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An Introduction to Managing Programmatic Growth and Development in Academic Geriatrics
Environmental Challenges
Programmatic Challenges
Common Themes
Environmental Challenges
Fewer physicians are being recruited into academic medicine in general and geriatrics in particular. The 2008 Institute of Medicine report, Retooling for an Aging America: Building the HealthCare Workforce, leaves no doubt about this challenge: "As of 2007, there were 7,128 physicians certified in geriatric medicine and 1,596 certified in geriatric psychiatry. According to one estimate, by 2030 these numbers will have increased by less than 10 percent; others predict a net loss of these physicians because of a decreased interest in geriatric fellowships and the decreasing number of physicians who choose to recertify in geriatrics. According to the Alliance for Aging Research, by 2030 the United States will need about 36,000 geriatricians."
Contributing factors are many. Low physician reimbursement by Medicare (on average 8 percent less than managed care reimbursement), and the additional time needed to provide care for frail elderly patients have resulted in low salaries and other factors that discourage physicians-in-training from pursuing careers in geriatric medicine.
For those hardy individuals who make it through to academic geriatrics, challenges related to variable funding streams from the National Institutes of Health (NIH) and other federal, local, and private sources mean that CoE directors must piece together funding for geriatrics fellowships and other activities from a variety of sources.
Programmatic Challenges
Leaders of CoEs are challenged to build the capacity of junior faculty to become the teachers and researchers of tomorrow, to address the shortage of senior faculty, and increasingly, to expand geriatrics expertise beyond academic geriatrics programs. As champions of geriatrics training and research, program directors are looking closely at how they can optimize resources and embed sound management practices. Many are working to develop internal marketing strategies, and some have increasingly explored fundraising strategies for local support and beyond.
Common Themes
A few common themes, or key points, emerged from interviews with CoE directors around the country:
CoEs are innovative. Leaders have incorporated a range of novel approaches that successfully address challenges related to expanding academic geriatrics programs, managing training and research activities, and training subspecialties physicians in geriatrics.
Leadership and management skills are not taught in medical school. Most CoE directors have had to learn management skills and business-oriented strategies primarily on the job. Many of those interviewed credited leadership training received after completing their medical training for strengthening their management skills and stimulating them to think in new ways. That additional training, advice from peers, plus experience, have taught them to think strategically, a critical component of smart growth for their programs.
Geriatrics is Collaborative. In order to address the complexities of caring for older patients, clinical geriatrics is by necessity collaborative and multidisciplinary. Academic geriatrics is also collaboratively oriented with regard to aging-related research and expanding geriatrics training into other subspecialties and disciplines. Long before the NIH formally recognized a new roadmap for collaboration and cross-specialty and cross-disciplinary engagement, geriatrics “got it.” Leaders interviewed in this report include some who have found ways to simultaneously strengthen geriatrics and build bridges with other disciplines to expand resources and develop new approaches.
The personal connection is powerful. CoE directors frequently emphasized the importance of the mentoring they received as they were forging their careers, the support and role modeling they received for building their programs via on-site consultations with senior leaders, and their own satisfaction in mentoring others. Many advocated for broader programs for mentoring and consultation. For programs to thrive, leaders stressed building strong relationships with senior management, including keeping deans and other administrators up-to-date about successes and goals, but also asking how geriatrics could be helpful to them and the institution.
Build a diversified portfolio. CoEs are expanding the number and type of funding sources to ensure longer-term stability and growth.
With CoEs, one size does not fit all. In terms of the management strategies described in this report, not all "best practices" are easily transferable from one setting to another. This is due to differences in the programmatic focus; maturity of the program; size and interests of faculty; sources, kinds, and depth of resources for geriatrics; and a variety of institutional characteristics. Nevertheless, it is hoped that the views and information shared here can stimulate discussions and opportunities.
Collaborative Grant Review and Mentoring for Clinician-Researcher and Clinician-Educator Trainees
at Emory University/University of Alabama at Birmingham Southeast Center of Excellence in Geriatric Medicine
| SUMMARY |
| Target Audience Senior fellows and junior faculty physicians Purpose Program History Operating Costs Outcomes Available Materials For More Information Peter Bosworth, MBA |
Program Overview
Emory University and the University of Alabama at Birmingham (UAB) Schools of Medicine, which comprise the joint Southeast Center of Excellence in Geriatric Medicine, collaborate to provide a program of financial support and mentoring for the advanced training of senior fellows and junior faculty physician-scholars preparing for careers in geriatric medicine as clinician-researchers or clinician-educators.
The joint Center of Excellence (CoE) was developed to capitalize on the institutions’ geographic proximity, mutual areas of research expertise, and other synergies that enhance the capabilities of both institutions to serve the educational and research needs of future academic geriatricians. The joint CoE seeks to foster interdisciplinary and interinstitutional research programs that offer trainees access to a broader range of mentoring, training, and research opportunities than each institution could provide individually.
The goals of the joint program are to:
- provide salary support that gives scholars protected time for research or for clinician- educator training
- provide rigorous training in grant writing, research, and advanced level clinical education
- provide mentoring, oversight, and evaluation of a pilot research project for the duration of the grant project (and beyond, if requested).
The CoE provides funding for the following activities:
- Training Support Grants— one year of salary support of up to $50,000 plus benefits for senior geriatric medicine fellows (PGY 5 and 6) and physician junior faculty, to ensure at least 50% protected time for scholars to obtain research training or to obtain advanced level training in clinical education.
- Pilot Project Grants—up to $20,000 for scholars to conduct one-year pilot research projects that will yield preliminary data for scientific presentations, publications, and subsequent major grant proposals. Educational or quality improvement projects may be proposed by trainees pursuing careers as clinician- educators.
- Combination Grant Program—applicants for Training Support Grants may incorporate a pilot project into their application. Salary support for the trainee must be within the limits specified for Training Support Grants (50% FTE or $50,000 plus benefits). The Pilot Project Grant limit of $20,000 applies to the pilot project portion of the combination application. Expenses in this case are defined as everything except the trainee’s salary and benefits.
Program Operations
Potential applicants are recruited through university-wide funding announcements, fellowship recruitment, and ongoing promotion at the joint CoE quarterly research seminars held alternately at UAB and Emory. A research advisor is provided at each site to assist the applicant with formulating the research questions and developing a proposal utilizing a standardized format and process. Applicants are encouraged to utilize potential mentors at both sites during this initial process, to provide a greater range of perspectives and mentoring Up to four new scholars are accepted each year. Scholars with meritorious projects may be granted additional funding after the initial one-year period.
Applicants can request up to 50% of protected time by submitting a letter from their program director that provides assurance of protected time.
All proposals are reviewed by at least two selected reviewers from the alternate university and all members of the Joint CoE Steering Committee. Reviewer feedback is provided in a letter to each applicant and revised proposals are encouraged.
Once the research proposal is accepted, a joint mentoring committee is established for each scholar. Mentors are generally senior academic geriatricians or other faculty with a strong interest in aging who can provide professional development guidance. Each scholar selects a senior faculty member from Emory or UAB to serve as their primary mentor.
Quarterly progress reports to the Joint CoE Steering Committee are required of all scholars. Scholars are also expected to attend the joint CoE Quarterly Research Seminars and associated training (didactic and discussion groups) and social activities (joint scholar/mentor dinners prior to each quarterly session). The informal social interactions with senior faculty and potential mentors from both universities at the quarterly joint sessions provide a supportive environment for potential and current clinical fellows and scholars.
Staffing Requirements
The following personnel are needed:
- A Program Director and six faculty from Emory and UAB who sit on the Joint Steering Committee
- Partially funded (10-15% effort) Research Advisors
- Business Administrators at each site
- Curriculum/Evaluation Coordinators at each site
Program Costs and Funding Sources
The program is funded through the Hartford CoE grant, with matching funds from Emory and UAB. Estimated per year costs for the next cycle are: scholars’ salary support and Pilot Projects: $300,000–350,000; fellows recruitment: $35,000; leadership and mentors: $100,000; administration: $32,000; travel, conferences, etc.: $83,000.
Process and Outcomes Data
As of September 2008, the joint CoE has provided research opportunities and mentoring to over 65 geriatric medicine fellows and funding for 27 junior faculty scholars. To date, 20 of the junior faculty scholars are currently practicing in an academic setting and at least eight of these have developed their academic careers in geriatrics research.
Success is measured by career development, publications, presentations, intramural and extramural grants, and other related achievements of the Joint CoE scholars and other participants.
Implementation Lessons
- The joint CoE discovered within the first two years of operation that a research advisor was needed to assist in the initial proposal development process for both potential clinician-educators and clinician-researchers. Partially supported (10% effort) research advisors for each site were recruited from within the faculty of each university. The advisors continue to provide oversight to the ongoing research process as part of the Joint CoE Steering Committee.
- The continued support and mentorship from all joint CoE faculty and mentors are imperative at the earliest points in a fellow’s or junior faculty member’s research and/or clinical educator development.
- A collaborative program between two universities can improve the quality of the training through effective planning, partnering, and frequent communication. The joint CoE stays in touch daily by e-mail, meets monthly by conference calls, and meets quarterly for joint training sessions at the Quarterly Research Seminars.
Available Materials
Tools/Resources
Tools/Resources
- Joint CoE Homepage, which features an overview of the grant program, including proposal development process, review criteria and research areas www.aging.uab.edu/SubChannel/Training/scegm.aspx
For More Information
Carol Reis-Starr, PhD
Associate Director for Curriculum and Evaluation
Southeast CoE in Geriatric Medicine
Division of Geriatric Medicine and Gerontology
Emory University
1841 Clifton Rd #530
Atlanta, GA 30329
(404) 728-6570
creisst@emory.edu
or
Peter Bosworth, MBA
Associate Director for Administration
Southeast CoE in Geriatric Medicine
Division of Gerontology, Geriatrics, and Palliative Care
University of Alabama at Birmingham
201CH 19
Birmingham, AL 35294-2041
(205) 934-9261
PBosworth@aging.uab.edu
Interdisciplinary Academic Advancement Seminar for Junior Faculty Interested in Aging Research
at the David Geffen School of Medicine at the University of California, Los Angeles
| SUMMARY |
| Target Audience Junior faculty from various disciplines who are interested in aging research Purpose Program History Operating Costs Outcomes Available Materials For More Information |
Program Overview
The Academic Advancement Seminar was created to support the academic career development of junior faculty from various disciplines who are interested in aging research. The goal is to offer seminars that will help provide participants with progressive skills and prepare them for independence in research as well as academic leadership. The program is a forum for junior faculty from various disciplines to collaborate in and promote their aging-related research. The program also emphasizes skills for mentoring students and fellows.
Program Operations
Faculty from the UCLA Multicampus Program in Geriatric Medicine and Gerontology teach the one-hour, bimonthly seminars that focus on: Trainees may bring sections of their research proposals, manuscripts, or new study ideas for the group to review and discuss. Alternatively, a topic such as “How to Communicate with the Media” may be presented by a guest speaker or by one of the junior or senior faculty members. Relevant resources are distributed to the trainees at the seminars. Information on funding opportunities and seminars of interest to researchers in aging are also distributed via a listserv. Approximately 18-20 sessions are held every year. Course participation is mandatory, and attendance records are kept for trainees supported by research training grants. Other potential seminar participants who have expressed an interest in aging or have received aging research grants are identified at the start of each academic year by current and former trainees. In addition, throughout the year senior faculty identify and invite junior faculty with an interest in aging to participate. The seminar is enriched by involving participants from a variety of disciplines and by welcoming new participants, and thus new perspectives, throughout the year. Each seminar is moderated by a senior faculty member from the Multicampus Program in Geriatrics and Gerontology. Usually two or three senior faculty attend each session. A staff member assists by maintaining a listserv of attendees and a schedule of meetings and topics to be presented, and by copying and distributing materials as needed. Senior faculty time to teach the one-hour seminars is included as part of their ongoing teaching responsibilities. In addition, approximately one hour a week is required of a Division of Geriatrics administrative staff member. 41 junior faculty have participated in the seminar series since its inception. The program began in 2000 with 10 faculty members in geriatrics and has expanded so that in 2007-08 it included 31 faculty members in geriatrics, psychiatry, neurology, general internal medicine, endocrinology, oncology, rheumatology, emergency medicine, family medicine, public health, nursing, urology, and general surgery. Both formal and informal evaluations have been extremely positive and have guided modifications from year to year. In addition, many of the early participants have been promoted, and funded as principal investigators. Each year, the program has attracted trainees from new disciplines who are interested in issues of aging, which has helped to promote interdisciplinary collaboration within the institution. The seminar has been a model for other institutions, such as the University of Texas Medical Branch Pepper Center. Tools/Resources Alison A. Moore, MD, MPH
Staffing Requirements
Program Costs and Funding Sources
Process and Outcomes Data
Implementation Lessons
Available Materials
For More Information
Associate Professor of Medicine
Division of Geriatric Medicine
David Geffen School of Medicine at UCLA
10945 Le Conte Avenue, Suite 2339
Los Angeles, CA 90095
(310) 825-8253
aamoore@mednet.ucla.edu
Portfolio Structure for Fellows and Junior Faculty in the Academic Geriatrics Research Track
at the University of Pittsburgh School of Medicine
| SUMMARY |
| Target Audience Fellows and junior faculty from various health professions who are pursuing an academic geriatrics research track Purpose Program History Operating Costs Outcomes Available Materials For More Information |
Program Overview
This activity provides a structure for fellows and junior faculty who are pursuing academic geriatrics research careers to plan, implement, and evaluate their career goals, with the advice of mentors and a program coordinator.
Given the short supply of researchers in various aging-related fields, this activity aims to ensure the academic success of health professional trainees who are pursuing careers as researchers in these fields. Because these junior investigators need to have a diverse skill set and knowledge base, the structured portfolio was created to help trainees break out of the traditional mindset in which research careers start with a PhD, followed by years spent in a lab under one mentor, learning a predetermined set of skills.
Trainees develop a clear career and research plan that is an individualized roadmap to what they want to learn, and who and what will help them achieve success along the way. As they progress through their career, trainees add evidence—including abstracts and papers, and feedback from their biannual progress report—that goals are being met and progress is being made. These and other materials can subsequently assist each trainee in job searches, applying for research grants, and receiving academic promotions.
Program Operations
Trainees undergo an initial assessment of their research competencies using a format developed at the University of Wisconsin (see Clinical Research Appraisal Inventory in Available Materials). Trainees then follow a defined format for establishing and monitoring career goals, tracking mentor meetings, and reporting their progress. The trainee sets his or her own goals and markers of
success, with advice from a panel of program leaders and mentors from various health professions and divisions.
Every six months, the trainee presents his or her progress to the panel. During this session, the panel and trainee analyze the trainee's progress, and the trainee is able to give feedback on the panel’s and department's roles in advancing her or his career plan. Goals and plans are then modified as needed.
The portfolio structure is completely up to the trainee. Most trainees prefer to use a three-hole binder, but some have opted to use a digital format. The portfolio is mandatory only for the first year of full-time research, but many trainees maintain their portfolios long after the required period.
Staffing Requirements
A faculty member of the division of geriatrics serves as the program coordinator, and an administrative coordinator’s time is needed for sending out reminders for submission of biannual progress reports, scheduling portfolio review meetings, etc.
Program Costs and Funding Sources
The program coordinator and administrative coordinator require approximately 5% FTE each. The mentors' time is a part of their teaching responsibilities.
The program is funded by the Hartford Center of Excellence, the Pepper Center, and a National Institutes of Health T32 research training grant.
Process and Outcomes Data
Since 2003, 15 trainees have maintained their portfolio as part of the mandatory research training program, but many—including one alumnus who is now an Associate Professor—continue to utilize the structure throughout their careers.
Implementation Lessons
- One of the values of the portfolio approach is that everyone involved—trainees, teachers, mentors—agrees on the trainee’s goals and plans for meeting them.
- This shared plan facilitates collaboration between the entire team and helps to ensure that the trainees’ educational, research, and career objectives are met.
Available Materials
Tools/Resources
For More Information
Stephanie Studenski, MD, MPH
Professor, Department of Medicine
Division of Geriatric Medicine
University of Pittsburgh School of Medicine
3471 Fifth Avenue
Kaufmann Medical Building, Suite 500
Pittsburgh, PA 15213
(412) 692-2360
StudenskiS@dom.pitt.edu
Year-long Master Clinician Educator Program
at Mount Sinai School of Medicine
| SUMMARY |
| Target Audience Geriatrics fellows, chief residents, and junior faculty Purpose Program History Operating Costs Outcomes Available Materials For More Information |
Program Overview
In order to assure the highest quality of teaching in geriatrics among physician-training programs across the country, clinician-educators must possess significant pedagogic skills and a mastery of relevant content. The goal of the annual Master Clinician-Educator Program in Geriatrics is to produce expert geriatrics educators within geriatric medicine as well as within other disciplines.
In 2005, its pilot year, the program was offered exclusively to fellows enrolled in Mount Sinai’s geriatrics fellowship program. Starting in the 2005-06 academic year, the program was expanded to include selected Mount Sinai nongeriatrician chief residents and/or junior faculty in addition to geriatrics fellows.
The Master Clinician-Educator Program focuses on fundamental teaching principles, clinical teaching in sites specific to geriatrics, education research skills, and evaluation/assessment techniques that address issues fundamental to the care of older adults.
The specific learning objectives are for participants to:
- become familiar with classic teaching principles
- become aware of venue-specific skills necessary for teaching geriatrics
- acquire skills in curricular development
- design learner- and topic-specific curricula in geriatrics content
- communicate his/her curricular design effectively
Upon satisfactory completion of the program, scholars receive a Certificate in Geriatrics Medical Education from the Department of Geriatrics.
Program Operations
The Master Clinician-Educator Program is offered during the second year of the geriatrics fellowship, during the final year of chief resident training, or over a one-year period for selected junior faculty from other disciplines. Up to four geriatrics fellows and three junior faculty or chief residents are enrolled in the program annually. Chief residents or junior faculty are chosen by a competitive application process that favors those planning to
relocate and practice academic medicine at another institution within the next three to five years. To encourage those who are not geriatrics fellows to participate, the Department of Geriatrics provides mentorship to enable trainees to develop expertise and visibility as geriatrics-oriented educators within their disciplines.
The program consists of a weekly two-hour seminar. Additional hours of independent study and scholarly work are expected between sessions. Seminars include didactic sessions, experiential learning opportunities, other classroom sessions, and application-based work and workshops. The workshops consist of work in progress reports on goals, objectives, curricula, and evaluations based on the scholars’ own work. Scholars are also able to watch others teach in the medical school and reflect on the process and content of that teaching. Four sessions result in educational tools produced by the scholars that can be added to their portfolio of portable, ready-to-use geriatrics training materials.
Program trainees also teach in different clinical arenas where they are observed and receive feedback from faculty. Because of the interdisciplinary nature of the Clinician-Educator Program, all scholars learn how to work with a variety of other specialists in order to integrate geriatrics curriculum, content, and teaching throughout institutions and across the continuum of care.
Participants are also required to complete a scholarly project and a publication timeline during their training year. They also develop a mentored career plan to enable them to become faculty who promote and teach geriatrics at other institutions.
Staffing Requirements
Three geriatrics faculty members (one at 20% and two at 10%) and one part-time administrative assistant who serves as program coordinator (at 20%) are needed to staff the program.
Program Costs and Funding Sources
The total annual budget of approximately $150,600 covers staffing costs, fellows’ salaries, food, books, and office expenses.
The program development was funded by the Donald W. Reynolds Foundation via its Consortium for Faculty Development to Advance Geriatric Education (FD~AGE) grants; its ongoing operation is supplemented by funds from the John A. Hartford Foundation Center of Excellence and the Brookdale Department of Geriatrics and Adult Development.
Process and Outcomes Data
44 Scholars have graduated from the program since 2005.
Pre- and post-survey program evaluations are conducted. Prior to the course, 85% of the scholars wanted a career in academics, 5% stated they had experience with curricular development, and 1% reported that they had formal training. After the course was completed, 85% of the scholars felt more comfortable in starting curricular projects.
10% of the participants have presented their work at national meetings and are currently working on their manuscripts.
32% of the scholars are faculty members in geriatrics/palliative care at Mount Sinai, 59% are in geriatrics/palliative care or geriatrics/internal medicine at other institutions, and 9% are faculty in other subspecialties with geriatrics interest.
Implementation Lessons
- This is a developmental process for the scholars, which requires a time commitment from them to work outside the classroom, as well as a time commitment from the teaching faculty to hold individual mentoring meetings.
- An evaluator should be part of the development team.
Available Materials
Tools/Resources
Publications
- Learning in Adulthood
Merriam, SB, Caffarella, RS
Jossey-Bass. San Francisco 1999 - Curriculum Development for Medical Education
Kern, DE
The John Hopkins Press. Baltimore 1998 - ABC of teaching and learning
Kern DE, Thomas PA, Howard DM, et al
BMJ series: 2003;326
For More Information
Helen Fernandez, MD
Mount Sinai School of Medicine
Brookdale Department of Geriatrics and Adult Development
10th Floor, Annenberg Building
One Gustave L. Levy Place
Box 1070
New York, NY 10029-6574
(212) 241-5561
Helen.Fernandez@mssm.edu
Aging-Related Research Career Development Core for Junior Investigators
at the University of Michigan
| SUMMARY |
| Target Audience Junior faculty from schools in the health professions Purpose Program History Operating Costs Outcomes Available Materials For More Information |
Program Overview
The Research Career Development Core aims to recruit, select, support, mentor, and train junior faculty to become independent investigators in aging-related research and academic leaders in geriatrics and gerontology within their respective disciplines.
A mock NIH study section held during the annual research retreat component of the Core is a unique educational experience. Junior faculty have the opportunity to evaluate their peers’ research proposals and to have their proposals evaluated by top University of Michigan and visiting faculty experts. Both local trainees and trainees from around the country have participated. This unique program model has been reproduced at national conferences.
Program Operations
The components of the program include:
- monthly scientific seminars held from September through April (see appendices for list of topics)
- periodic lectures by senior faculty on mentoring, funding, and subject recruitment, and presentations by junior faculty illustrating their research
- an annual retreat at the end of May, which includes a mock NIH study section for select local and national researchers, led by national experts from the University of Michigan and other institutions.
The Research Career Development Core seminars are held on the main medical campus and are open to junior faculty (and others with an interest in aging research) from all disciplines. A monthly e-mail is sent to a campus-wide group list, the Division’s Aging Directory, as well as to specific Research Career Development Core participants, promoting the scientific seminars.
Staffing Requirements
Over 10 faculty from geriatrics and other divisions and departments are involved with presenting the various seminar series. Existing administrative staff members provide approximately 0.2 FTE effort in support of these activities.
Program Costs and Funding Sources
The cost related to the retreat is approximately $10,000 per year. In addition, staff salaries are approximately $12,000 per year (not including fringe benefits). Some faculty effort is also required to direct these activities. The program is part of the Claude D. Pepper Older Americans Independence Center at the University of Michigan, funded by the National Institute on Aging. The Pepper Center, the Hartford Foundation, the Department of Veterans Affairs, and various external grants also support research efforts for some of the junior faculty.
Process and Outcomes Data
Satisfaction surveys are collected at the conclusion of each Annual Retreat to evaluate the program content, experience, and venue. Anonymous anecdotal comments are also encouraged on the survey. An informal mentorship evaluation program is also being formulated for those trainees who receive salary support.
Implementation Lessons
- It is recommended that junior faculty have an opportunity to present their work in front of both their peers and their senior mentors.
- Careful review of proposals by senior mentors who have experience on study sections is particularly useful.
- Other career development seminars including topics such as research funding opportunities and mentorship are also useful.
Available Materials
Tools/Resources
For More Information
James Jensen
Administrator
Research Career Development Core
UM Older Americans Independence Center
University of Michigan Health System
300 North Ingalls Building
Room 974, Box 2007
Ann Arbor, MI 48109-2007
(734) 615-0143
jejensen@umich.edu
Clinical Investigator Training Enhancement Program
at the Indiana University School of Medicine
| SUMMARY |
| Target Audience Fellows, junior faculty and other health care professional trainees committed to a career in clinical research Purpose Program History Operating Costs Outcomes Available Materials For More Information |
Program Overview
The purpose of the Clinical Investigator Training Enhancement (CITE) program is to prepare health care professionals for a career in clinical research and to teach the skills necessary to compete successfully for grant funding, conduct and analyze research findings, and publish work in scientific journals. Over the past several decades, it has been increasingly recognized that a cadre of clinician-scientists committed to and trained in patient-centered research is essential to complement the numerous advances emanating from the basic biomedical and laboratory sciences.
The program serves as an excellent local resource for advancing careers in academic geriatrics.
Most participants already have a doctoral degree (MD, PhD, DNS, DDS, or DPT) or are in training for one. Potential applicants include, but are not limited to:
- fellows or other health care professional trainees who have substantial protected time for clinical research
- junior faculty who have career awards or support from their division or department head for participation in the program
- other faculty who have focused previously on basic research or other academic activities but are now committed to pursuing a career in clinical research.
Program Operations
The program includes two main components:
- a two-year formal clinical research curriculum, at the end of which participants receive a Master of Science in Clinical Research degree
- a clinical research project conducted under the mentorship of a faculty scientist whose discipline or area of clinical investigation corresponds to the research interests and career aims of the student.
This is an integrated program in which the formal curriculum complements and parallels the ongoing clinical research that is relevant to each enrollee's career. This differs from a sequential program in which individuals focus predominantly on formal coursework for several years, deferring actual research until they have attained their degree.
The rationale for the integrated approach is two-fold. First, the coursework is most meaningful when applied to research in which the enrollee is engaged and hopes to continue following program completion. Second, success in clinical research requires not only formal training, but also several primary outcomes, particularly publications and grants.
Program participants meet at least once a month with their primary mentor, and five times during the two-year program with their Advisory Committee, at approximately four-month intervals.
In addition to the work for the MS degree, program graduates complete a grant proposal for funding as well as one or more manuscripts for publication. The combination of a degree and research output substantially enhances the likelihood of a participant’s sustained success as a clinical investigator following program completion. Because the program involves both coursework and ongoing clinical research, a 70% time allocation for a two-year period is strongly recommended.
Staffing Requirements
The following personnel are needed:
- A primary mentor who chairs the trainee’s Advisory Committee and forwards an evaluation report to the Program Director following each Advisory Committee meeting.
- The Program Director, who meets individually with each program trainee twice a year to discuss his or her progress and needs,as well as to solicit feedback.
- An Advisory Committee consisting of the primary mentor and other relevant faculty scientists for each enrollee. The Committee oversees the trainee's progress, provides guidance and necessary support, evaluates the completion and quality of research, and offers ongoing career advice.
Program Costs and Funding Sources
The major cost of the program is the time commitment of the program participants (a recommended 70% time allocation for two years) for the completion of the full program; typically, this requires support by the head of the division, department, or research unit in which the trainees reside. Many program participants have salary or stipend support funded by a fellowship, training grant, or junior faculty career award. Others arrange for the necessary protected time with their supervisor, with the express purpose and intent of building the research capacity and productivity of their division or department. Participants receive no salary support from the CITE program.
There is no salary support from the CITE program for mentoring activities. Time for administrative activities depends on the number of trainees and the trainees' projects.
Program funding is through a National Institutes of Health K-30 grant.
Process and Outcomes Data
The program is too new to have any outcomes data on the number of trainees who go on to achieve R01s. Because this is a general program, there is also no data specific to geriatrics or aging-related research.
Implementation Lessons
- Because its goal is to support advanced training in clinical research, the program is an excellent local resource for advancing careers in academic geriatrics. Other Hartford Centers of Excellence and geriatrics programs may have access to similar research enhancement programs on campus, and trainees should be encouraged to participate in them.
- Hands-on experience with a specific research project is a major aspect of the CITE program; the geriatric message and methods are best introduced through this practical experience.
- This program provides a strong foundation of training for fellows and junior faculty with only minimum prior training in clinical research methods and design.
- It is very important to pair participants interested in aging and geriatrics with mentors who have experience and interest in aging research.
Available Materials
Website
- Contents include program description, curriculum, and application http://www.regenstrief.org/training/cite
For More Information
Christopher M. Callahan, MD
Professor of Medicine and Director
Indiana University Center for Aging Research
Regenstrief Health Center, 6th floor
1050 Wishard Boulevard
Indianapolis, IN 46202-2859
(317) 423-5592
ccallaha@iupui.edu
Scholarly Activities Clinic for Clinician-Educator Junior Faculty in Geriatrics
at the Indiana University School of Medicine
| SUMMARY |
| Target Audience Geriatrics clinician-educator junior faculty Purpose Program History Operating Costs Outcomes Available Materials For More Information |
Program Overview
The Indiana University School of Medicine developed the Scholarly Activities Clinic in 2005 to support self-motivated clinician-educator junior faculty in geriatrics who want to pursue scholarly activities leading to first-authored publications in peer-reviewed journals. Participation in scholarly activities leading to publication is a goal of many geriatrics clinician-educators who also strive to achieve excellence in either clinical service and/or teaching. It is also required for academic promotion.
During a retreat dedicated to discussion of scholarly activities and promotion for clinician-educators, faculty geriatricians in the Hartford Center of Excellence identified several key barriers to the success of junior clinician-educators in pursuing scholarly activities:
- overall time constraints
- frequent interruptions related to clinical service responsibilities
- inadequate knowledge and skills in scientific writing
- the need for mentorship by a senior faculty clinician-researcher.
The program objectives are to have each junior faculty participant submit an abstract for presentation at the American Geriatrics Society (AGS) annual meeting, and then have a first-authored paper either submitted, under review, or accepted for publication by a peer-reviewed journal by the end of the academic year.
Program Operations
Scholarly Activities Clinic participants are assigned a clinician-research mentor (Medical Director), attend required small-group orientation seminars covering topics pertaining to scientific writing, and have regularly scheduled half-day clinic sessions that are held in the Center for Aging Research. Prearranged pager coverage helps avoid interruptions and insures availability of their mentor for consultation.
The Medical Director facilitates participants’ skill development and efforts in writing and publishing, with the goal of identifying a project that has a projected 95% to 100% chance of being accepted in a journal if the program participant and the Medical Director follow through on expectations.
One or more Medical Directors facilitate the seven one-hour orientation seminars conducted during the first four months of the academic year. These seminars take place before or after scheduled clinic time. The only excused absences are for illness, vacation, or attendance at a CME conference.
Two half-day or four-hour clinic sessions dedicated to writing are scheduled in advance for each program participant and are included on the weekly Geriatrics Clinical Schedule. These sessions are held in a reserved space in the Center for Aging Research when the assigned Medical Director can be generally available to the participating junior faculty for questions and/or discussion. The program participants are expected to be present in the clinic area during these designated time periods, just as if they were in a clinic with scheduled patient visits. Clinical and pager coverage are prearranged for the program participants as if they were on vacation or attending a Continuing Medical Education conference. Similarly, if a program participant has a planned absence, this will be communicated, just as a vacation/conference request is made for any absence from a clinical patient care session (including notifying the Medical Director).
At the end of December and in June, each program participant provides a brief Productivity Report to the Center of Excellence leadership. Each respective Medical Director is expected to review and contribute to these Productivity Reports and to notify the Center of Excellence leadership at the earliest indication that the program participant is consistently not meeting agreed upon Scholarly Activity Clinic productivity targets. (This is similar to the steps a clinical Medical Director would take in the event that a clinic attending was falling behind on expected visits.)
Staffing Requirements
Scholarly Activity Clinic Orientation Seminars and mentorship of two to four junior faculty require senior faculty clinician-researcher time (total 5% FTE effort). In addition, approximately 10% FTE effort for data management is needed, depending on the specific projects undertaken.
Program costs include support for 5% dedicated time (two half-day Scholarly Activities Clinic sessions a month) for each participating junior faculty clinician-educator as well as the faculty time and data management support noted above. Potential funding sources include the Hartford Center of Excellence grant or matching funds, Geriatrics Academic Career Awards, endowed chair support, faculty development funds, and discretionary monies. In the first year, two junior faculty clinician-educators participated, and both submitted an abstract and subsequently presented it at the AGS annual meeting. One of the participants successfully submitted a paper to a peer-reviewed journal, and the second participant completed a draft of a paper by the end of the academic year. Tools/Resources Steven R. Counsell, MDProgram Costs and Funding Sources
Process and Outcomes Data
Implementation Lessons
Available Materials
For More Information
Mary Elizabeth Mitchell Professor and
Director, IU Geriatrics
Indiana University School of Medicine
1001 West 10th Street, WOP-M200
Indianapolis, IN 46202
(317) 630-7007
scounsel@iupui.edu
