Terence P. Gade, MD, PhD, is the co-director of the Penn Research Track Radiology Residency at The University of Pennsylvania, together with David Mankoff, MD, PhD, and Misun Hwan, MD, MSTR. The Research Track Residency pathway recently received funding from the National Institutes of Health (NIH) enabling the program to expand its support of clinician scientist training to the IR/DR program. IRQ spoke with Dr. Gade about the program, the impact of funding and why clinician science is crucial for the future of IR.
Can you tell us about the Radiology Research Track Residency at Penn, and how it differs from your traditional training programs?
Terence P. Gade, MD, PhD
Terence P. Gade, MD, PhD: We have three tracks at the University of Pennsylvania: the diagnostic radiology track, the research track and the IR/DR track. The Radiology Research Track Residency, at Penn and other institutions, is a separate match from other radiology residency tracks and is a formal Physician Scientist Training Program recognized by the AAMC. In our research track, additional research time is built into the first 3 years of training, and after the third year, residents pursue a dedicated year of research in which they have 82% protected time to pursue their research. They are also guaranteed their fellowship. So, if you were a research track resident who wanted to go into neuroradiology, for example, your fellowship would be guaranteed. After you finish the research year, you would go straight into fellowship with additional research time in those subsequent years to ensure completion of the work while developing grants to support applications for faculty positions. Pursuing a fellowship at Penn is not a requirement of the research track of courser. If the resident opts not do that, then we work with them at their new institution to make sure they can continue their research.
Why is it important to have a dedicated research pathway?
TG: The research track allows the residents to develop their research to a degree that's not often possible in the context of regular clinical training. Given that IR is built on pioneering cutting-edge science, it’s important that our residents grow into clinician scientists who are capable of delivering on that mission. Having research training built into residency allows trainees to develop their skills as a researcher and develop a research niche early so that they can be positioned for success as an independent investigator.
Congratulations on receiving the NIH funding. That must have been very exciting for you and your team.
TG: We were thrilled. Given the current funding environment, we didn't anticipate that we would be awarded an expansion of the program to include a dedicated IR position. We had applied for it before, and did not receive it so this award was especially exciting and gratifying.
What do you think made the difference in receiving funding for this cycle, as opposed to in the past?
TG: Our institution believed in this initiative and supported a forerunner of the program which strengthened this most recent application. At the time of applying, we had a research track resident who had already gone through and successfully completed it. I believe it was helpful to show that despite not getting the extra funding, we had implemented the program and demonstrated the potential of the program to deliver on the mission of producing clinician scientists in IR—and in the meantime, we matched an additional resident directly into that spot. So, the program was bearing fruit.
We also received a letter of support from SIR Foundation that underscored the importance of this need and demonstrated the society’s commitment to the development of research. All of our residents apply for SIR Foundation grants and seek to get involved in SIR Foundation programs, and I think that letter was instrumental in demonstrating to the reviewers that there is a community and need for this which is supported by professional societies.
How will NIH funding expand the opportunities available in the track?
TG: Previously, the research residency track was sort of agnostic to specialty, meaning that we matched based on our own evaluations. We weren’t focused on bringing in an IR or anyone with a specific focus. With the NIH funding, which will last for 5 years and hopefully longer, we are now able to bring in a candidate each year will pursue this new IR-DR research track.
Additionally, if we continue to be successful and there’s strong enough interest, we could possibly expand to include additional IR/DR track slots that will allow us to increase the cohort further.
What kind of research projects have come out of this pathway so far?
TG: Our first resident, Brian Park, MD, is currently an attending at the Dotter Institute at Oregon State, and his projects focused on the development of mixed reality in interventional radiology. These projects explored how to co-register cross-sectional imaging to image-guided interventions, but also to enable direct tumor targeting using these mixed and augmented reality platforms.
The other resident was Jamaal Benjamin, MD, PhD, who is currently an attending at UT Southwestern, and his research focused on the metabolic stress response in hepatocellular carcinoma and how we can characterize that stress response in the context of locoregional therapies leverage this information to develop novel therapies.
Do you have any recommendations or advice for other programs looking to introduce a research track to their training?
TG: It’s certainly a team effort to create the infrastructure within your institution and advocate for this pathway. There are several institutions with research tracks that have the infrastructure to expand their programs similarly, and there’s a huge opportunity for prospective programs to hire and work with leadership from those institutions to help build out new programs. It not only helps increase the number of slots available for residents, but it also showcases a general need in IR to develop clinician scientists.
IR science is distinct in many ways from DR science; we’re thinking a lot more about therapies and fundamental biology, in addition to imaging physics. So, creating a research track is really an opportunity to enrich the research environment at your institution, and that can be part of the case presented when engaging with leadership.
The other step I’d recommend is engaging with the NIH and the National Institute of Biomedical Imaging and Bioengineering—who have been so instrumental in developing these programs—to get their perspectives, and hopefully support, around the need to continue funding research training in IR.
Is there anything else you’d like to share with the IR community?
TG: IR science is important, and I believe the NIH recognizes how crucial it is to have scientists in our field to advance science and improve clinical care. We have so much talent coming into IR right now, and so much enthusiasm from trainees who have significant research backgrounds or who have a passion for research and a desire to learn. This is an important moment in the history of IR, and we have an opportunity to leverage that talent by helping grow and support it through programs like this.
Through the collaborative development of this research track residency with our IR/DR program director, Susan Shamimi-Noori, MD, this program offers the highest levels of clinical and research training. We are excited to develop this program further and would encourage interested candidates to reach out to learn more.
