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The education and career development program within the Oregon Clinical and Translational Research Institute (OCTRI) was purposefully designed as an integrated, institutional home for clinical and translational science students, trainees, and early researchers. Our philosophy has been to create a program in response to the needs of the institution and learners at all levels, rather than creating programs specifically to meet the requirements of the Clinical and Translational Science Award (CTSA).[1] This foresight has resulted in a program that has become the institution-wide resource for research career development for undergraduate medical students, fellows, and faculty at Oregon Health and Science University (OHSU).

The education and career development program in OCTRI was designed around major inflection points in the research career trajectory (Figure 1).[2] These points represent the major decision points in the research career pipeline, time periods in which a program can potentially have the most impact through offering education and career development programs specifically tailored to the stage. These decision points are at the time of selecting a residency and clinical or postdoctoral fellowship path; at the close of fellowship and selection of an academic career path; and subsequently at the end of the research career development stage. We have developed specific education and career development programs that focus on developing the research pipeline of undergraduate medical, dental, and graduate students; expanding postdoctoral research opportunities and programs for clinicians and scientists; and supporting early career investigators to optimize their transition to independence.

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Figure 1. Major decision points in the research career trajectory.

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We have centralized these resources in one institutional home for clinical and translational research education. Through this, we can have the largest effect on improving transition through the pipeline and maximizing the corps of successful clinical and translational scientists at OHSU. One benefit of this centralization is that it creates a single resource for students, trainees, and faculty; this one-stop shopping concept allows students to naturally progress to the next step or stage in a coordinated manner. A second benefit is that this resource serves all schools and programs within OHSU, including schools of medicine, nursing, and dentistry, as well as a graduate program focused on biomedical science and engineering. This creates an interprofessional environment that facilitates training with other trainees outside an individual's core discipline, and promotes a transdisciplinary view of research across the spectrum of learners. Finally, the lack of resource duplication at OHSU for education and career development creates an economical model for the institution.

The following sections describe the essential elements of our centralized, campus-wide educational program set around the three inflection points (Figure 1).

Human Investigations Program

  1. Top of page
  2. Human Investigations Program
  3. OCTRI Scholars Program
  4. Developing New Career Development Awards
  5. Optimizing Successful Career Development Outcomes
  6. Summary
  7. References

We created the Human Investigation Program, known colloquially as HIP, in 2001 through a K30 award from NIH; this curriculum expanded in scope with the CTSA to now include more than 25 courses. The HIP curriculum serves as a unified platform for all educational and career development programs within OCTRI (Figure 2), as well as a central curriculum at OHSU in clinical and translational research. Having one curriculum yet allowing for entry at different levels of training, from students in doctoral programs to faculty, allows an economy of scale.

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Figure 2. Integrated education and career development platform.

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Our paradigm within HIP is to maximize flexibility as well as creating a program that is competency-based and learner-centered.[3] Students and trainees participate through taking individual courses or entering degree-granting programs: a 2-year course of study culminating in a certificate or a master's degree with focused study to enhance an individual's research focus. We consulted with clinical fellowship, residency, and T32 directors to ensure that the program would meet graduate medical education (GME) and program requirements and complement more focused needs.[4] Our goal has been to create a curriculum that is utilized by fellowship directors as a central resource, creating efficiency and eliminating a need to develop department-based education seminars.

This HIP curriculum is supported centrally by institutional commitment. No tuition is charged for enrolling in the core curriculum or for education through a Certificate in Human Investigations. Students in the masters' track pay tuition for about half their coursework. We have targeted new courses in the curriculum to meet emerging needs of learners, often through collaboration with training grants and curriculum development grants.

The HIP curriculum has become a core resource for faculty and staff development at OHSU, and has increased a cadre of clinical and translational researchers. Almost 500 students have participated in the HIP program since the inception of the CTSA in 2006 including 121 faculty members. Between 50 and 60 individuals enter the HIP cohort annually; between half and two-thirds of the individuals seek a degree. In the earlier years of the program, 41% of matriculating students were faculty members. In the two most recent years, 60% of the entering class are residents, clinical fellows, or postdoctoral fellows; 23% are faculty; 9% are doctoral students (MD, DMD, and PhD); and the remainder are community or international clinicians and scientists. Every major department at OHSU has sent students to the HIP program, in addition to seven local colleges and universities. The reach of the OCTRI education program includes a large fraction of clinical fellows at OHSU as well as clinicians and scientists.

OCTRI Scholars Program

  1. Top of page
  2. Human Investigations Program
  3. OCTRI Scholars Program
  4. Developing New Career Development Awards
  5. Optimizing Successful Career Development Outcomes
  6. Summary
  7. References

Two other major inflection points in the research career trajectory relate to mentored career development. In 2007, we launched the OCTRI Scholars program across OHSU to increase the number of career development awardees and to optimize scholar outcomes in achieving research independence. This includes but is not limited to the OCTRI KL2 program, the CTSA career development program; it also includes everyone with any career development award at OHSU as well as in the Portland community. OCTRI Scholars have included individuals with K awards from NIH and AHRQ, VA CDA1 and CDA2 awards, as well as awards from professional societies and disease-focused foundations; in addition, individuals with NIH Research Program Grants (RPG) or similar as their first grants participate.

The program is constructed around four major themes: mentorship, peer networking, research support, and team science.[5] Individuals can apply for temporary membership in the OCTRI Scholar program to gain assistance in applying for a career development award; once a career development award is received, full OCTRI Scholar status is granted.

Developing New Career Development Awards

  1. Top of page
  2. Human Investigations Program
  3. OCTRI Scholars Program
  4. Developing New Career Development Awards
  5. Optimizing Successful Career Development Outcomes
  6. Summary
  7. References

To stimulate development of new career development awards and first RPGs, we have created a resource program that is promoted among training programs, fellows, and early faculty.

  1. Centralized support for career development awards. This includes a library of successful career development grants that any applicant can access. Because some departments do not have experienced administrative personnel to assist applicants, we will address this by assigning an individual within OCTRI to work individually with scholars on the processes required to submit a career development award.
  2. Design Studio. We have created a forum for scholars to present their proposed research to experienced, successful researchers in the OHSU clinical and translational research community for feedback. At monthly conferences, scholars present key components of their research, including specific aims, proposed methods, and key questions. This interactive, “internal study section” allows the scholar an opportunity to revise their proposal in order to submit the strongest proposal possible, and for a broad range of learners to attend and benefit.
  3. Research support. To optimize a proposal, scholars need access to biostatistical and research design support, research budget support, and often consultation with the IRB, clinical or biomedical informatics, and patient recruitment resources. All scholars applying for research funding gain complementary access to these OCTRI services to plan their application.

Prior to the start of the OCTRI Scholar program, there was an average of 8.4 new scholars appointed each year; after implementation, the average has risen to 17.3. We believe that the OCTRI Scholar program has been an essential element of this increase.

Optimizing Successful Career Development Outcomes

  1. Top of page
  2. Human Investigations Program
  3. OCTRI Scholars Program
  4. Developing New Career Development Awards
  5. Optimizing Successful Career Development Outcomes
  6. Summary
  7. References

After a career development award is received, the focus of the OCTRI Scholar program shifts to promoting transition to the next step of research funding. The elements of this program include the following.

  1. Peer networking. Monthly peer meetings are held for all OCTRI Scholars; scholars direct the content of the discussion toward topics of specific interest to career development awardees, such as creating and leading a research team; responding to reviewers; establishing a research path to an R01; and improving relationships with the mentor team. These sessions create a forum to network and learn from individuals at a similar level of training across all disciplines.
  2. Research support. OCTRI offers considerable support to the career development awardees, a high-priority group. OCTRI Scholars receive support to develop their IRB submission; determine the size of the eligible cohort within OHSU; create a database for information capture; and up to $20,000 per year in clinical research support that can include time, nursing, bionutrition, study coordinator, and laboratory assay services. In addition, scholars receive up to 30 hours of statistical analysis time.
  3. Design Studio. As described previously, a Design Studio conference can assist a scholar formulating their next funding step. The conference can be used by a scholar to work through implementation of their research proposal using a team-based seminar.
  4. Team Science and Research Support. Finally, the OCTRI Scholars program is utilized to promote specific funding and mentorship opportunities to scholars.

All OCTRI Scholars are tracked in order to determine the impact of this program. Overall, considering all scholars who have completed at least their first career development award, 70% have gone on to the next step of research funding. We define that as continuing to an independent career development award, or NIH research grant or equivalent. Similarly, of scholars who have completed their career development phase, 68% have gone on to independent research funding, either through an NIH research grant or equivalent. We believe this meets or exceeds the proportion at similar CTSA institutions, and across all NIH career development recipients.[6]

Summary

  1. Top of page
  2. Human Investigations Program
  3. OCTRI Scholars Program
  4. Developing New Career Development Awards
  5. Optimizing Successful Career Development Outcomes
  6. Summary
  7. References

We have created an education and career development program within the CTSA structure at OHSU that serves the entire institution. We believe that this is unusual in scope among CTSA programs and has contributed to an increase in career development funding and research skills among fellows and faculty. While the key element is the institutional scope, important elements include:

  • Tailoring programs of emphasis to points of inflection on the career pathway.
  • Minimizing barriers to education by creating a flexible, tuition-free program.
  • An integrated one-stop education and career development approach.
  • An institutional program for career development award applicants as well as recipients.

This career development program was developed within the context of a midsize health science university but the overall strategy may be applied to other CTSAs to simplify and reduce costs of education program development.

References

  1. Top of page
  2. Human Investigations Program
  3. OCTRI Scholars Program
  4. Developing New Career Development Awards
  5. Optimizing Successful Career Development Outcomes
  6. Summary
  7. References