Molecular, cytogenetics, proteomics, telepathology, optical imaging, etc... Do you think residency programs today are teaching us what we need to know tomorrow? In many of the national pathology venues, the changes the future holds for our practice has become a huge topic for debate and concern. But are these same concerns being relayed to you in residency training? Do you think that pathologists will always be able to survive by simply "pushing glass"? What about those already in practice, will they be able to adapt?
I am currently a junior committee member of the CAP's Professional Affairs Committee, one of the venues in which this topic is being discussed. Additionally, at the recent CAP Resident's Forum held on March 24th, the CAP president Dr. Sodeman spoke to us about the need to prepare for these advances and take control of them. So I am interested to hear about how you view the future. Do you feel that your residency program offers the appropriate insight and education you need to succeed in the future? What ideas or suggestions do you have to help educate our colleagues, both in and out of residency?
Please feel free to reply on the blog with questions, ideas, additional concerns or email me at cardod@pathology.ufl.edu. And for additional comments, please read Dr. Coco's entry "Comments on the Future of Pathology."
Thank you!
Tuesday, April 3, 2007
Friday, February 23, 2007
Does the Fellowship Application Process Work?
This is an article that I wrote for the ASCP, featured in Pathology Today. I am republishing it on this blog space in hope of getting your input with the permission of the American Society of Clinical Pathology. It can also be found at http://www.ascp.org/AboutUs/Newsroom/pathologytodaynews.aspx
Does the Fellowship Application Process Work?
Spring has arrived and the end of the academic year is in sight. For many, this time of the year will bring a heightened level of anxiety about their professional future. For seniors, the reality of starting a career nears. Boards are only months away and contracts for fellowships and jobs have been signed (we hope). For juniors, it's the time to start thinking about fellowships. Yes, even if you feel like it is too early, it's probably not. Much anxiety about our career paths is now displaced down the resident hierarchy to junior residents - they are the ones now forced to make lasting career decisions which have traditionally been made later in training. The primary reason for this is the advancement of application deadlines and interviews for fellowships by one year because of the change in our length of training. In the five-year training program of the past, a decision to do a fellowship could be postponed until the third or even fourth year of training. Now, residents who are in a four-year AP/CP program begin making that decision at the end of their second year. Because of this, residents have to begin thinking about fellowships very early in their training with only a year's worth of experience. Most agree that this is very difficult given the little exposure that pathology receives in the final two years of medical school and the limited exposure that residents get to pathology subspecialties in
the first year of training. This problem will likely be compounded by a higher level of competition for fellowship positions. In the past three years, we have witnessed a steady increase in the percentage of residents seeking fellowship training, and there has been an increase in the number of graduating residents per year (see my January column). Because of this, many residents now feel that they have to apply to multiple programs to increase their chances of getting a position. Unfortunately, this creates a problem. Individual programs have customized schedules for interviewing and selecting residents for their fellowship positions. There is no centralized or monitored application process like the National Residency Match Program (NRMP). Therefore, a considerable amount of variation exists in the timing of application deadlines and interview dates among programs. This creates an environment which ultimately rewards programs who interview early and, more importantly, limits resident options. For example, a resident may apply to two programs that have significantly differing interview schedules (let's say 2 months apart). After the resident interviews with Program A, he or she may be offered a position and asked to give a final decision within a reasonable time frame (2-4 weeks). This is great, right? Well, not quite. Unfortunately, their next interview (with Program B) is not for another two months, forcing them to either take the fellowship position with Program A without interviewing at Program B or declining the position at Program A and hoping that Program B offers them a position. I'd bet most residents would choose the former of the two options. Therefore, the program that interviews later is indirectly penalized, creating an incentive to begin the interview process earlier.
Intuitively, it is best for residents and programs to delay the fellowship decision to allow residents a better opportunity to learn more about pathology. Counterintuitively, we have shortened this time frame. To rectify this, changes will need to be made to the application and interview process. It's obvious that we cannot change the length of pathology training (at least not immediately); therefore, efforts should be made to remove the incentive for programs to interview early. The direction of this effort needs to be openly discussed between the parties involved: residents and programs. Could we or should we convert to a 'match' system? Are there other ways to provide structure to the interview
process as a whole? This will be a subject that your ASCP Resident Council will address within the next couple of months. I need to hear your opinions and learn more about your experience with the fellowship application process. We are your voice. Collectively, we can find a solution.
Does the Fellowship Application Process Work?
Spring has arrived and the end of the academic year is in sight. For many, this time of the year will bring a heightened level of anxiety about their professional future. For seniors, the reality of starting a career nears. Boards are only months away and contracts for fellowships and jobs have been signed (we hope). For juniors, it's the time to start thinking about fellowships. Yes, even if you feel like it is too early, it's probably not. Much anxiety about our career paths is now displaced down the resident hierarchy to junior residents - they are the ones now forced to make lasting career decisions which have traditionally been made later in training. The primary reason for this is the advancement of application deadlines and interviews for fellowships by one year because of the change in our length of training. In the five-year training program of the past, a decision to do a fellowship could be postponed until the third or even fourth year of training. Now, residents who are in a four-year AP/CP program begin making that decision at the end of their second year. Because of this, residents have to begin thinking about fellowships very early in their training with only a year's worth of experience. Most agree that this is very difficult given the little exposure that pathology receives in the final two years of medical school and the limited exposure that residents get to pathology subspecialties in
the first year of training. This problem will likely be compounded by a higher level of competition for fellowship positions. In the past three years, we have witnessed a steady increase in the percentage of residents seeking fellowship training, and there has been an increase in the number of graduating residents per year (see my January column). Because of this, many residents now feel that they have to apply to multiple programs to increase their chances of getting a position. Unfortunately, this creates a problem. Individual programs have customized schedules for interviewing and selecting residents for their fellowship positions. There is no centralized or monitored application process like the National Residency Match Program (NRMP). Therefore, a considerable amount of variation exists in the timing of application deadlines and interview dates among programs. This creates an environment which ultimately rewards programs who interview early and, more importantly, limits resident options. For example, a resident may apply to two programs that have significantly differing interview schedules (let's say 2 months apart). After the resident interviews with Program A, he or she may be offered a position and asked to give a final decision within a reasonable time frame (2-4 weeks). This is great, right? Well, not quite. Unfortunately, their next interview (with Program B) is not for another two months, forcing them to either take the fellowship position with Program A without interviewing at Program B or declining the position at Program A and hoping that Program B offers them a position. I'd bet most residents would choose the former of the two options. Therefore, the program that interviews later is indirectly penalized, creating an incentive to begin the interview process earlier.
Intuitively, it is best for residents and programs to delay the fellowship decision to allow residents a better opportunity to learn more about pathology. Counterintuitively, we have shortened this time frame. To rectify this, changes will need to be made to the application and interview process. It's obvious that we cannot change the length of pathology training (at least not immediately); therefore, efforts should be made to remove the incentive for programs to interview early. The direction of this effort needs to be openly discussed between the parties involved: residents and programs. Could we or should we convert to a 'match' system? Are there other ways to provide structure to the interview
process as a whole? This will be a subject that your ASCP Resident Council will address within the next couple of months. I need to hear your opinions and learn more about your experience with the fellowship application process. We are your voice. Collectively, we can find a solution.
Will I Have A Job When I Finish My Residency?
This is an article that I wrote for the ASCP, featured in Pathology Today. I am republishing it on this blog space in hope of getting your input with the permission of the American Society of Clinical Pathology. It can also be found at http://www.ascp.org/AboutUs/Newsroom/pathologytodaynews.aspx
Will I Have A Job When I Finish My Residency?
What pathology resident doesn’t have that question on their mind? I’ll bet not many. It’s only natural to look forward to the start of your professional career. Many of our non-physician friends – even those with post-graduate education – have been in the workplace for years now. (I’ll also bet that they keep asking you the same question they ask me:"So when are you going to finish?" During the holidays, I ran into a high school friend who informed me that he had been practicing law for seven years. I nearly dropped my eggnog.) So, yes, I am a little anxious about the Pathology job market. In an attempt to ease this anxiety, I turned to the ASCP Resident Job Market Survey to give me some insight. Here is what I learned. [You’ll find the complete report in the News section at this link: http://www.ascp.org/MyAscp/ForResidents.aspx]
Significance of the 2006 ASCP Resident Job Market Survey
For 10 years the ASCP Resident Job Market Survey has been providing graduating residents with data about job availability by geographic location, practice type, salary, and lately, the expanding fellowship market. This year’s survey was different from the others for two reasons: 1. There were two graduating classes of residents entering the job/fellowship market – a result of the American Board of Pathology’s decision to shorten residency training. 2. For the first time, the Job Market Survey was attached to the ASCP Resident In-Service Exam (RISE).That meant that the survey statistics are based on virtually 100 percent participation of the graduating residents.
Residents, Fellows, and Jobs
According to the 2006 Job Survey, 278 (37%) of the 742 respondents finishing their residency had applied for a job.Of those, 71% had interviewed for 1-3 jobs, 9% had interviewed for 4-6 jobs, and 3% had interviewed for greater than 6 jobs.The remainder (17%) had not yet interviewed. Eighty-five percent of those who had interviewed were offered at least one job; 50% of those were offered more than one job. These percentages are very similar to those from previous years. Surprised? I was, considering that last year was exceptional in terms of the number of graduating residents.Then I realized why the numbers had probably not dropped.Again, there were two reasons: 1. There has been a rapid increase in the number of non-ACGME-accredited fellowships. 2. Almost half of the accredited fellowship positions were not being filled prior to 2005.This provided significant room in the fellowship market to absorb the extra "graduating" class of residents.
Fellowships
According to the ASCP Survey, 638 of the respondents were finishing their residency training (PGY-4 or PGY-5); 702 respondents (PGY-3 and higher) indicated that they had applied for a fellowship within that year. Of the graduating residents, 174 (excluding fellows) had applied for a job. Assuming that those who applied for a fellowship did not apply for a job, approximately 464 (73%) of the graduating residents chose to apply for a fellowship position.
What Effect Will This Have on the Workforce?
Using these numbers, I speculate that there are approximately 450 fellows in Anatomical and Clinical Pathology this academic year in both ACGME accredited and non-accredited fellowship programs. It is difficult to compare this number to previous years because no one is keeping track of the non-ACGME-accredited programs, but I think that we are safe in making the assumption that there are more fellows now than ever before and thus, more fellows applying for jobs next year than in any year previously. Suffice it to say, getting a job without a fellowship will be much harder in the future. That was confirmed during the Resident Luncheon at the ASCP Annual Meeting in Las Vegas last October by pathologists from the private and public sector who participated in the "How To Get a Job" panel for residents.The underlying message was, as I’ve said, that fellowships are becoming more important in securing a job in pathology. In essence, the fellowship year is taking the place of the 5th "credentialing year" that was recently dropped from residency training. Determining how these changing dynamics in the profession will affect the overall workforce is tricky. In general, you might think that it would not disrupt the number of jobs available as long as you complete a fellowship but there is one caveat.To my knowledge, most programs have not decreased their total resident number in response to the change in the length of residency training. On the contrary, they have increased the
number of residents per year to compensate. For example, if your program has 20 ACGMEfunded residency spots, it probably switched from having 4 residents per year (4 residents × 5 years = 20) to having 5 residents per year (5 residents × 4years = 20). Therefore, your program is graduating one extra resident per year, which ultimately increases the total graduating rate by 20%.The ASCP Resident Job Market Survey actually confirms this increase. If you compare the total number of PGY3s who took the Survey to the combined total number of PGY4s and PGY5s, the numbers are almost equivalent. How this increase will affect the job market is difficult to predict.To my knowledge, a comprehensive workforce analysis has not been performed in recent years. Gathering demographic information from current practicing pathologists would give us more insight.
Conclusion
It appears that shortening residency training has resulted in:
1. More residents entering a fellowship which, in turn, has greatly increased the competition for fellowships and the demand for fellowship training by future employers.
2. Residency programs increasing their number of residents per year, raising the number of graduating residents by 20%.
Both of these conditions will impact the job market. Getting a job without a fellowship will be much harder in the future, and the increase in graduating residents will likely make the job market more competitive.To what degree the market will be affected will remain largely unknown until a comprehensive workforce analysis is performed.
Will I Have A Job When I Finish My Residency?
What pathology resident doesn’t have that question on their mind? I’ll bet not many. It’s only natural to look forward to the start of your professional career. Many of our non-physician friends – even those with post-graduate education – have been in the workplace for years now. (I’ll also bet that they keep asking you the same question they ask me:"So when are you going to finish?" During the holidays, I ran into a high school friend who informed me that he had been practicing law for seven years. I nearly dropped my eggnog.) So, yes, I am a little anxious about the Pathology job market. In an attempt to ease this anxiety, I turned to the ASCP Resident Job Market Survey to give me some insight. Here is what I learned. [You’ll find the complete report in the News section at this link: http://www.ascp.org/MyAscp/ForResidents.aspx]
Significance of the 2006 ASCP Resident Job Market Survey
For 10 years the ASCP Resident Job Market Survey has been providing graduating residents with data about job availability by geographic location, practice type, salary, and lately, the expanding fellowship market. This year’s survey was different from the others for two reasons: 1. There were two graduating classes of residents entering the job/fellowship market – a result of the American Board of Pathology’s decision to shorten residency training. 2. For the first time, the Job Market Survey was attached to the ASCP Resident In-Service Exam (RISE).That meant that the survey statistics are based on virtually 100 percent participation of the graduating residents.
Residents, Fellows, and Jobs
According to the 2006 Job Survey, 278 (37%) of the 742 respondents finishing their residency had applied for a job.Of those, 71% had interviewed for 1-3 jobs, 9% had interviewed for 4-6 jobs, and 3% had interviewed for greater than 6 jobs.The remainder (17%) had not yet interviewed. Eighty-five percent of those who had interviewed were offered at least one job; 50% of those were offered more than one job. These percentages are very similar to those from previous years. Surprised? I was, considering that last year was exceptional in terms of the number of graduating residents.Then I realized why the numbers had probably not dropped.Again, there were two reasons: 1. There has been a rapid increase in the number of non-ACGME-accredited fellowships. 2. Almost half of the accredited fellowship positions were not being filled prior to 2005.This provided significant room in the fellowship market to absorb the extra "graduating" class of residents.
Fellowships
According to the ASCP Survey, 638 of the respondents were finishing their residency training (PGY-4 or PGY-5); 702 respondents (PGY-3 and higher) indicated that they had applied for a fellowship within that year. Of the graduating residents, 174 (excluding fellows) had applied for a job. Assuming that those who applied for a fellowship did not apply for a job, approximately 464 (73%) of the graduating residents chose to apply for a fellowship position.
What Effect Will This Have on the Workforce?
Using these numbers, I speculate that there are approximately 450 fellows in Anatomical and Clinical Pathology this academic year in both ACGME accredited and non-accredited fellowship programs. It is difficult to compare this number to previous years because no one is keeping track of the non-ACGME-accredited programs, but I think that we are safe in making the assumption that there are more fellows now than ever before and thus, more fellows applying for jobs next year than in any year previously. Suffice it to say, getting a job without a fellowship will be much harder in the future. That was confirmed during the Resident Luncheon at the ASCP Annual Meeting in Las Vegas last October by pathologists from the private and public sector who participated in the "How To Get a Job" panel for residents.The underlying message was, as I’ve said, that fellowships are becoming more important in securing a job in pathology. In essence, the fellowship year is taking the place of the 5th "credentialing year" that was recently dropped from residency training. Determining how these changing dynamics in the profession will affect the overall workforce is tricky. In general, you might think that it would not disrupt the number of jobs available as long as you complete a fellowship but there is one caveat.To my knowledge, most programs have not decreased their total resident number in response to the change in the length of residency training. On the contrary, they have increased the
number of residents per year to compensate. For example, if your program has 20 ACGMEfunded residency spots, it probably switched from having 4 residents per year (4 residents × 5 years = 20) to having 5 residents per year (5 residents × 4years = 20). Therefore, your program is graduating one extra resident per year, which ultimately increases the total graduating rate by 20%.The ASCP Resident Job Market Survey actually confirms this increase. If you compare the total number of PGY3s who took the Survey to the combined total number of PGY4s and PGY5s, the numbers are almost equivalent. How this increase will affect the job market is difficult to predict.To my knowledge, a comprehensive workforce analysis has not been performed in recent years. Gathering demographic information from current practicing pathologists would give us more insight.
Conclusion
It appears that shortening residency training has resulted in:
1. More residents entering a fellowship which, in turn, has greatly increased the competition for fellowships and the demand for fellowship training by future employers.
2. Residency programs increasing their number of residents per year, raising the number of graduating residents by 20%.
Both of these conditions will impact the job market. Getting a job without a fellowship will be much harder in the future, and the increase in graduating residents will likely make the job market more competitive.To what degree the market will be affected will remain largely unknown until a comprehensive workforce analysis is performed.
Comments on the Future of Pathology
This is an article that I wrote for the ASCP, featured in Pathology Today. I am republishing it on this blog space in hope of getting your input with the permission of the American Society of Clinical Pathology. It can also be found at http://www.ascp.org/AboutUs/Newsroom/pathologytodaynews.aspx
In 2005,ASCP formed the Task Force on the Future of Pathology and Laboratory Medicine to assess the future of our profession, undoubtedly the subject in which we residents should have the greatest interest. After all, it is in the future where we will spend our professional careers as practicing pathologists.We’re all banking that the future and pathology will provide us with stable, rewarding careers. I am certain that there is a cornucopia of reasons why we chose to pursue careers in pathology. I do not pretend to know all – or even most – of them, but I’ll bet they share one common thread: our perception of the field is based on our relationships with practicing pathologists. By working, interacting, and talking with those in the profession, we have developed our own ideas and concepts about the scope of the profession. For this reason, I found that reading the Task Force report was a sobering experience. Why? The contention of the Task Force is that the current scope of pathology may have to change to maintain, not to mention enhance, its role in the healthcare system. Initially, this was difficult for me to accept because I have spent the last three years working hard to develop my skills in pathology based on my current expectations of the field. If the scope of our field and our practice were to change, does that mean the expectations, and ultimately our skill sets, also have to change? The answer is "Yes," we will face changes, but, fortunately not everything about this profession will change. Reading further, I realized the changes recommended by the Task Force were not radical to the fundamentals of our field and could be applied without making impractical leaps. Importantly, though, many of the recommended changes would ultimately require not only our willingness to adapt, but to play active roles in making the changes. In other words, as the future changes, it will be we – today’s resident pathologists – who will play a major role in creating that future. As with many specialties in healthcare, the Report states, the role of the pathologist is changing – and doing so faster than most because of globalization, the rapid development of molecular technology, and our relative isolation from direct patient contact.
Globalization
The Task Force suggests that globalization has increased economic competition in our profession
just as it has in every other segment of our world. Consolidation, regionalization and national laboratories are more of a reality than ever before. Furthermore, continuing advances in digital technology will likely make routine remote analysis of anatomic specimens a reality in the very near future.
Molecular Technology
The Report points out that there is an everexpanding role for the use of genetic analysis and
proteomics for prognostic and diagnostic purposes today than ever before – and this technology is still in its infancy.New molecular techniques have improved accuracy and cost of performance. Additionally, many clinical specialties have embraced this technology and are demanding access to it.While histologic morphology still comprises the backbone of our diagnostics, molecular
biology will likely play a bigger role in the future.
Isolation From Direct Patient Care
While there are always brilliant exceptions to the general perception that we are laboratorians rather than clinicians, the Task Force points out that that perception may be based on the unfortunate reality that many of the services we perform are perceived as commodities at a time when collegial interaction is at an all-time low.
Creating Our Own Future
It is our duty, as the next generation of pathologists, to understand these trends in healthcare and our world at large. Most importantly, however, it is imperative that we use this understanding to shape our profession by embracing these trends and actively being part of making the right changes to the profession for the right reasons. The risk of doing otherwise is unthinkable: if we wait and are forced to react rather than respond to the demands of our clinical colleagues, then we only increase the probability of losing their respect and being further marginalized. Along with defining the trends, some of which I have not mentioned here (i.e., patient safety and quality, medical informatics, and demographics), the ASCP Task Force has suggested changes that can be made to address these trends. A new Task Force with the same name has been convened to formulate a more definitive outline for possible changes to our profession’s scope. And that, too, is great news for residents because ASCP wants resident input to this process. Your Society recognizes very well that we are the future of this profession. I will be a participating member of this Task Force and I want – and need –to hear your comments, questions, and concerns regarding this topic.
In 2005,ASCP formed the Task Force on the Future of Pathology and Laboratory Medicine to assess the future of our profession, undoubtedly the subject in which we residents should have the greatest interest. After all, it is in the future where we will spend our professional careers as practicing pathologists.We’re all banking that the future and pathology will provide us with stable, rewarding careers. I am certain that there is a cornucopia of reasons why we chose to pursue careers in pathology. I do not pretend to know all – or even most – of them, but I’ll bet they share one common thread: our perception of the field is based on our relationships with practicing pathologists. By working, interacting, and talking with those in the profession, we have developed our own ideas and concepts about the scope of the profession. For this reason, I found that reading the Task Force report was a sobering experience. Why? The contention of the Task Force is that the current scope of pathology may have to change to maintain, not to mention enhance, its role in the healthcare system. Initially, this was difficult for me to accept because I have spent the last three years working hard to develop my skills in pathology based on my current expectations of the field. If the scope of our field and our practice were to change, does that mean the expectations, and ultimately our skill sets, also have to change? The answer is "Yes," we will face changes, but, fortunately not everything about this profession will change. Reading further, I realized the changes recommended by the Task Force were not radical to the fundamentals of our field and could be applied without making impractical leaps. Importantly, though, many of the recommended changes would ultimately require not only our willingness to adapt, but to play active roles in making the changes. In other words, as the future changes, it will be we – today’s resident pathologists – who will play a major role in creating that future. As with many specialties in healthcare, the Report states, the role of the pathologist is changing – and doing so faster than most because of globalization, the rapid development of molecular technology, and our relative isolation from direct patient contact.
Globalization
The Task Force suggests that globalization has increased economic competition in our profession
just as it has in every other segment of our world. Consolidation, regionalization and national laboratories are more of a reality than ever before. Furthermore, continuing advances in digital technology will likely make routine remote analysis of anatomic specimens a reality in the very near future.
Molecular Technology
The Report points out that there is an everexpanding role for the use of genetic analysis and
proteomics for prognostic and diagnostic purposes today than ever before – and this technology is still in its infancy.New molecular techniques have improved accuracy and cost of performance. Additionally, many clinical specialties have embraced this technology and are demanding access to it.While histologic morphology still comprises the backbone of our diagnostics, molecular
biology will likely play a bigger role in the future.
Isolation From Direct Patient Care
While there are always brilliant exceptions to the general perception that we are laboratorians rather than clinicians, the Task Force points out that that perception may be based on the unfortunate reality that many of the services we perform are perceived as commodities at a time when collegial interaction is at an all-time low.
Creating Our Own Future
It is our duty, as the next generation of pathologists, to understand these trends in healthcare and our world at large. Most importantly, however, it is imperative that we use this understanding to shape our profession by embracing these trends and actively being part of making the right changes to the profession for the right reasons. The risk of doing otherwise is unthinkable: if we wait and are forced to react rather than respond to the demands of our clinical colleagues, then we only increase the probability of losing their respect and being further marginalized. Along with defining the trends, some of which I have not mentioned here (i.e., patient safety and quality, medical informatics, and demographics), the ASCP Task Force has suggested changes that can be made to address these trends. A new Task Force with the same name has been convened to formulate a more definitive outline for possible changes to our profession’s scope. And that, too, is great news for residents because ASCP wants resident input to this process. Your Society recognizes very well that we are the future of this profession. I will be a participating member of this Task Force and I want – and need –to hear your comments, questions, and concerns regarding this topic.
Tuesday, February 20, 2007
When Do I Have Time To Do Research?
For many residents I bet that the word 'research' is always looming in the back of their minds. We are all expected, to some degree, to contribute to the academic literature during our short four years as a resident. But do we really have the time? Even though our programs stress the importance of getting involved in research projects, do they offer any protected time to ensure that we do quality work?
Currently at my program, we are given 10 research days that we can apply individually throughout the year during most rotations. It would be impossible to perform the research entirely (or even partly) during those 10 days, but it does allow for time to meet with my mentors periodically during the day (since it is almost impossible to set up a meeting in the evening or on the weekend when I am performing the bulk of my research). Some in my program, including myself, have used elective time for research also. We are allowed use a total of two months of elective time for research. But this is a major problem since our elective time has been severely truncated due to the shortening of the training.
I would like to hear from others concerning this topic. What does your program do to promote research? Are you allowed any time off? Is research mandatory?
Currently at my program, we are given 10 research days that we can apply individually throughout the year during most rotations. It would be impossible to perform the research entirely (or even partly) during those 10 days, but it does allow for time to meet with my mentors periodically during the day (since it is almost impossible to set up a meeting in the evening or on the weekend when I am performing the bulk of my research). Some in my program, including myself, have used elective time for research also. We are allowed use a total of two months of elective time for research. But this is a major problem since our elective time has been severely truncated due to the shortening of the training.
I would like to hear from others concerning this topic. What does your program do to promote research? Are you allowed any time off? Is research mandatory?
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