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Making It As a Clinical Researcher or Educator

Making It As a Clinical Researcher or Educator. Andrea E. Reid, MD, MPH Massachusetts General Hospital Harvard Medical School Boston, MA. How do you define success?. Publications Promotion Prestige Payment Parity Peace. Franklin Covey The Seven Habits of Highly Effective People.

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Making It As a Clinical Researcher or Educator

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  1. Making It As a Clinical Researcher or Educator Andrea E. Reid, MD, MPH Massachusetts General Hospital Harvard Medical School Boston, MA

  2. How do you define success? • Publications • Promotion • Prestige • Payment • Parity • Peace

  3. Franklin CoveyThe Seven Habits of Highly Effective People • Be Proactive • Begin with the End in Mind • Put First Things First • Think Win-Win • Seek First to Understand, Then to be Understood • Synergize • Sharpen the Saw

  4. Definition of Clinical Research • Patient-oriented research. Research conducted with human subjects or on material of human origin for which an investigator directly interacts with human subjects. This area of research includes: • Mechanisms of human disease • Therapeutic interventions • Clinical trials • Development of new technologies • Epidemiologic and behavioral studies • Outcomes research and health services research.

  5. Translational Blocks in the Clinical Research Continuum JAMA 2003: 289; 1278-87

  6. Funding Roadblocks on the Way Toward Improved Public Health JAMA 2004: 291; 1120-6

  7. NIH Director’s Panel on Clinical Research (CRP) • Three questions: • Who is going to do clinical research and how are these individuals to be properly trained? • Where will clinical research be conducted? • How will clinical research be funded?

  8. The problems in clinical research • Numbers down • Attrition up • Insufficiently nurturing environment in AMC to sustain CI • Insufficient infrastructure • Insufficient mentoring • Increased pressure for more clinical activity • Shrinking revenues

  9. Solutions to the crisis • Funding • New investigators • Mid-level investigators • Equitable grant review • Formalized training • Loan Repayment Programs

  10. How to succeed as a clinical researcher • Define your interests • Explore • Discuss • Commit • Supportive environment is crucial • Find a good research mentor • Experienced • Well-known • Funded • Interested in your success • Obtain formal training in methology

  11. Explore funding mechanisms • NIH • Veteran’s Administration • Industry • Foundations • Private money • Institutional grants

  12. The Current State of Affairs • NIH funds 212,000 researchers • ~ 30% extramural support devoted to clinical research • NIDDK programs directed to clinical research: • K01:Mentored Research Scientist Development Award • K08: Mentored Clinical Scientist Development Award • K23: Mentored Patient-Oriented Research Career Development Award • K24: Midcareer Investigator Award in Patient-Oriented Research

  13. Get someone else to pay your loans National Institutes of Health Extramural Programs • Loan Repayment Program for Minority Health Disparities Research • Extramural Clinical Research Loan Repayment Program for Individuals from Disadvantaged Backgrounds • Loan Repayment Program Regarding Clinical Researchers • Pediatric Research Loan Repayment Program

  14. Success as a clinical researcher depends on your network • Clinical research is collaborative • Be creative about your collaborations • Use your mentor’s network • Be open to forming new, unexpected connections with people and projects • Publish or perish

  15. How are you evaluated as a clinician-educator? • Objective criteria • Scholarly output • Book chapters, reviews, clinical guidelines, curricula • Grant support • Recognition as an education leader by peers • Teaching awards • National committees • Administrative skills • Revenue generated from clinical care

  16. How are you evaluated as a clinician-educator? • Subjective criteria: what are the measures of good teaching? • How well others learn • How much student grows as a learner because of input • Practice methods • “Impact factor”

  17. Components of evaluation • Teaching skills • Clinical skills • Mentoring • Academic administration • Developing educational programs • Non-research scholarship • Clinical research • Service coordination • Education research

  18. Methods of evaluation • Peer evaluation • Awards • Trainee evaluation • Teaching portfolio • Clinical service time • Leadership qualities • Grant support • Publications • The weight placed on each component varies by institution

  19. Importance of specific aspects of a clinician-educator's performance when the promotion committee makes decisions about promotion to associate professor JAMA 1997: 278; 723-8

  20. Know what your institution values • Hospital: revenue, efficiency, quality, community involvement • The medical school: publications, notoriety • Know the promotions process • Know your worth on the academic market

  21. Make the most of every opportunity • Teaching opportunities • Local: Medical students and residents • Regional: Medical societies • National: curriculum boards, national meetings, educational symposia • Service opportunities • Hospital and medical school committees • Don’t overdo • Evaluate benefit to you • Health organizations • GI Societies

  22. Begin with the end in mind • Document everything • When, where, why, how, to how many • Time keeping • Resume building • Mentor and be mentored • Seek feedback from educators you respect • Training • Challenge yourself

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