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Knapke JM, Tsevat J, Succop PA, Djawe K, Kuhnell P, Haynes EN. Publication track records as a metric of clinical research training effectiveness. Clin Transl Sci 2013; 6:458-62. [PMID: 24330690 DOI: 10.1111/cts.12089] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Clinical research training programs exist across the country, but no quantitative studies have been performed to evaluate the effectiveness of these programs. The goal of this study was to evaluate the success of the clinical research training program at the University of Cincinnati by comparing the publication histories of pediatric fellows who graduated from the clinical and translational research Master of Science (MS) degree programs between 1995 and 2011 with fellows who did not pursue an MS degree. Among 296 pediatric fellows, 44 of 54 graduates (81%) published at least 1 first-authored paper, as compared with 149 of 242 (62%) fellows who did not obtain an MS degree (P < 0.01). In multivariable analysis, 3-4 years after program completion, MS graduates published more papers overall (R(2) = 0.10) and more first-authored papers than did non-MS graduates (R(2) = 0.04). These findings suggest that graduate training in clinical and translational research is related to an increase in research productivity as assessed by publication rates.
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Affiliation(s)
- Jacqueline M Knapke
- Clinical and Translational Research training program in the Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio, USA
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Szilagyi PG, Haggerty RJ, Baldwin CD, Paradis HA, Foltz JL, Vincelli P, Blumkin A, Cheng TL. Tracking the careers of academic general pediatric fellowship program graduates: academic productivity and leadership roles. Acad Pediatr 2011; 11:216-23. [PMID: 21570006 DOI: 10.1016/j.acap.2011.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 12/20/2010] [Accepted: 02/05/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Little is known about the careers of graduates of academic general pediatric (AGP) fellowship programs. We evaluated the careers of 2 cohorts of AGP fellowship graduates: an early cohort trained during 1978 to 1988, and a later cohort trained during 1989 to 1999. METHODS We surveyed all known AGP fellowship graduates in both cohorts by using a confidential mailed survey. We assessed graduates' current professional work and analyzed curricula vitae for principal investigator (PI) grants; first-authored, peer-reviewed publications; and leadership positions. RESULTS From the early cohort, 95 of 131 eligible graduates (73%) responded; from the later cohort, 93 of 133 (70%) responded. Two thirds of each cohort remain in academics; of these, nearly half are on tenure tracks and over half have major educational roles within their university. The percentage in the early cohort who have been PI on a research grant by 5, 10, and 15 years postfellowship was 44%, 53%, and 54%, respectively; in the later cohort, it was 62%, 75%, and 75%, respectively (P = .004 vs early cohort). During the 10 years postfellowship, the early and later cohorts averaged 5.5 and 7.4 first-authored, peer-reviewed papers, respectively (P = .4). By 10 years, a high proportion of both cohorts had become division chief (19% vs 16%), had other academic leadership positions (43% vs 59%), or were leaders in professional organizations (20% vs 30%; all P = NS). CONCLUSIONS Graduates of AGP fellowship programs have achieved considerable academic success. Recently trained fellows appear even more successful. The academic outcomes of these AGP fellows bode well for the future of AGP.
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Affiliation(s)
- Peter G Szilagyi
- Division of General Pediatrics, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, USA.
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Goldhamer MEJ, Cohen AP, Bates DW, Cook EF, Davis RB, Singer DE, Simon SR. Protecting an endangered species: training physicians to conduct clinical research. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2009; 84:439-445. [PMID: 19318774 DOI: 10.1097/acm.0b013e31819a7cb1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE The Program in Clinical Effectiveness (PCE) at Harvard School of Public Health is a postgraduate program emphasizing clinical research. The authors sought to evaluate the research careers of physician graduates and to determine correlates of National Institutes of Health (NIH) grant funding. METHOD In 2006, all 1,489 graduates from 1986-2005 were sent a 48-item survey that collected information on demographics, program experience, chosen career path, grant awards, and research pursued postprogram. Reported NIH grants were verified on the NIH Computer Retrieval of Information on Scientific Projects Web site. Cox proportional hazard regression was used to determine participant and program features associated with NIH grant funding. RESULTS Overall, 994 of the 1,365 located graduates (73%) responded to the survey. Graduates pursued research in the following areas: 437 respondents (44%) pursued clinical trials, 537 (54%) pursued epidemiology, and 408 (41%) pursued health services research. A total of 156 respondents (24%) were principal investigators on an NIH grant. Correlates of receiving NIH grant funding included age less than 40 years at time of program enrollment (hazard ratio [HR] 1.87, CI 1.03, 3.41), generalist status (HR 1.57, CI 1.14, 2.16), and publishing research begun as course projects (HR 1.65, CI 1.19, 2.31). Gender, academic status at enrollment, ethnicity, tuition sponsorship, and earning an advanced degree were not associated with receipt of NIH grant funding. CONCLUSIONS Physicians who enrolled in the PCE at an early age and generalist physicians were particularly successful in establishing careers as clinician-investigators. Programs such as the PCE can help to sustain the workforce of physician-investigators.
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Dyrbye LN, Lindor KD, LaRusso NF, Cook DA. Research productivity of graduates from 3 physician-scientist training programs. Am J Med 2008; 121:1107-13. [PMID: 19028208 DOI: 10.1016/j.amjmed.2008.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 08/30/2008] [Indexed: 10/21/2022]
Affiliation(s)
- Liselotte N Dyrbye
- Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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DeWitt TG, Cheng TL. The role of Title VII funding in academic general pediatrics fellowships and leadership. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2008; 83:1103-1106. [PMID: 18971667 DOI: 10.1097/acm.0b013e3181890988] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Since 1979, the Health Resources and Services Administration, Bureau of Health Professionals Title VII, Section 747 (Title VII) programs have been critical to both fellowship and leadership training in academic general pediatrics. Title VII-funded faculty development programs and targeted contract funding have played an important role in training pediatric academic generalist faculty, supporting individual fellowship programs, defining the core elements of such programs, and expanding faculty development to include leadership training. As the major continuing source of external funding for these programs, Title VII has produced documented successful outcomes in all areas in terms of both numbers and accomplishments of trainees. Title VII-funded fellows, as well as the leaders trained, have formed and extended the field of general pediatrics, ultimately improving the health of children, especially in underserved and vulnerable populations.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.
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Affiliation(s)
- Thomas G DeWitt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
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Landrigan PJ, Woolf AD, Gitterman B, Lanphear B, Forman J, Karr C, Moshier EL, Godbold J, Crain E. The ambulatory pediatric association fellowship in pediatric environmental health: a 5-year assessment. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:1383-7. [PMID: 17938724 PMCID: PMC2022661 DOI: 10.1289/ehp.10015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Accepted: 06/28/2007] [Indexed: 05/25/2023]
Abstract
BACKGROUND Evidence is mounting that environmental exposures contribute to causation of disease in children. Yet few pediatricians are trained to diagnose, treat, or prevent disease of environmental origin. OBJECTIVES To develop a cadre of future leaders in pediatric environmental health (PEH), the Ambulatory Pediatric Association (APA) launched a new 3-year fellowship in 2001-the world's first formal training program in PEH. Sites were established at Boston Children's Hospital, Mount Sinai School of Medicine, George Washington University, University of Cincinnati, and University of Washington. Fellows are trained in epidemiology, biostatistics, toxicology, risk assessment, and preventive medicine. They gain clinical experience in environmental pediatrics and mentored training in clinical research, policy development, and evidence-based advocacy. Thirteen fellows have graduated. Two sites have secured follow-on federal funding to enable them to continue PEH training. DISCUSSION To assess objectively the program's success in preparing fellows for leadership careers in PEH, we conducted a mailed survey in 2006 with follow-up in 2007. CONCLUSIONS Fifteen (88%) of 17 fellows and graduates participated; program directors provided information on the remaining two. Nine graduates are pursuing full-time academic careers, and two have leadership positions in governmental and environmental organizations. Ten have published one or more first-authored papers. Seven graduates are principal investigators on federal or foundation grants. The strongest predictors of academic success are remaining affiliated with the fellowship training site and devoting < 20% of fellowship time to clinical practice. CONCLUSION The APA fellowship program is proving successful in preparing pediatricians for leadership careers in PEH.
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Affiliation(s)
- Philip J Landrigan
- Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
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Dores GM, Chang S, Berger VW, Perkins SN, Hursting SD, Weed DL. Evaluating research training outcomes: experience from the cancer prevention fellowship program at the National Cancer Institute. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2006; 81:535-41. [PMID: 16728801 DOI: 10.1097/01.acm.0000225216.07584.b0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
PURPOSE The authors describe an evaluation approach to assess research training that is easy to implement, takes into account individual experience and diversity in research disciplines, and can be adapted to measure various outcomes, depending upon program goals. METHOD Using publications as the outcome measure, the authors analyzed data from 66 trainees in the National Cancer Institute's Cancer Prevention Fellowship Program (CPFP) to illustrate this evaluation strategy. For postdoctoral fellows entering the CPFP between 1987 and 1997, the authors considered the three-year period prior to entry in the CPFP (pre-CPFP), the period during training, and the three-year period after completion of the CPFP (post-CPFP). Summary measures for individuals' publications during each of the three time periods were calculated, and the probability of change in total, peer-reviewed, and first-authored publications post-CPFP compared to pre-CPFP was assessed. RESULTS Compared to pre-CPFP, the CPFP fellows published significantly more total, peer-reviewed, and first-authored publications post-CPFP. Post-CPFP younger individuals published more than older fellows. MDs had a greater increase in publications over time than did PhDs, but both groups had similar overall numbers of publications post-CPFP. Individuals pursuing a master of public health degree during training published more post-CPFP than did those who did not pursue this training in the program. CONCLUSIONS Training programs facing the challenge of evaluating research outcomes will require new evaluation methods that take into account program goals. This easily adaptable, longitudinal evaluation strategy allows for diversity in research disciplines and research experience and can inform programmatic needs and individual progress.
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Affiliation(s)
- Graça M Dores
- Office of Preventive Oncology, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-7361, USA.
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Steiner JF, Curtis P, Lanphear BP, Vu KO, Main DS. Assessing the role of influential mentors in the research development of primary care fellows. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2004; 79:865-872. [PMID: 15326013 DOI: 10.1097/00001888-200409000-00012] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE To assess the association between mentorship and both subsequent research productivity and career development among primary care research fellows. METHOD In 1998, using a self-administered questionnaire, the authors surveyed 215 fellows who graduated from 25 National Research Service Award (NRSA) primary care research programs between 1988-1997 to assess quantitative aspects and qualitative domains of their mentorship experience during fellowship training. RESULTS A total of 139 fellows (65%) responded to mentorship questions a median of four years after their fellowship. Thirty-seven fellows (26.6%) did not have an influential mentor, 42 (30.2%) reported influential but not sustained mentorship, and 60 (43.2%) had influential and sustained mentorship. Individuals with influential mentorship spent more time conducting research (p =.007), published more papers (p =.003), were more likely to be the principal investigator on a grant (p =.008), and more often provided research mentorship to others (72.5% versus 66.7% of those with unsustained mentorship, and 36.4% of those with no influential mentor, p =.008). After controlling for other predictors, influential and sustained mentorship remained an important determinant of career development in research. On qualitative analysis, fellows identified three important domains of mentorship: the relationship between mentor and fellow (such as guidance and support), professional attributes of the mentor (such as reputation), and personal attributes of the mentor (such as availability and caring). CONCLUSIONS Influential and sustained mentorship enhances the research activity of primary care fellows. Research training programs should develop and support their mentors to ensure that they assume this critical role.
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Affiliation(s)
- John F Steiner
- Mailstop F-443, University of Colorado Health Sciences Center, PO Box 6508, Aurora, CO 80045, USA.
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Steiner JF, Kempe A, Davidson AJ, Dickinson WP, Westfall JM, Berman S, Kutner JS, DeGruy FV. The case for interdepartmental research in primary care. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2004; 79:617-622. [PMID: 15234910 DOI: 10.1097/00001888-200407000-00002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Research problems in human biology, clinical medicine, and health services delivery are complex, and increasingly require collaborative approaches. Despite the commitment of general internists, general pediatricians, and family physicians to comprehensive, coordinated, and longitudinal care, their substantial overlap in research topics, methods, and data sources, and their shared emphasis on research conducted in community-based settings, the three primary care disciplines rarely collaborate in research. The research enterprises of most primary care departments and divisions in the United States are small "cottage industries," while interdepartmental research units are rare. Interdepartmental research units can develop and maintain the critical mass of investigators, trainees, and staff that is necessary for an intellectually vibrant and financially sound primary care research enterprise. The University of Colorado Health Sciences Center School of Medicine has developed a successful interdepartmental research effort in primary care that includes joint fellowship training and faculty development programs and a Primary Care Research Unit that supports the analysis of secondary databases, practice-based research networks, and interdisciplinary research projects. Key elements of this collaboration include shared projects among faculty and trainees, proactive negotiation about resources, and shared research space, staff, and faculty. Such a collaboration provides the breadth of perspectives necessary to address complex health care problems, and the pragmatic infrastructure necessary to sustain research themes and careers.
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Affiliation(s)
- John F Steiner
- Division of General Internal Medicine, university of Colorado Health Sciences Center, Denver, CO, USA.
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Albert E, Mickan S. A new perspective on "development" skills and their place within research training programmes in primary care. Eur J Gen Pract 2004; 10:27-30. [PMID: 15060479 DOI: 10.3109/13814780409094224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The gap between research and policy and practice is well documented. So too is the relative paucity of research undertaken in general practice. Various programmes have been initiated to address these issues in different countries. As an example, the Brisbane International Initiative has been set up to develop a comprehensive curriculum for primary care research training. In order to inform this process, the neglected concept of "development" was explored theoretically and through a small pilot study. A number of issues and concepts are highlighted that may assist in closing the gap between research and practice. These included the consideration of a range of skills not conventionally included in current research training curricula. It is argued that these "development" skills are essential in order to enhance the relevance of researchers' contributions in the highly complex and specialised field of primary care practice. A large international study is proposed to validate this skill set.
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Affiliation(s)
- Edi Albert
- Department of Rural Health, University of Tasmania, Locked Bag 33, Hobart, TAS 7001, Australia.
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Abstract
OBJECTIVE Little is known about the impact of fellowship training in primary care on subsequent research productivity. Our goal was to identify characteristics of research fellows and their training associated with subsequent publications and research funding. DESIGN Mail survey in 1998. SETTING AND PARTICIPANTS 1988-1997 graduates of 25 National Research Service Award primary care research fellowships in the United States. OUTCOME MEASURES 1) Publishing 1 or more papers per year since the beginning of fellowship, or 2) serving as principal investigator (PI) on a federal or non-federal grant. RESULTS One hundred forty-six of two hundred fifteen program graduates (68%) completed the survey. The median age was 38 years, and 51% were male. Thirty-two percent had published 1 or more papers per year, and 44% were PIs. Male gender (odds ratio [OR], 3.6; 95% confidence interval [95% CI], 1.4 to 9.2), self-reported allocation of 40% or more of fellowship time to research (OR, 4.4; 95% CI, 1.8 to 11.2), and having an influential mentor during fellowship (OR, 5.0; 95% CI, 1.5 to 17.2) were independently associated with publishing 1 or more papers per year. Fellows with funding as a PI were also more likely to have an influential mentor (OR, 3.0; 95% CI, 1.3 to 7.2). CONCLUSION Primary care fellows who had influential mentors were more productive in research early after fellowship. Awareness of the indicators of early research success can inform the policies of agencies that fund research training and the curricula of training programs themselves.
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Affiliation(s)
- John F Steiner
- Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, Colo, USA.
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Steiner JF, Lanphear BP, Curtis P, Vu KO. The training and career paths of fellows in the National Research Service Award (NRSA) Program for Research in Primary Medical Care. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2002; 77:712-718. [PMID: 12114148 DOI: 10.1097/00001888-200207000-00015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE To describe the training and career paths of fellows in the National Research Service Award (NRSA) Program for Research in Primary Medical Care. METHOD All fellows who graduated from 25 NRSA programs nationally between July 1988 and June 1997 (n = 215) were mailed a questionnaire. Personal characteristics, fellowship experiences, and current professional positions were compared between faculty researchers, faculty clinician-educators, and individuals who were not in full-time academic positions. RESULTS A total of 146 NRSA graduates (68%) completed the survey. A mean of four years had elapsed since their fellowships. Of the respondents, 36% were faculty researchers, 32% were faculty clinician-educators, and 32% were not on full-time faculties. Faculty researchers did not differ from the other groups in demographics or acquisition of advanced degrees, but they were more often general internists than general pediatricians, family physicians, or from other disciplines (p =.002). Fellowship graduates spent a mean of 29% of their training in course work and 38% conducting research. Faculty researchers spent a greater proportion of their fellowship conducting research (46% versus 34% for clinician-educators and 31% for those not on full-time faculties, respectively, p <.0001). They were also more productive in terms of subsequent publications and grant acquisitions. CONCLUSIONS Only a minority of those completing NRSA programs held positions as faculty researchers. The preponderance of general internists among researchers may indicate problems in the capacity of general pediatrics and family medicine to support primary care research. The amounts of direct research time during these fellowships may need to be increased to enhance the likelihood of subsequent research success.
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Affiliation(s)
- John F Steiner
- Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, USA
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Ringel SP, Steiner JF, Vickrey BG, Spencer SS. Training clinical researchers in neurology: we must do better. Neurology 2001; 57:388-92. [PMID: 11502901 DOI: 10.1212/wnl.57.3.388] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The pace of scientific discoveries, the increasing complexity of managing patients, and the runaway cost of neurological services have created an urgent need for a wide range of clinical research in neurology. Despite increasing recognition of this need and recent increases in funding for training clinical investigators, neurologists conducting cellular and molecular investigations are more likely to join faculties, maintain research careers, and attain academic advancement. Because academic departments of neurology are successful in producing and nurturing basic science researchers, why aren't they just as triumphant in spawning clinical investigators? This crisis in the preparation of clinical investigators has been brought about by many factors: competing time demands for clinical service, lack of methodologically rigorous training in the disciplines necessary to conduct clinical research, and lack of mentorship. Neurology residents contemplating a clinical research career may observe junior faculty who lack career guidance, are ill-prepared as independent investigators, and must juggle patient demands while trying to write a research grant or conduct a study. Already burdened by medical school debts, is it any wonder that our neurology graduates don't leap to a career with a future that seems so insecure? Academic departments of neurology must develop full-scale clinical research training programs if they are to meet the pressing need for clinical research. As a starting point, they must free themselves from their dependence on providing clinical services to generate income. Following the model which has produced successful basic researchers, much greater effort must be given to establishing rigorous methodological training in collaboration with other departments, creating senior role models, and protecting time for clinical investigators to conduct research. Unless we create incentives to careers in clinical research, we will never answer the growing number of clinical research questions we face today.
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Affiliation(s)
- S P Ringel
- Department of Neurology, University of Colorado Health Science Center, Denver 80262, USA. steven
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