All ACES fellows complete at least one research project and are expected to present results at the Society of General Internal Medicine annual meeting (or similar meeting) and to submit the findings for publication in peer-reviewed journals. Several types of projects are pursued by ACES fellows. One type of project typically involves the design, implementation, and evaluation of an educational intervention (e.g., a new curriculum, course, or educational program) utilizing quasi-experimental or experimental research design. Another type of project involves carrying out a cross-sectional survey of a group of physicians or trainees on a particular topic related to medical education. A third type of project involves conducting focus groups to gain a better understanding of physicians’ or trainees’ perspectives on a given topic related to medical education. ACES fellows have also directed educational projects using quality improvement (QI) methodology. Although we encourage independent primary research, fellows are encouraged to balance pragmatism with idealism and to choose projects that are feasible within two years. Project proposals are generally finalized during the fall semester of the first year.

Clinical care is an integral part of our fellowship training program. All fellows will have some clinical responsibilities, although the mix of inpatient and outpatient care varies with the particular area of interest. In general, ACES fellows will spend one half-day per week in the continuity outpatient clinic and two half-days per week precepting the intern and resident outpatient clinic. Fellows also serve as the attending-of-record for an inpatient team of residents, interns, and medical students. ACES fellows attend on the inpatient general medicine service approximately two months per year (divided into two or three-week blocks of time) at the VA Medical Center, UPMC Presbyterian/Montefiore, or UPMC Shadyside, depending on primary clinical assignment.

Learning to teach effectively in clinical and classroom situations is a critical and necessary skill for academic clinician-educators. Opportunities to practice and hone teaching skills are available in a number of venues during the ACES Fellowship:

• Outpatient Precepting – As described above, all fellows will precept the residents’ outpatient continuity clinic. A faculty member (clinical mentor) will be present during precepting sessions. The faculty member will observe the fellow’s teaching and give periodic feedback.
• Inpatient Attending – A faculty member will be present for 2-3 hours each week to observe the fellow’s inpatient teaching and to give feedback.
• Medical Student Attending – ACES fellows spend one month each year meeting for one hour a day, four days a week, with third-year medical students during their internal medicine clerkship. Fellows give feedback on oral presentations and H&P write-ups. A faculty member will be present for 1-2 hours each week to observe the fellow’s teaching and to give feedback.
• Journal Club – The Division of General Internal Medicine holds a weekly Journal Club on Fridays from 10 a.m. to 11 a.m. Fellows are expected to present a critical review of a paper at this forum at least once during each year of fellowship. Fellows meet with a faculty member after the presentation to receive written and oral constructive feedback.
• Medical Education Journal Club – ACES fellows have the opportunity to present new findings from the literature on medical education at this conference held once a month.
• Medical Education Research Seminar – ACES fellows have the opportunity to present their research-in-progress at this conference held once a month.
• Interdisciplinary Fellows Seminar – September through June, the general medicine, medicine-pediatric, general pediatric, adolescent medicine, palliative care, and family medicine fellows meet two Tuesday mornings of the month to discuss research project progress and to learn about professional issues, leadership, and cultural competence. Each fellow presents at this seminar twice each year and has the opportunity to discuss and receive feedback on their project(s) during this forum.
• Evidence-Based Medicine Journal Club – ACES fellows serve as co-facilitators for the internal medicine resident evidence-based medicine curriculum.
• Women’s Health Seminars – Women’s Health fellows have teaching opportunities in this weekly seminar.
• Other Teaching Opportunities – ACES fellows participate in other medical student teaching (e.g. medical interviewing, advanced physical diagnosis) and resident teaching (e.g. pre-clinic conference) opportunities.

Establishing successful relationships with mentors is one of the most important predictors of academic success during fellowship and beyond. A mentor may provide career and academic guidance, feedback, support, and review of ongoing research, methodological expertise, moral support, introduction to key personal contacts, and serve as a role model for the type of desired academic career. Fellows in the ACES Fellowship typically have three types of mentors: (1) a primary career mentor (THE mentor) who will provide primary career guidance and oversee all aspects of the fellowship experience; (2) a research mentor who will provide guidance, expertise, and support for fellowship projects (note: this may be more than one individual, especially if more than one project); and (3) one or more clinical mentors who will provide guidance and feedback for clinical activities, especially precepting of residents in the outpatient clinic and teaching during inpatient attending activities. In some cases, a single faculty member may serve all these roles for a fellow. Fellows meet with the program leadership early in the first year to discuss who the primary mentor will be. Choice of research mentor and clinical mentor will then depend on specific projects and clinical site. Mentors will help the fellow develop a portfolio of research, clinical, teaching, and leadership activities and develop a timeline for completion of tasks. Fellows also participate in the Institute for Clinical Research Education half-day workshop entitled “Mentoring Matters” during the first summer.