feasible to engage in research activities. Along the way, I discovered several mechanisms that relieved my debt burden, including the National Institute of Health's Loan Repayment Program, which gave me an incentive to continue pursuing a research career after residency. It also helped that my mentor was an exceptional role-model and showed me how feasible it was to be a successful woman in science.

Resolving these practical issues is key to a successful research career, along with zeal and creative time-management. Silberman et al. (2) identified an important limitation in their study, in that they only surveyed senior psychiatry residents. Their study raises the important issue that it is not sufficient to simply recruit highly motivated individuals into an academic career in psychiatry and that retention of physician-researchers may be equally important. Besides attracting and developing early-career academic psychiatrists into general and specialized psychiatric research, to retain highly motivated physician-researchers in the field, there needs to be adequate mentoring and career-development resources (3), especially during the vulnerable period of transition from training to independent research funding. Psychiatry departments should consider incorporating successful research benchmarks and mentorship into calculations for salaries, bonuses, or bridge-funding to encourage these activities and to lessen the “cost” of mentoring (4). Faculty-development programs, such as “boot camps,” could help outline institutional expectations for promotion, and departments should strive for equal pay-lines for men and women (5). All of these strategies could aid in promoting retention of promising young investigators in academic medicine.

Toward the end of my fifth and final year of residency training, I toiled about the choice between a postdoctoral research fellowship and taking a junior faculty position. I reasoned that advanced research training would enable me to delay the onset of my “academic clock” for a couple of years and protect my time fully to collect some pilot data and publish additional articles, both of which would strengthen my application for independent funding. It would also simulate the kind of work–life balance that a career in academic medicine entails, solidifying my commitment to such a pathway. There are even data to support the idea that that my survival in academics would be higher with more than 2 years of research training or with affiliation with a major research institution (6). I applied for loan repayment to soften the blow of a continued low income after residency, but after having already putting in 5 years, could I tolerate another 2? I sought advice once again from my chairman, who gave me the perspective that a couple of years in training was a “drop in the bucket” in terms of time and income lost, but may be the critical next step to launching my research career. It turns out he was right.