Letters to the Editor
To the Editor: We read the report by Lipner et al1 with great interest. The report is significant in highlighting that, at least for exceptional physicians, an alternative specialized approach to residency training that follows a short-track research pathway and reduces clinical training to two years is possible without sacrificing patient care or clinical judgment.
We maintain that for some physicians, a “short-track” specialized pathway could streamline graduate education, give earlier exposure of areas of interest to trainees, and lessen concerns regarding length of training. More important, we feel that specialized pathways in graduate medical education have the potential to stem the increasing tide of physician burnout.2 Indeed, a recent study found that as many as one in two physicians have symptoms of burnout.2
While calls have been made for policy makers and health care organizations to make changes addressing burnout, the role of graduate medical education remains largely unexplored; more research is needed. Even so, it seems clear that since physicians who spend more time in their most meaningful area (i.e., clinical care, education, or research) have been shown to experience significantly less burnout,3 early specialization makes particular sense. Alternative pathways in those three areas could not only give trainees a head start in focusing on the specific areas of medicine they are most passionate about but also increase the likelihood for them to maintain a successful career in their chosen area.
Tarak S. Shah
Fourth-year medical student, American University of Antigua College of Medicine, New York, New York.
Aibek E. Mirrakhimov, MD
Resident, Saint Joseph Hospital, Department of Internal Medicine, Chicago, Illinois.
Shawn G. Kwatra, MD
Resident, Saint Joseph Hospital, Department of Internal Medicine, Chicago, Illinois; firstname.lastname@example.org.
1. Lipner RS, Lelieveld C, Holmboe ES. Performance of physicians trained through the research pathway in internal medicine. Acad Med. 2012;87:1594–1599
2. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work–life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:1377–1385
3. Shanafelt TD, West CP, Sloan JA, et al. Career fit and burnout among academic faculty. Arch Intern Med. 2009;169:990–995