Intended for individuals wishing to pursue a career in clinical research. This fellowship provides the skills and experiences necessary to develop, execute, interpret, and secure funding for clinical and health services research studies. The foundation of this track is the Master of Science in Clinical Research Program, which is offered by the Institute for Clinical Research Education (ICRE). Fellows complete a mentored research project, develop a full-length grant proposal ready for submission (e.g., NIH-mentored K23 award), and participate in clinical and teaching activities in the Division of General Internal Medicine.
Clinician-Researcher Program Structure
The University of Pittsburgh GIM Clinical Research Fellowship prepares outstanding physicians for successful careers in academic GIM. The main components of the fellowship are: (1) completion of a Master of Science (MS) in Clinical Research; (2) mentored clinical research project(s); (3) clinical care; (4) teaching; and (5) training in professionalism and leadership. The approximate percentages of time spent on specific components are: MS coursework (25%), research (50%), clinical care (20%), and teaching/training (5%).
The Learning Health System Fellowship prepares graduates to be on the front lines of the transformation of the health care system. Fellows gain quantitative experience in reforming payment or delivery systems, and are given the opportunity to participate in meetings with thought-leaders and executives about how to stimulate change and reform within a complex health system. Graduates will be well-prepared for leadership positions in academic medicine or a large health system or health plan.
MS in Clinical Research
Clinician-Researcher fellows receive exceptional training in research methodology and statistical analysis through completion of the MS in clinical research which is administered through the Institute for Clinical Research Education at the University of Pittsburgh. Tuition for the MS is provided by the fellowship program. All first-year fellows start fellowship in the summer with an intensive set of master’s-level courses to bring everyone to the same level methodologically. Fellows take 9 credits during the first summer: clinical research methods (3 credits), biostatistics (4 credits), computer methods (1 credit, one week only), and measurement in clinical research (1 credit). Clinician-Researcher fellows who participate in the intensive summer courses during the first summer do not have clinical or teaching responsibilities during that time.
After the initial summer courses, fellows choose required and elective courses in one of the four specialty tracks within the MS in clinical research: health services research, comparative effectiveness research, clinical trials, and translational research. (Learning Health System Fellows will follow the health services research track.) All tracks include the Research Design and Development course, otherwise known as “grant writing,” in which fellows develop a full-length NIH-style grant proposal (typically a K23 Career Development Award or similar). The MS in clinical research culminates in an MS thesis review by a formal review committee. The options for a thesis project are: (1) two clinical research manuscripts (published, under review, or ready for submission) based on work completed during fellowship; (2) a full-length grant proposal for an R01, K Award, or equivalent award; or (3) a standard thesis.
Fellows who have prior advanced research training (e.g., PhD, MS, or MPH) are not required to complete the MS in clinical research. However, such fellows may wish to take additional coursework to fill in methodological gaps in their training.
All Clinician-Researcher fellows complete at least one research project and are expected to present results at the Society of General Internal Medicine annual meeting (or similar meetings) and to submit the findings for publication in peer-reviewed journals. The project will typically involve a clinical or health services research project designed by the fellow, usually attached or complementary to a division faculty member’s ongoing, existing research project. 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 of the first year.
Fellows work closely with one or more accomplished Clinician-Researcher faculty mentors. We begin matching fellows with prospective mentors very early in the application process. Prior to the interview day, we have an extended phone conversation with the prospective fellow to determine areas of research and methodological interest. This ensures the prospective fellow will be able to meet with several potential research mentors during their interview day. Once a prospective fellow is accepted into the program, we encourage the fellow and potential faculty research mentors to initiate communications and planning, even before the fellow begins the program.
Clinical care is an integral part of our fellowship training program. Fellows also serve as the attending-of-record for an inpatient team of residents, interns, and medical students. Inpatient attending is generally 4-6 weeks a year 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 general internists. Opportunities to practice and hone teaching skills are available in a number of venues during the Fellowship:
- Inpatient Attending – A faculty member is expected to be present for 2-3 hours each week to observe Fellows’ inpatient 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 once during each year of fellowship. Fellows meet with a fellowship faculty member after the presentation to receive written and oral constructive feedback.
- 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.
- Other Teaching Opportunities – Many 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. Clinician-Researcher fellows 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) a clinical mentor who will provide guidance and feedback for clinical activities, especially precepting of residents in the outpatient clinic. 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 depend on specific projects and clinical precepting 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.
Leadership and Professionalism
The development of strong leadership and professionalism skills is critical to success in academic medicine. Clinician-Researcher fellows develop these skills through multiple program activities, including monthly group meetings for fellows and fellowship faculty, the Interdisciplinary Fellows Seminar held twice a month, leadership and management courses and workshops offered by the Institute for Clinical Research Education, and workshops sponsored by the University of Pittsburgh Office of Academic Career Development.
Division of General Internal Medicine Academic Offices
UPMC Montefiore Hospital
Pittsburgh, PA 15213