Clinician-Scientist Faculty Mentoring Program (FAME) – A New Inclusive Training Model at Penn State Increases Scholarly Productivity and Extramural Grant Funding
Year: 2022
Type: article
Abstract: Purpose: Clinician-scientists have a high attrition rate at the junior-faculty level, before they gain independent funding. We identified the lack of skill set, clinician-scientist community and collaboration between clinician-scientists and clinicians with predominantly clinical duties, as key problems in our medium-size college of medicine. Methods: We designed a novel two-year educational program, the Clinician-scientist Faculty Mentoring program (FAME) specifically to target junior clinician-scientists. The program enrollment included both lab-based, “traditional” and “non-traditional” clinician-scientists, with predominantly clinical duties and limited time for research. The curriculum included the novel educational tools: Emerging technology seminars and mentored work-in-progress research seminars, integrated with mock grant review. Results: The first class enrolled 17 clinician-scientists with diverse clinical subspecialty, previous research training, and protected research time. After two years in the program, the self-assessment of FAME scholars demonstrated strong improvement in grantsmanship skills, career development, emerging technologies, and the sense of community and collaboration. Compared to the period before initiating FAME, scholars increased annual scholarly output by 65% and new extramural funding by > 20-fold ( Introduction Over the last 30 years, there has been a decline in the number of clinician-scientists in the US, largely due to a high attrition rate.1–5 The major period of loss in the clinician-scientist pool occurs at the junior faculty level, prior to someone achieving an independent position.6–8 At the Penn State College of Medicine, and other institutions, educational programs have been designed for junior faculty and are attended by both basic and clinician-scientists.9–11 These efforts, however, have not reversed the trend of the high attrition rate of clinician-scientists either nationally or at Penn State. In mid-sized colleges of medicine, such as ours, two additional problems that contribute to the high attrition rate of clinician-scientists were identified: small clinician-scientist community due to the overall low number of clinician-scientists12–14 and minimal collaboration between clinician-scientists and clinicians with predominantly clinical duties.12,13,15–21 This lack of collaboration especially limits the ability of clinician-scientists to conduct translational, patient-oriented team science. It also exacerbates a sense of isolation, causing clinician-scientists, to miss opportunities to make advances in medicine, decreasing their scholarly activity and their academic advancement of clinicians.20,22–27 To address this issue, we created a novel educational program entitled the Clinician-Scientist Faculty Mentoring program (FAME). This program was specifically developed for junior faculty clinician-scientists, and we formulated a unique, inclusive approach to provide training and integrate the research of lab-based clinician-scientists with clinical investigators with predominantly clinical duties. For our purposes, we define “junior faculty” as clinicians with an initial full-time academic appointment as instructor or assistant professor and early-stage investigator status (ie, yet to obtain NIH-R01 or R01 equivalent funding award). The design of the program is based on the two hypotheses: 1) during the junior faculty stage, clinician-scientists would benefit professionally from an additional educational program designed specifically to address their unique needs and 2) providing a training program for both “traditional” lab-based clinician-scientists (“clinician-scientists”, as defined by McKinney2) and “non-traditional” clinician-scientists (“clinical researchers”, as defined by McKinney2), will increase the scholarly output of both groups and enhance the sense of community and collaboration. Here, we present the approach and organization of the FAME curriculum, with an emphasis on the novel aspects of the program and an assessment of the early analysis of outcomes as it relates to the original goals. Specific Goals and Objectives of FAME Program Prepare/mentor lab-based clinician-scientists for a sustainable research career Provide research training for clinician-investigators with predominantly clinical duties and limited protection time for research Establish novel collaborations between lab-based clinician-scientists and clinical-researchers Establish a sense of community among all types of clinician-scientists. Organization and Content of FAME Program Penn State College of Medicine had developed several scholarly programs to assist in scientific development, including the Junior Faculty Development Program (JFDP), Grants Academy, K-workshop series and the Clinical and Translational Science Institute (CTSI) sponsored KL2 program (Figure 1A). The FAME program was a directed supplement/complement to these and other existing educational, career development, and mentoring resources for clinician-scientists at Penn State College of Medicine (Figure 1A).9 For the purposes of the FAME program, a clinician-scientist is defined as a medical doctor (MD or DO) or other health professional (eg, nurse practitioner, clinical psychologist, etc.), who is working to advance medical knowledge through clinical, translational, or basic research. The program was aimed at being inclusive and involving all health care professionals who have either a substantial portion of their effort allocated for research or have expressed a strong desire to advance their research skills and take part in collaborative research at the Penn State College of Medicine. Defining “protected research time” as the amount of “full time equivalent” (FTE) allocated and supported by institution/employer to a faculty to perform research activities free of clinical, teaching or administrative responsibilities,28 the FAME program requires a minimum of 0.1 FTE “protected research time” during the two-years of the FAME program. The FAME scholars have been selected based on their background in research, personal statement that expressed a strong commitment toward advancing their career in research, and strong support from their respective department chairs. The prior research experience of the selected scholars was diverse: six had a formal research training (ie, MD/PhD degrees or equivalent), whereas the research training of others was limited to that from their clinical fellowships and/or attending the other mentoring programs noted above. Figure 1 Clinician-scientist Faculty Mentoring Program (FAME) – curriculum and role in faculty development programs at Penn State College of Medicine. (A) Faculty development programs at Penn State College of Medicine. (B) Clinician-scientist Faculty Mentoring Program (FAME) Core Curriculum.Abbreviations: CTSI, Clinical and Translational Science Institute; NIH, National Institute of Health. The leadership of the FAME training program consisted of a program director and approximately 20 instructors/mentors who were all clinician-scientists and/or basic scientists with substantial track records of NIH funding and service on NIH study sections. FAME instructors/mentors gave individual lectures and actively participated in interactive sessions that are detailed below. The duration of FAME training was two academic years and consisted of 36 interactive two-hour lectures given biweekly. The lectures alternated with weekly scholarly advancement time (2 hours), which involved self-learning scholarly activities during which FAME scholars reviewed the didactic sessions from the previous week and engaged in additional reading related to the selected topic. Curriculum The FAME program core curriculum consists of 4 types of seminars and core activities (Figure 1B and Supplemental Table S1–S3): Grant Writing Workshop Seminars: This consists of two-hour sessions (12 hours total) given consecutively at the start of the FAME program (Supplemental Table S1). The main goal is to improve grant writing skills of clinician-scientists that will be an essential part of their careers. Clinician-scientist Career Development (CD) Seminars: This is composed of eight interactive sessions (16 hours) presented by the program director and other experienced Penn State faculty (Supplemental Table S2). These sessions are focused on the describing the specific requirements for achieving excellence and national recognition in research, as well as achieving a high level of performance in teaching, service, and administration that are also criteria for promotion and tenure of clinician-scientist faculty. Additional career opportunities (eg, research collaborations with industry; consulting; etc.) are also discussed. There is a specific emphasis on the importance of ethical and responsible conduct of research, and the need to enhance diversity in the clinician-scientist pool. These interactive sessions are interspersed with the other types of seminars that are essential components of FAME program. Emerging Technology Seminars: These are specialized seminars with three goals: 1) to educate clinician-scientists about emerging technologies that can be used in different research settings, with different disease models, and in a cross-disciplinary contexts and 2) to provide clinician-scientists with the intellectual and logistical resources to use emerging technologies at Penn State University. Each seminar (2 hours) consists of a one-hour presentation of the emerging technology (eg, gene editing using CRISPR Cas9; scRNA-seq; etc.) that is followed by a one-hour presentation, of a real-world research project that uses this particular emerging technology. A total of 12 two-hour Emerging Technology Seminars are given during the two-year FAME program (Supplemental Table S3). Clinician-scientist Mentored Work-in-Progress Research Seminars: These are innovative presentations we designed to promote project-oriented thinking among clinician-scientists and to improve their manuscript and grant writing skills. In these seminars, the FAME scholars, with an input from their primary mentor, prepare an oral presentation of their research project using a specific, 1-hour presentation template structured to include: Presentation of scholar’s research results (20 minutes). Discussion of research problems, pitfalls, alternatives, and future plans (20 minutes). Plans for grant submission in the form of an NIH-style Specific Aims page and additional slides to elaborate and justify each specific aim for future grants (20 minutes). The Emerging Technology Seminars and Clinician-scientist Mentored Work-in-Progress Research Seminars are novel educational tools incorporated into the FAME program curriculum. These presentations are highly interactive sessions, during which FAME instructors, mentors, and other FAME scholars ask questions and provide advice and suggestions to the presenter regarding his/her project and plans for future grant submission. Mentored Work-in-Progress Research Seminars complement mentoring by a primary mentor with feedback from other mentors in the FAME program. In addition, the FAME scholars learn how to provide constructive feedback to the presenters, with the goal of developing their grant reviewing skills. During the two-year duration of the FAME program, scholars give a total of 12 two-hour work-in progress seminars (total 24 presentations), which allows each FAME scholar to present their data and grant plans at least once (most of them twice) and obtain valuable feedback from FAME instructors, mentors, and other scholars. In addition, FAME scholars participated in our Institutional Mock Review of Grants (MoRe) sessions to receive feedback on their Specific Aims page from senior faculty members with NIH study section experience. Their participation in MoRe was in three different roles: 1) as an observer; 2) as an applicant, but witnessing an NIH style review processed internally (but prior to submission of their application); and 3) as a reviewer, where the FAME scholars serve as one of the secondary or tertiary reviewers of proposals submitted by other junior investigators and FAME scholars (the primary and at least one secondary reviewer are all seasoned investigators). The purpose of the FAME scholars’ participation in MoRe is to demystify the NIH review process and to provide FAME scholars with different perspectives of how to analyze grant proposals, both as an applicant and as a reviewer. Methods Program Assessments The effectiveness of the FAME program was assessed in several ways: Self-assessment survey of FAME scholars. The self-assessment survey was performed using a semantic differential scale with adjectives. Deidentified data from the self-assessment survey were collected by administrative associates of FAME program. Data analysis was performed in Excel (Microsoft), and the statistical analysis was performed using paired Student’s t-test with Bonferroni correction. Data collection and analysis of scholarly productivity and career progress of FAME scholars. Data regarding scholarly productivity (manuscript submissions, publications, and funded awards) were collected and analyzed using both self-reporting and objective methods. These include: Data regarding manuscript submission and publications of FAME scholars were obtained using self-reporting. The number of published manuscripts was confirmed objectively by using PubMed (sometimes supplemented by verifiable data from other sources). Data regarding the number of funded extramural awards and the dollar amount of each extramural-funded award were obtained using Research Electronic Data Capture (REDCap) tool at Penn State College of Medicine.29 Award data were validated via the university’s Strategic Information Management System (SIMS), which is the central source of sponsored research and grant budgeting. To calculate total new extramural grant funding secured during a particular year, the total amount of the award was used. For example, if a FAME scholar secured a 5-year grant of $100,000 in annual funding, the total amount of $500,000 was used to calculate the total new extramural funding obtained in that particular year. Results Diverse Background of FAME Program Participants The first FAME cohort enrolled 17 clinician-scientists (scholars) with a diverse formal research training (PhD and/or formal research training at Penn State) and research experience (based on the number of 1st and corresponding authorship papers) (Figure 2A–C), from 6 different departments (Figure 2D). The class was heterogeneous regarding designated protected research time (Figure 2E), as well as research and clinical career stage (Figure 2F). High diversity of the FAME scholars was designed purposefully to fulfill the goals of the program. Figure 2 Diverse background of clinician-scientists enrolled into FAME program. (A) Medical and research background of Clinician-scientists – FAME scholars; (B) completion of formal scholarly and/or research training programs at Penn State College of Medicine before enrollment to the FAME program; (C) number of first and corresponding authorship papers before enrollment to the FAME program; (D) specialty background of FAME scholars; (E) designated research time of FAME scholars; (F) stage of clinical/research career of FAME scholars. FAME Scholars’ Self-Assessment Survey of Competency The research training of FAME scholars focused on three areas: 1) Improvement of grant writing skills; 2) Development of strategy for a career as a and 3) of knowledge of and emerging technologies that be used in their research We the of the research training using a self-assessment survey of FAME scholars on the three (Figure Results that FAME scholars in knowledge of the NIH funding process and grant writing skills, as well as increased in their ability to obtain funding (Figure The FAME scholars a of the role of publications and educational activities in career advancement and the ability to their career as a clinician-scientist (Figure The of the seminar that focused on the emerging technologies in clinical research was analyzed by a self-assessment survey of three lectures that focused on basic and technologies, as well as their clinical with The analysis that FAME scholars their knowledge and of emerging technologies (Figure as well as their with resources at Penn State (Supplemental Figure S1). Figure Results of the self-assessment survey of FAME scholars. Results of self-assessment survey a strong improvement in (A) grant writing skills; (B) clinician-scientist career and (C) emerging technology before FAME, the scholars to have a knowledge in all of the by research training included in the FAME program curriculum, as by a low of knowledge a in FAME, the knowledge level of all as well as their in extramural funding, FAME Scholars’ Self-Assessment Survey of the of and goals of the FAME program were to new collaborations between lab-based clinician-scientists and clinical as well as to a sense of community among all types of clinician-scientists. At the self-assessment FAME scholars that the of novel collaborations was highly increased (Figure and that a sense of community of FAME scholars was one of attending FAME (Figure It is to that the initial sense of community of FAME scholars was at an low level and improvement one of attending the program. Figure 4 The of FAME program on sense of community among clinician-scientists. of collaboration (A) and increased sense of community (B) of FAME scholars completion of the The results presented in and 4 that FAME scholars identified all of the in the FAME program curriculum as which was defined as a 2 scale 1 to 12 of the FAME program, the scholars which was defined as a in from to 12 of FAME in specific The was both in research knowledge and in the improvement in the sense of community and collaboration. of Scholars’ Career and Grant the completion of the program, a number of FAME scholars high scholarly as by an increased number of submitted manuscripts and manuscripts Supplemental Figure and Supplemental Figure These data that attending the FAME program was with increased productivity of FAME scholars. The total number of grants the completion of the FAME program increased to the prior to the FAME program Figure In the prior to the FAME program, the amount of new extramural funding, was low in the the completion of FAME program, scholars were a total of by NIH or national (Figure FAME scholars were an extramural grant in the the completion of FAME program, as to two in the prior to the program (Supplemental Figure S3). of FAME scholars by the amount of protected research time that the “traditional” clinician-scientists with research time an increased number of funded grants by Figure and extramural grant funding by Figure The “non-traditional” clinician-scientists, with research time increased the number of new funded grants by (2 Figure and funding from new extramural grants by with Figure Figure The of FAME program on ability of FAME scholars to obtain new extramural grant funding. The total number of new grants (A) and total grant amount (B) of all FAME scholars completion of FAME program the before The number of new grants (C) and funding amount from the new grants (D) of FAME scholars – “traditional” research clinician-scientists completion of FAME program the before The number of new grants (E) and funding from the new grants (F) of FAME scholars – “non-traditional” clinician-scientists research completion of FAME program the before Discussion The results of our and review of the of the FAME program were in the career development of clinician-scientists. in the FAME program had the on the ability of FAME scholars to obtain new extramural grant funding. This that the of the FAME program was on the of clinician-scientists to results of their research into grant The unique approach of the FAME program is the of lab-based clinician-scientists with clinical with predominantly clinical duties in the program. The increase of new extramural grant funding, with an increase of scholarly activity by both groups of clinician-scientists, to the of the program. extramural funding was increased among both “traditional” and “non-traditional” clinician-scientists. with predominantly clinical duties to the time for scholarly in in achieving academic promotion as well as a sense of from the of the academic of these can contribute to one of the main problems in academic of the and There are several to our this study a we it has this will have to be by This also a unique if different their and that can make this approach and this was one and one class of scholars, the number of scholars included is data from our and FAME are the will be if our data can be with that of other institutions, the of the approach will be is the we have will into on the academic of the FAME scholars; this is the A related is that one of the FAME program to has been the high diversity of the scholars, this can also be a of scholarly performance of the FAME scholars in will to additional opportunities to the curriculum toward specific needs of the specific These are of the future we to use to our and use them to improve the program. this can be a collaborative effort with other the benefit to the as a be of the FAME Program in The analysis of the of the FAME program that additional training to clinician-scientists to increased scholarly activity of the scholar’s previous experience in research. The educational tools used in FAME to be in the training of clinician-scientists. The FAME cohort has been enrolled and they also will use this curriculum as a for their career development program. of We the importance of the substantial in the first cohort also occurs in this as well as It is also to the of FAME training are and these faculty members engaged in research the is to perform an annual to their scholarly and extramural funding. of Additional for results that clinician-scientists with predominantly clinical duties and limited time have that can be with The amount of funding in new grants obtained by “non-traditional” clinician-scientists was that of “traditional” clinician-scientists. This is the of grants of the are in they a toward We have several new for the of additional training programs for to them extramural the FAME Program We that the and organization of the FAME program would have the on the scholarly activity in institutions, such as Penn State College of Medicine, where the small of clinician-scientists is in we that in academic the FAME program be to individual etc.) to have a focused in each We also would to a program such as FAME nationally via national professional for Research results that a training and mentoring to clinician-scientists to increased scholarly activity of research The developed educational tools were well and the results they enhance the productivity of early-stage The data also that scientists with limited time have that can be by an that is and the lack of a sense of community and the low collaboration between lab-based clinician-scientists and clinician-scientists with predominantly clinical duties can be by an inclusive program that both data the use of this of clinician-scientist junior faculty training program in academic health institutions, and it well have a for other academic This study was from the Penn State College of Medicine Institutional Review review results were This is supported by funding from Penn State College of Medicine. 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DOI: 10.2147/amep.s365953
Institution: Penn State Milton S. Hershey Medical Center
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,320
OpenAlex ID: W4296325524