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Al-Busaidi IS, Al-Mandhari RA. Sustainable Clinical Academic Training Pathways: A framework for implementation in Oman. Sultan Qaboos Univ Med J 2020; 20:e251-e259. [PMID: 33110639 PMCID: PMC7574797 DOI: 10.18295/squmj.2020.20.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/31/2019] [Accepted: 03/09/2020] [Indexed: 11/30/2022] Open
Abstract
Clinical academics—medical doctors with additional training in basic science or clinical research— play a pivotal role in translating biomedical research into practical bedside applications. However, international studies suggest that the proportion of clinical academics relative to the medical workforce is dwindling worldwide. Although efforts to reverse this trend are ongoing in many countries, there is little perceptible dialogue concerning these issues in Oman. This article explores the current status of clinical academic training pathways worldwide, concluding with a framework for the implementation of a dual-degree medical-research training programme in Oman in order to stimulate and develop a sustainable national clinical academic workforce.
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Affiliation(s)
- Ibrahim S Al-Busaidi
- Department of Medicine, Christchurch Hospital, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
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2
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Adeola HA, Adefuye A, Soyele O, Butali A. The dentist-scientist career pathway in Africa: opportunities and obstacles. KOREAN JOURNAL OF MEDICAL EDUCATION 2018; 30:189-198. [PMID: 30180506 PMCID: PMC6127611 DOI: 10.3946/kjme.2018.93] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 05/14/2023]
Abstract
The future of evidence-based dentistry in developing Africa heavily depends on a sustainable establishment of a vibrant dentist-scientist workforce. A dentist scientist is saddled with the responsibility of carrying out robust cutting edge research projects that are inspired by clinical experience. Currently, there are no pipelines in place to systematically train such dentists, neither are there programs in place to allow trained African dentists choose such a career pathway. A dentist-scientist is a person who studied oral, dental, maxillofacial (or craniofacial) diseases, prevention, and population sciences (obtaining a medical degrees such as bachelor of dental surgery [BDS] or BChD) alone; or in combination with other advanced degrees such as doctor of dental surgery (DDS)/doctor of philosophy (PhD) or BDS/PhD. This situation has resulted in overdependence of African clinical practice on research findings from technologically advanced Western countries and a decline in clinical research capacity building. The career path of a dentist-scientist should involve research along the spectrum of basic biomedical sciences, translational, clinical and public health sciences. There are several factors responsible for the ultra-low count of dentist-scientist in the heterogeneous African communities such as: poor biomedical research infrastructure; lack of funding; absence of structured dentist scientist career pathways; lack of personnel, inter alia. Hence, this review hopes to discuss the opportunities of setting up a dentist-scientist training pathway in Africa (as obtains in most developed world settings), identify opportunities and prospects of developing an African dentist-scientist workforce, and finally discuss the challenges involved.
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Affiliation(s)
- Henry Ademola Adeola
- Department of of Oral and Maxillofacial Pathology, Faculty of Dentistry, University of the Western Cape, Republic of South Africa
- Division of Dermatology, Faculty of Health Sciences, University of Cape Town, Cape Town, Republic of South Africa
| | - Anthonio Adefuye
- Division of Health Sciences Education, Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Olujide Soyele
- Department of Oral Maxillo-Facial Surgery and Oral Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
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Alman BA, Purtill JJ, Pellegrini VD, Scoles P. The Fourth Year of Medical School: Time for Reassessment: AOA Critical Issues. J Bone Joint Surg Am 2017; 99:e72. [PMID: 28678133 DOI: 10.2106/jbjs.16.01094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Most U.S. medical schools follow the 4-year model, consisting of 2 preclinical years, core clinical experience, and a fourth year intended to permit students to increase clinical competency, to explore specialty areas, and to transition to residency. Although the design and delivery of Years 1 through 3 have evolved to meet new challenges and expectations, the structure of Year 4 remains largely unchanged. For most students considering a career in orthopaedics, Year 4 is a series of elective rotations in which educational objectives become secondary to interviewing for residency programs. Most accreditation bodies recognize the importance of attainment of competency over the duration of medical school as the goal of educating physicians, and thus, there is a growing interest in reexamining the traditional medical school curriculum with the goal of integrating the final phases of undergraduate education and the first phases of postgraduate education.A literature search was undertaken to identify publications on the duration of medical education. Pilot approaches to competency-based integration of undergraduate medical school and postgraduate training in orthopaedic surgery were reviewed.There have been few data suggesting that 4 years of medical education is superior to shorter-duration programs. Three approaches to competency-based integration of undergraduate medical school and postgraduate training are presented. Their goal is to use student and faculty time more effectively. Each approach offers the opportunity to lower the cost and to decrease the time required for Board Certification in Orthopaedic Surgery. Two approaches shorten the entire duration of medical school and graduate training by using various proportions of the fourth year to begin residency, and one approach expands the duration of orthopaedic training by starting in the fourth year of medical school and including training equivalent to a fellowship program into the residency experience.The effectiveness of such programs will form the basis for revisions to the current orthopaedic training paradigm, resulting in a more effective, efficient, and integrated orthopaedic training curriculum.
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Affiliation(s)
- Benjamin A Alman
- 1Duke University, Durham, North Carolina 2Thomas Jefferson University, Philadelphia, Pennsylvania 3Medical University of South Carolina, Charleston, South Carolina
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Kim BJ, Valsangkar NP, Liang TW, Murphy MP, Zimmers TA, Bell TM, Davies MG, Koniaris LG. Impact of Integrated Vascular Residencies on Academic Productivity within Vascular Surgery Divisions. Ann Vasc Surg 2016; 39:242-249. [PMID: 27671458 DOI: 10.1016/j.avsg.2016.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 06/13/2016] [Accepted: 06/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Changing training paradigms in vascular surgery have been introduced to reduce overall training time. Herein, we sought to examine how shortened training for vascular surgeons may have influenced overall divisional academic productivity. METHODS Faculty from the top 55 surgery departments were identified according to National Institutes of Health (NIH) funding. Academic metrics of 315 vascular surgery, 1,132 general surgery, and 2,403 other surgical specialties faculty were examined using institutional Web sites, Scopus, and NIH Research Portfolio Online Reporting Tools from September 1, 2014, to January 31, 2015. Individual-level and aggregate numbers of publications, citations, and NIH funding were determined. RESULTS The mean size of the vascular divisions was 5 faculty. There was no correlation between department size and academic productivity of individual faculty members (R2 = 0.68, P = 0.2). Overall percentage of vascular surgery faculty with current or former NIH funding was 20%, of which 10.8% had major NIH grants (R01/U01/P01). Vascular surgery faculty associated with integrated vascular training programs demonstrated significantly greater academic productivity. Publications and citations were higher for vascular surgery faculty from institutions with both integrated and traditional training programs (48 of 1,051) compared to those from programs with integrated training alone (37 of 485) or traditional fellowships alone (26 of 439; P < 0.05). CONCLUSIONS In this retrospective examination, academic productivity was improved within vascular surgery divisions with integrated training programs or both program types. These data suggest that the earlier specialization of integrated residencies in addition to increasing dedicated vascular training time may actually help promote research within the field of vascular surgery.
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Affiliation(s)
- Bradford J Kim
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Nakul P Valsangkar
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Tiffany W Liang
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Michael P Murphy
- Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Teresa A Zimmers
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Teresa M Bell
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Mark G Davies
- Division of Vascular Surgery, The University of Texas Health Science Center, San Antonio, TX
| | - Leonidas G Koniaris
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.
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Abstract
Typically lasting 7-9 years, medical-scientist training programmes (MSTPs) allow students a unique opportunity to simultaneously intercalate medical (MBBS, MBChB or MD) and research (PhD) degrees. The nature of both degrees means that the combined programme is arduous, and selection is often restricted to a few highly motivated students. Despite the many successes of MSTPs, enthusiasm about MSTPs and the number of intercalating students, at least in some countries, appear to be diminishing. In this review, I shed light on MSTPs around the world, highlight the plethora of successes such programmes have had and provide insights on the setbacks experienced and solutions offered, with the aim of reigniting interest in these programmes.
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Affiliation(s)
- Yassar Alamri
- New Zealand Brain Research Institute and Department of Medicine, University of Otago, Christchurch, New Zealand
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Montalvo-Javé EE, Mendoza-Barrera GE, Valderrama-Treviño AI, Alcántara-Medina S, Macías-Huerta NA, Tapia-Jurado J. [The importance of master's degree and doctorate degree in general surgery]. CIR CIR 2016; 84:180-5. [PMID: 26769529 DOI: 10.1016/j.circir.2015.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 11/20/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Doctor of Philosophy is the highest academic degree that can be obtained in universities. Graduate Education Program in Medicine in Mexico is divided into 2 major categories: Medical Specialty and Master studies/Doctor of Philosophy. The objective of this study was to demonstrate the importance of master's degrees and Doctor of Philosophy in general surgery. MATERIAL AND METHODS A literature search in PubMed and Medline among others, from 1970 to 2015 with subsequent analysis of the literature reviews found. DISCUSSION The physicians who conducted doctoral studies stand out as leaders in research, teaching and academic activities. Dual training with a doctorate medical specialty is a significant predictor for active participation in research projects within the best educational institutions. RESULTS It is important to study a PhD in the education of doctors specialising in surgery, who show more training in teaching, research and development of academic activities. Currently, although there is a little proportion of students who do not finish the doctoral program, the ones who do are expected to play an important role in the future of medical scientific staff. It has been shown that most doctors with Doctor of Philosophy have wide range of career options. CONCLUSION The importance of doctoral studies in the formation of general surgery is due to various reasons; the main one being comprehensively training physician scientists who can develop in clinical, teaching and research.
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Affiliation(s)
- Eduardo Esteban Montalvo-Javé
- Servicio de Cirugía General, Unidad 304, Hospital General de México Dr. Eduardo Liceaga, Secretaría de Salud, México D.F., México.
| | | | | | - Stefany Alcántara-Medina
- Departamento de Cirugía, Facultad de Medicina, Universidad Nacional Autónoma de México, México D.F., México
| | - Nain Abraham Macías-Huerta
- Departamento de Cirugía, Facultad de Medicina, Universidad Nacional Autónoma de México, México D.F., México
| | - Jesús Tapia-Jurado
- Departamento de Cirugía, Facultad de Medicina, Universidad Nacional Autónoma de México, México D.F., México
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Raymond JR, Kerschner JE, Hueston WJ, Maurana CA. The Merits and Challenges of Three-Year Medical School Curricula: Time for an Evidence-Based Discussion. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2015; 90:1318-23. [PMID: 26266464 PMCID: PMC4585483 DOI: 10.1097/acm.0000000000000862] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The debate about three-year medical school curricula has resurfaced recently, driven by rising education debt burden and a predicted physician shortage. In this Perspective, the authors call for an evidence-based discussion of the merits and challenges of three-year curricula. They examine published evidence that suggests that three-year curricula are viable, including studies on three-year curricula in (1) U.S. medical schools in the 1970s and 1980s, (2) two Canadian medical schools with more than four decades of experience with such curricula, and (3) accelerated family medicine and internal medicine programs. They also briefly describe the new three-year programs that are being implemented at eight U.S. medical schools, including their own. Finally, they offer suggestions regarding how to enhance the discussion between the proponents of and those with concerns about three-year curricula.
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Affiliation(s)
- John R. Raymond
- J.R. Raymond Sr is professor of medicine, president, and chief executive officer, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Joseph E. Kerschner
- J.E. Kerschner is professor of otolaryngology and communication sciences, dean of the medical school, and executive vice president, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - William J. Hueston
- W.J. Hueston is professor of family and community medicine and senior associate dean for academic affairs, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Cheryl A. Maurana
- C.A. Maurana is professor of population health, vice president for academic outreach, and director, Advancing a Healthier Wisconsin Endowment, Medical College of Wisconsin, Milwaukee, Wisconsin
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Raymond RM, Madden MM, Ferretti SM, Ferretti JM, Ortoski RA. Preliminary outcomes of the Lake Erie College of Osteopathic Medicine's 3-year Primary Care Scholar Pathway in osteopathic predoctoral education. J Osteopath Med 2015; 114:238-41. [PMID: 24677462 DOI: 10.7556/jaoa.2014.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT In 2007, the Lake Erie College of Osteopathic Medicine initiated its Primary Care Scholar Pathway (PCSP), a 3-year osteopathic predoctoral education curriculum. OBJECTIVE To assess preliminary outcomes of the PCSP curriculum. METHODS Scores for the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Levels 1 and 2-Cognitive Evaluation (CE) and pass rates for Level 2-Performance Evaluation (PE) were obtained for individuals who graduated from the PCSP program in 2010, 2011, and 2012. Scores for Levels 1 and 2-CE were compared with national mean scores. Acceptance rates for residency programs were also recorded. RESULTS Nineteen PCSP graduates were included in the study: 3 graduated in 2010, 6 graduated in 2011, and 10 graduated in 2012. Scores for PCSP students were not significantly different than national average scores for COMLEX-USA Levels 1 and 2-CE (P>.05). All 19 PCSP graduates passed the COMLEX-USA Level 2-PE on the first attempt, and all graduates were accepted into primary care residency programs. CONCLUSION The COMLEX-USA scores of PCSP graduates were similar to national mean scores, suggesting that it is possible for osteopathic medical students to attain the same level of education as students of 4-year programs in less time. A 3-year osteopathic predoctoral education curriculum would allow students to complete their education at a reduced cost. This potential reduction in debt burden could encourage more students to pursue a primary care career and thus could help address the shortage of primary care physicians in the United States.
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Affiliation(s)
- Richard M Raymond
- Lake Erie College of Osteopathic Medicine, 1858 W Grandview Blvd, Erie, PA 16509-1025.
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Kosik RO, Tran DT, Fan APC, Mandell GA, Tarng DC, Hsu HS, Chen YS, Su TP, Wang SJ, Chiu AW, Lee CH, Hou MC, Lee FY, Chen WS, Chen Q. Physician Scientist Training in the United States: A Survey of the Current Literature. Eval Health Prof 2014; 39:3-20. [PMID: 24686746 DOI: 10.1177/0163278714527290] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The declining number of physician scientists is an alarming issue. A systematic review of all existing programs described in the literature was performed, so as to highlight which programs may serve as the best models for the training of successful physician scientists. Multiple databases were searched, and 1,294 articles related to physician scientist training were identified. Preference was given to studies that looked at number of confirmed publications and/or research grants as primary outcomes. Thirteen programs were identified in nine studies. Eighty-three percent of Medical Scientist Training Program (MSTP) graduates, 77% of Clinician Investigator Training Program (CI) graduates, and only 16% of Medical Fellows Program graduates entered a career in academics. Seventy-eight percent of MSTP graduates succeeded in obtaining National Institute of Health (NIH) grants, while only 15% of Mayo Clinic National Research Service Award-T32 graduates obtained NIH grants. MSTP physician scientists who graduated in 1990 had 13.5 ± 12.5 publications, while MSTP physician scientists who graduated in 1975 had 51.2 ± 38.3 publications. Additionally, graduates from the Mayo Clinic's MD-PhD Program, the CI Program, and the NSRA Program had 18.2 ± 20.1, 26.5 ± 24.5, and 17.9 ± 26.3 publications, respectively. MSTP is a successful model for the training of physician scientists in the United States, but training at the postgraduate level also shows promising outcomes. An increase in the number of positions available for training at the postgraduate level should be considered.
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Affiliation(s)
- R O Kosik
- Santa Clara Valley Medical Center, San Jose, CA, USA
| | - D T Tran
- Department of Nephrology and Endocrinology, Children's Hospital 2, HoChiMinh City, Vietnam
| | | | - G A Mandell
- Santa Clara Valley Medical Center, San Jose, CA, USA
| | - D C Tarng
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - H S Hsu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Y S Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - T P Su
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - S J Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - A W Chiu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - C H Lee
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - M C Hou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - F Y Lee
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - W S Chen
- Santa Clara Valley Medical Center, San Jose, CA, USA
| | - Q Chen
- School of Medicine, Nanjin Medical University, Nanjin, China
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Benbassat J, Baumal R. Expected benefits of streamlining undergraduate medical education by early commitment to specific medical specialties. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2012; 17:145-155. [PMID: 21698422 DOI: 10.1007/s10459-011-9311-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 06/14/2011] [Indexed: 05/31/2023]
Abstract
Undergraduate medical education is too long; it does not meet the needs for physicians' workforce; and its content is inconsistent with the job characteristics of some of its graduates. In this paper we attempt to respond to these problems by streamlining medical education along the following three reforms. First, high school graduates would be eligible for undergraduate medical education programs of 4 years duration. Second, medical school applicants would be required to commit themselves to a medical specialty and choose one of four undergraduate paths: (1) "Interventions/consultations" path that would prepare its graduates for residencies in secondary and tertiary specialties, such as cardiology and surgery, (2) "continuous patient care" path for primary care specialties, such as family medicine and psychiatry, (3) "diagnostic laboratory medicine and biomedical research" path that would prepare for either laboratory-based careers, such as pathology, biochemistry and bacteriology, or research in e.g., immunology and molecular genetics, and (4) "epidemiology and public health" path that would include population-based research, preventive medicine and health care administration. Third, the content of each of these paths would focus on relevant learning outcomes, and medical school graduates would be eligible for residency training only in specialties included in their path. Hopefully, an early commitment to a medical specialty will reduce the duration of medical education, improve the regulation of physicians' workforce and adapt the curricular content to the future job requirements from medical school graduates.
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Affiliation(s)
- Jochanan Benbassat
- Myers-JDC-Brookdale Institute, Smokler Center for Health Policy Research, PO Box 3886, 91037, Jerusalem, Israel.
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Stewart PM, Bryan S, Dukes P, van Oudheusden HL, Walker R, Maxwell PH. What happens to clinical training fellows? A retrospective study of the 20 years outcome of a Medical Research Council UK cohort. BMJ Open 2012; 2:bmjopen-2012-001792. [PMID: 22936819 PMCID: PMC3432844 DOI: 10.1136/bmjopen-2012-001792] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The Clinical Research Training Fellowship (CRTF) allows up to 3 years support for clinically qualified candidates to undertake specialised or further research training in biomedical sciences. CRTFs are perceived as a crucial step in the career development and progression of Clinical Academics but there are no published data to support this notion. We conducted an electronic survey of a large cohort of Medical Research Council (MRC) CRTFs followed for up to 20 years. DESIGN Retrospective analysis of CRTF outcome data held with the MRC, UK. PARTICIPANTS Two cohorts comprising 40 CRFTs awarded by the MRC in the year 1991 and 299 MRC CRTFs who were awarded a fellowship between 1993 and 2003. RESULTS The MRC CRTF scheme built capacity in clinical academia across the UK with 40% of CRTFs progressing to a University professorship. Importantly, the CRTF scheme is also providing NHS consultants who remain research active. CONCLUSIONS This is the first analysis of outcome of CRTFs in the UK and provides robust evidence of the importance of this capacity building mode of funding to underpin research excellence at the University-NHS interface.
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Affiliation(s)
- Paul M Stewart
- Medical School, University of Birmingham, Medical Research Council, London, UK
| | - Simone Bryan
- Medical School, University of Birmingham, Medical Research Council, London, UK
| | - Peter Dukes
- Medical School, University of Birmingham, Medical Research Council, London, UK
| | | | - Rhoswyn Walker
- Medical School, University of Birmingham, Medical Research Council, London, UK
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