scholarly journals Supporting the Development of Physician-scientists

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Mimi Xiaoming Deng

In the last decade, there has been a discrepancy between the increasing recognition for research involvement in medical training and the stagnation in the number physician-scientists. Health research funding cutbacks, inadequate mentorship, heavy schedules, and unfamiliarity with scientific methodology are obstacles that limit research interest amongst junior medical learners and cause attrition of promising physician-scientist in training. This article outlines five strategies to promote and facilitate the development of physician-scientists with the understanding that research is integral to clinical excellence. Some of the ways the undergraduate and postgraduate medical curricula can better lend themselves to producing clinicians with the skillset to address clinical uncertainties through an evidence-based approach are: partnerships between healthcare and academia, increasing admission to MD/PhD and Clinical Investigator programs, establishing fundamentals of scientific thinking, long-term research mentorship, facilitating knowledge translation.

2019 ◽  
Vol 3 (s1) ◽  
pp. 67-68
Author(s):  
Stephanie A. Freel ◽  
Michael Gunn ◽  
Andrew Alspaugh ◽  
Gowthami Arepally ◽  
Gerard Blobe ◽  
...  

OBJECTIVES/SPECIFIC AIMS: 1.Identify barriers to pursuing research for physician trainees 2.Develop a sustainable pipeline of physician-scientists at Duke 3.Coordinate physician-scientist development programs across the School of Medicine under one central Office 4.Provide infrastructure and resources for all physician-scientists 5.Increase the number of MDs and MD/PhDs who pursue, succeed, and are retained in research METHODS/STUDY POPULATION: To establish a baseline understanding of the needs and concerns of physician-scientist trainees at Duke, we conducted focus groups using a standardized interview guide and thematic analysis. Findings from these focus groups were used to develop a framework for support, leading to the creation of the Office of Physician-Scientist Development (OPSD) housed centrally within the Duke School of Medicine. The OPSD integrates programs and resources for multiple populations including medical students, residents, fellows, junior faculty, and faculty mentors. Pipeline programs will also be developed to enhance research engagement in targeted student populations prior to medical school. RESULTS/ANTICIPATED RESULTS: A total of 45 students and faculty participated in the focus groups and structured interviews (1st year medical student, n=11; 4th year medical students, n=11; residents/fellows, n=13; junior faculty, n=11). While participants raised a number of specific issues, one key message emerged: non-PhD MDs in basic research felt they lacked opportunities for directed training. Moreover, they felt the need to teach themselves many critical skills through trial and error. This has led to perceptions that they cannot compete effectively with PhDs and MD-PhD scientists for research funding and positions. Consensus recommendations included: better guidance in choosing mentors, labs, and projects; central resource for information relevant to physician scientists; training specifically tailored to physician scientists conducting laboratory-based research; improved infrastructure and well-defined training pathways; and assistance with grant preparation. To-date, over 90 students, residents, and fellows have been identified who identify as laboratory-based physician scientists. Additional efforts are underway to identify and characterize the broader range of physician-scientist students and trainees at Duke. DISCUSSION/SIGNIFICANCE OF IMPACT: Our planning study revealed specific steps forward toward developing a robust community of physician-scientists at Duke. As a first step, the Dean of the School of Medicine has appointed an Associate Dean of Physician-Scientist Development to oversee a new Office of Physician-Scientist Development (OPSD) being launched in December of 2018. The OPSD will offer four primary programs. 1) A concierge mentoring program will assist new trainees in identifying research areas of interest and mentors. Trainees will receive periodic contact to provide additional support as needed and promote success. 2) A physician-scientist training program is being created to provide training specific to laboratory research skills as well as career and professional development training to complement existing clinical and translational research programs. 3) Integrated training pathways will provide additional mentored research training for those pursuing research careers. Pathways will capitalize on existing resources from R38 programs, while pursuing additional R38 and R25 support. 4) An MD-Scientist funding program has been developed to provide additional research funding and protected time for students pursuing a second research year. Through the support and programming offered by the OPSD, we anticipate decreased perceptions of barriers to pursuing a physician-scientist career and increased satisfaction with training opportunities. Over time, we expect such support to increase the number of MD students pursuing research as a career and the number of residents, fellows, and MD junior faculty remaining in research careers.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2570-2570
Author(s):  
Tom Butler ◽  
John G. Gribben ◽  
Ann Hodgson

Abstract Abstract 2570 Physician-scientists spend a significant proportion of their time doing research, alongside clinical practice and teaching. Recruitment to academic medicine appears insufficient for workforce needs, with a perception of a 'crisis' in academic medicine (Andrew I. Schafer The Vanishing Physician Scientist 2009). Policy initiatives are in place to counter this recruitment problem and make an academic medicine career more attractive to trainees. Hematologists have a unique translational role in medicine and research, straddling the divide between laboratory and patient care. Since hematology may be inherently more academic compared to other medical specialties, this recruitment crisis may be more relevant to our specialty. Hematologists' experiences of research have been poorly reported. We employed mixed qualitative methods to explore hematologists' views on these issues, using focus groups (14 participants) to explore the experiences of research and higher degrees. Following themes from these, we used an online survey to gain quantitative data and obtained results from 39 hematologists in the local network in North East London serving approximately 4 million people, including two teaching hospitals. Among attendings, 72% had completed a research degree and 52% were in academic positions. Of trainees, 36% were enrolled in a higher degree program. The focus groups felt that hematology has a strong role in research because of the inherently lab-based aspects of the work, access to tissue for research and the history of translational research. The survey supported this, with most feeling that the lab experience facilitated the transition of hematologists to research, and 77% agreeing that 'compared to other medical specialities, hematology is more academic'. The focus groups explored the benefits of doing a research degree, such as a PhD. These included gains in critical thinking, data interpretation skills, a chance to study a topic in depth and CV development. Drawbacks included dislike of the work involved, financial loss and the stress of research. Some expressed concern about losing clinical skills during years of full-time research, whilst others felt that skills gained during research translated to better clinical acumen in the long term. The survey explored this further. 74% felt that whilst clinical acumen decreased during full-time research, this returned almost immediately on return to practice. 21% felt that clinical skills were better in the long term as a result of doing a PhD. Competition for non-academic hematology posts in the UK is low, and most doctors who do research will not become academics. However, there are expectations that hematologists need a research experience to further their careers, and most participants felt that there was greater pressure for hematologists to do research compared to other disciplines, with this pressure greater in London. We considered this perception of pressure in the context of UK research funding. The Royal College of Pathologists estimate that of ≤450 million spent on UK cancer research, ≤50-100 million are spent on hematological malignancies. Research funding is therefore out of proportion to the disease burden of blood cancers (8% of cancer deaths). London has 31% of UK academic doctors, 5 medical schools and receives 33% of UK research funding. These data help explain the greater pressure (or opportunity) for hematologists to undertake research, particularly in London. We explored views on recruitment to academic medicine. Whilst ‘becoming an academic doctor’ was rated as the strongest motivation for hematologists to do a PhD, doctors who subsequently did not proceed to an academic career benefitted from the research experience. Whilst academic doctors felt that more hematologists need to do research and become academic doctors, this view was not held by non-academic hematologists (p<0.05). In conclusion, hematologists consider their specialty to be more academic, with the nature of the work facilitating research. Particular motivations drive hematologists to undertake research. The pressure to do research may be higher in hematology compared to other areas of medicine, despite low competition for jobs overall. Concerns about loss of clinical skills do not appear to be justified. The perception of a recruitment problem within academic hematology varies depending on whether academic or non-academic hematologists are surveyed. Disclosures: Gribben: Roche: Consultancy; Celgene: Consultancy; GSK: Honoraria; Napp: Honoraria.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4654-4654 ◽  
Author(s):  
Magnus Mansouri Taleghani ◽  
Yoshihiro Fujimura ◽  
James N. George ◽  
Ingrid Hrachovinova ◽  
Paul Knoebl ◽  
...  

Abstract Abstract 4654 Background: Hereditary TTP, also known as Upshaw-Schulman syndrome (USS), is a rare disorder and the result of recessively inherited ADAMTS13 gene (located on chromosome 9q34) mutations. The clinical presentation is variable and may vary from mild isolated thrombocytopenia to recurrent severe TTP episodes leading to organ damage or even death. The first acute TTP episode may occur during the neonatal period up to older age. The same variety applies to the treatment requirements as some patients need regular plasma infusion every two to three weeks to prevent recurrent episodes while others only need plasma therapy in situations of increased risk, such as pregnancy or during infections. Due to the rareness of USS evidence based guidelines are lacking as are knowledge of long-term outcome which emphasizes the need of a multicenter cooperation. Aim: We have established a long-term observational study with an electronic database system for hereditary TTP patients (www.ttpregistry.net, ClinicalTrials.gov NCT01257269) to gather as much information as possible about the clinical courses and laboratory investigations performed. We aim at the identification of triggers that set about acute TTP bouts and of factors influencing the clinical course with the goal to possibly elucidated the underlying causes of the variable clinical presentation of this rare monogenic disorder eventually leading to optimization of therapy and evidence based recommendations. The study is open to any patient diagnosed with hereditary TTP and his/her interested family members. Eligibility criteria are as follows: • ADAMTS13 activity ≤10% on two separate occasions at least 1 month apart; and • Absence of a functional ADAMTS13 inhibitor and • ≥2 ADAMTS13 gene mutations and/or full recovery and normal half-life of infused plasma ADAMTS13); or • Being a family members of a confirmed patient Clinical information and laboratory investigations are collected retrospectively up to enrollment as well as prospectively every 12 months following enrollment. Analysis of ADAMTS13 related parameters including molecular analysis of ADAMTS13 gene are offered free of charge to patients and all family members. Conclusion: Our long-term goal is to establish an international network and knowledge platform to exchange information and experience on USS, that helps to improve diagnosis, treatment and prevention of acute episodes with risk of permanent organ damage for affected patients. Physicians treating USS patients are invited to contact us for diagnostics of suspected patients or enroll their confirmed patients. Disclosures: Fujimura: Baxter BioScience: Membership on an entity's Board of Directors or advisory committees; Alexion Pharma: Membership on an entity's Board of Directors or advisory committees. George:Baxter, Inc.: Consultancy; Alexion, Inc.: Consultancy; Amgen, Inc.: Consultancy, PI for clinical trial involving romiplostim, PI for clinical trial involving romiplostim Other, Research Funding. Kremer Hovinga Strebel:Baxter: Consultancy, Research Funding.


2018 ◽  
Vol 2 (5) ◽  
pp. 305-311
Author(s):  
Adrienne Zell ◽  
Lindsey Smith ◽  
N. David Yanez ◽  
Jeanne-Marie Guise ◽  
Ryan Pelkey ◽  
...  

AbstractIntroductionThere is growing concern about the declining physician-scientist workforce. NIH recently provided a national dashboard describing the biomedical research workforce, but local strategies are needed.MethodsWe used curated local and national data to develop a workforce dashboard.ResultsMany trends at Oregon Health & Science University (OHSU) were similar to those nationally, such as the increasing percentage of Research Project Grant (RPG)-holding PhDs and the aging RPG population, but differences were also apparent. At OHSU, nearly ¾ of physician-scientist RPGs hold MD-only, compared with nationally, where nearly half are MD/PhD. OHSU also lags in the percentage of RPGs held by women physician-scientists.ConclusionsOur analysis also permitted us to gain a more complete picture of research funding that has been done nationally. We used these data to develop a dashboard that allows our institution to develop policies to increase the numbers of physician-scientists. The data generation approaches and dashboard are likely to be useful at other institutions, as well.


2020 ◽  
Author(s):  
Kyoung Ja Moon ◽  
Chang-Sik Son ◽  
Jong-Ha Lee ◽  
Mina Park

BACKGROUND Long-term care facilities demonstrate low levels of knowledge and care for patients with delirium and are often not properly equipped with an electronic medical record system, thereby hindering systematic approaches to delirium monitoring. OBJECTIVE This study aims to develop a web-based delirium preventive application (app), with an integrated predictive model, for long-term care (LTC) facilities using artificial intelligence (AI). METHODS This methodological study was conducted to develop an app and link it with the Amazon cloud system. The app was developed based on an evidence-based literature review and the validity of the AI prediction model algorithm. Participants comprised 206 persons admitted to LTC facilities. The app was developed in 5 phases. First, through a review of evidence-based literature, risk factors for predicting delirium and non-pharmaceutical contents for preventive intervention were identified. Second, the app, consisting of several screens, was designed; this involved providing basic information, predicting the onset of delirium according to risk factors, assessing delirium, and intervening for prevention. Third, based on the existing data, predictive analysis was performed, and the algorithm developed through this was calculated at the site linked to the web through the Amazon cloud system and sent back to the app. Fourth, a pilot test using the developed app was conducted with 33 patients. Fifth, the app was finalized. RESULTS We developed the Web_DeliPREVENT_4LCF for patients of LTC facilities. This app provides information on delirium, inputs risk factors, predicts and informs the degree of delirium risk, and enables delirium measurement or delirium prevention interventions to be immediately implemented with a verified tool. CONCLUSIONS This web-based application is evidence-based and offers easy mobilization and care to patients with delirium in LTC facilities. Therefore, the use of this app improves the unrecognized of delirium and predicts the degree of delirium risk, thereby helping initiatives for delirium prevention and providing interventions. This would ultimately improve patient safety and quality of care. CLINICALTRIAL none


Obesity Facts ◽  
2021 ◽  
pp. 1-14
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
António L. Palmeira ◽  
Falko F. Sniehotta ◽  
Graham Horgan ◽  
...  

<b><i>Background:</i></b> Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. <b><i>The Project:</i></b> First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. <b><i>Impact:</i></b> The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 599-600
Author(s):  
Tracy Mitzner ◽  
Elena Remillard ◽  
Kara Cohen ◽  
Jordan Chen

Abstract Tele-technologies may be able to increase access to evidence-based exercise interventions for adults aging with long-term mobility disabilities. This population experiences substantial barriers in attending such programs in person, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. It is critical to overcome such barriers to ensure this population has an opportunity to receive the benefits of evidence-based programs. In this study we are translating an in-person evidence-based tai chi intervention, Tai Chi for Arthritis, to an online platform using videoconferencing software for those aging with long-term mobility disabilities. We will describe our approach of including users from the target population and industry representatives (videoconferencing software developer, Tai Chi for Arthritis program developer as well as local master trainer) in the adaptation of the intervention and present the key findings from doing so.


2012 ◽  
Vol 59 (1) ◽  
pp. 27-40 ◽  
Author(s):  
Jason Mayotte-Blum ◽  
Jenelle Slavin-Mulford ◽  
Meaghan Lehmann ◽  
Frank Pesale ◽  
Nikaya Becker-Matero ◽  
...  

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