Mentoring Clinician Scientists and Scientists in Clinical Departments

1
Mentoring Clinician Scientistsand Scientists in
Clinical Departments

• Thomas K. Henthorn, M.D.
• University of Colorado
• Health Sciences Center

2
Mentor Qualities

• Mentor was the name of the close friend to whom
  Homers Odysseus, during a protracted absence,
  entrusted his children
• Educate
• Tutor
• Prepare for succession
• Protect

trust
Protect
3
Developing the Young Academic Surgeon Kevin
Staveley-OCarroll M.D., Ph.D., et al. Journal of
Surgical Research, October 2005

• Physician-Scientists need mentorship in 3 areas
• - academic, scientific, clinical
• - usually means 3 different mentors
• Academic mentor
• - senior faculty with milestones
• - organizing time
• - balance between research and clinical
• Scientific mentor
• - learning science, methods, technologies, etc
• - writing, grantsmanship, presenting results,
  etc.
• Clinical mentor
• - cannot be ignored
• - credibility in a clinical department depends
  on clinical prowess
• - can help ensure critical protected time is
  available share time

4
Developing the Young Academic Surgeon Kevin
Staveley-OCarroll M.D., Ph.D., et al. Journal of
Surgical Research, October 2005
  Strategic Milestones in Transition to
Scientific Independence
5
(No Transcript)
6
Mentoring Faculty in Academic Medicine, A New
Paradigm? Pololi L, Knight S. J Gen Int Med
20866 2005

• 33-50 of faculty report being mentored
• Informal vs formal?
• How long?
• "Where have all the mentors gone?" (Dunnington
  GL. Am J Surg. 1996)
• Gone with the recent changes in medicine
• Potential mentors need training
• Result is a decline in junior faculty prepared as
  clinician-scientists

7
Mentoring Faculty in Academic Medicine, A New
Paradigm? Pololi L, Knight S. J Gen Int Med
20866 2005

• In GIM only 11 are now Professors and 58 are
  Assistant Professors
• Unlikely that all junior faculty can be assigned
  a senior faculty mentor
• Conflict of interest between senior protector
  of the division/department and a junior faculty
  members professional aspirations
• Although informal mentoring provides a more
  effective mentoring model the recognition that
  many faculty lack mentors has led institutions to
  increasingly implement formal mentoring programs.

8
Mentor Qualities

• Today, there is no agreed upon definition of a
  Mentor
• This is an increasing issue recognized by the
  leadership in Biomedical Science
• Part of the problem of the countrys lagging
  efforts in training the next generation of
  clinical scientists
• How do we fix this?

9
NIH Roadmap for Medical ResearchInstitutional
Clinical and Translational Science Awards
(CTSA) Building an Academic HomeOctober 17,
2005
10
NIH CTSA Awards A Home for Clinical and
Translational Science
Clinical Research Ethics
Trial Design
Advanced Degree-Granting Programs
Biomedical Informatics
CTSA HOME
Participant Community Involvement
Clinical Resources
Biostatistics
Regulatory Support
11
NIH Efforts

• NIH conference to specify the new RFA
  requirements for CTSAs (Clinical Translational
  Science Awards)

T-32

K-12
6 million
CTSA
K-30
GCRC
12
NIH Efforts
T-32

K-12
6 million
CTSA
K-30
GCRC
? New emphasis on mentoring for institutional
training (T32 K12 and K30).
? New requirement for a graduate school
accredited to award degrees in clinical research.
? New emphasis translational science, systems
biology, bioinformatics and industry studies
(GCRC).
13
Mentor Qualities

• "Mentors are
• advisors, people with career experience willing
  to share their knowledge
• supporters, people who give emotional and moral
  encouragement
• tutors, people who give specific feedback on
  one's performance
• masters, in the sense of employers to whom one is
  apprenticed
• sponsors, sources of information about and aid in
  obtaining opportunities
• models, of identity, of the kind of person one
  should be to be an academic."

The Council of Graduate Schools (1995), Morris
Zelditch
14
Enhancing the Discipline of Clinical and
Translational Sciences Meeting, May 23, 2005

• Clinical and Translational Science Program
  Descriptions

• 16 Programs were presented and discussed

15
Colorado Clinical Science Program Laurie
Shroyer, Ph.D.
16
Colorado Clinical Science Program Ronald Sokol,
M.D.
Young Investigators Guide to Research Mentoring
Protocol Writing and Submission
Meet With Your Mentor About The Nature of
Clinical Research Plan to spend sufficient time
with your mentor to discuss clinical
research..
BOOKS Principles and Practice of Clinical
Research, Ed. John I. Gallin, Academy Press,
2002, ISBN 0-12-274065 Ethical and Regulatory
Aspects of Clinical Research Readings and
Commentary, Ed. Ezekiel J. Emanuel et al, The
Johns Hopkins University Press, 2003, ISBN
0-8018-7813-6 ON-LINE RESOURCES St. Judes
Childrens Research Hospital http//www.cure4kids.
org/ums/home/courses/detail/content.php?courses_id
10 Registration and use of resources is free.
NIH Clinical Center Training and Education,
http//www.cc.nih.gov/ Colorado Pediatric
General Clinical Research Center, electronic
application, http//www.uchsc.edu/pedsgcrc/
Public Health Service Form 398,
http//grants.nih.gov/grants/funding/phs398/phs398
.html Colorado Multiple Institutional Review
Boards, http//comirbweb.uchsc.edu/
17
Colorado Clinical Science Program Ronald Sokol,
M.D.
Young Investigators Guide to Research Mentoring
Protocol Writing and Submission
Meet With Your Mentor To Review And Critique
Protocol Draft Have a draft of your protocol to
your mentor 5-7 days before the scheduled
Draft Meeting time .
The Protocol Draft Meeting - Your mentor
will want to know answers to questions like What
issues arose while writing the Methods
section?. He/she is looking for evidence that
you are growing. - The result of this
meeting should be a clear understanding,
preferably articulated by you regarding
modifications - Once the essential components
of the scientific portion of the protocol are at
least in rudimentary form it is time for
you to seek additional expertise
biostatistics, human subject issues,
bioinformatics, regulatory, etc. - Whatever
your research, data will be collected and must be
stored. Expert assistance in setting up
databases and data collection advice - Set a
time to meet again with your mentor for the
purpose of reviewing and discussing
the full best-possible draft of your protocol
18
Colorado Clinical Science Program Ronald Sokol,
M.D.
Mentoring the Young Investigator (YI) Protocol
Writing and Submission
? Meet With YI About The Nature of Clinical
Research review research-treatment ? Meet With
YI About His/Her Research Idea purpose, design
issues, background, significance, ? Provide YI
With Protocol Writing Resources on-line
resources (NIH, PHS), names of local experts ?
Meet With YI To Review And Critique Protocol
Draft examine and discuss all sections ?
Provide YI With Information about Additional
Resources and Expertise contact info for experts
? Meet With YI to Review And Critique The Full
Protocol Draft examine and discuss each
section ? Instruct YI To Personally Contact GCRC
Core Managers ? Meet With YI Post-GCRC
Pre-Review based upon readiness for submission,
advise YI to proceed or delay. ? Meet With YI
Prior To The Review Meeting Discuss the review
process, what to expect from reviewers ? Attend
Review Meeting With YI This is required by the
GCRC. ? Meet With YI Post-Review Meeting
debrief and discuss YIs experience of the review
process ? Meet With YI To Review And Assess
Adequacy of Responses to Reviewers advise YI to
proceed or delay. ? Protocol Approval or
Disapproval Proceed to protocol initiation, or
regroup.
19
PENN Training Program in Translational
ResearchEmma Meagher, MD

• Identification of the lead mentor at the outset
  is a critical feature for a successful training
  experience.
• In consultation with the lead mentor, and with
  the approval of the MTR Advisory Committee, the
  candidate selects from the PENN faculty an
  individualized candidate MTR mentoring committee.
  
• This three person committee functions as an
  ongoing monitoring group for the candidates
  progress.
• The committee meets on a trimester basis to
  review progress reports submitted by the trainee.
  Thus the students MTR Program Committee
  functions analogously to a graduate students
  thesis committee.

20
Vanderbilt Physician-Scientist Development
ProgramJeff Balser, M.D., Ph.D.

• Program is fully integrated with the coursework,
  seminars, and mentoring infrastructure of our
  K-30 supported Masters in Clinical Investigation
  and Masters in Public Health programs.
• A key feature of the VPSD is that participants
  are closely monitored (at 6 month intervals) by
  the VPSD Advisory Committee, which actively seeks
  input from both the awardee and the research
  mentor on progress.
• The program director directly engages the
  awardee, mentor, and clinical department chair
  when problems are identified.
• 47 of VPSD K-awardees are successfully
  converting to R-awards, more than twice the
  national average.
• Recognizing the value of the central monitoring
  and organization this program provides, they are
  developing plans to expand the oversight of the
  VPSD beyond the 2 year initial period, into years
  3-7, to include the K-award support period that
  almost always follows VPSD program participation.

21
Department of Anesthesiology What we do now.

• Every Physician-Scientist or Basic Scientist
  (anyone with a lab and a start-up package)
• - must have a senior mentor outside of the
  Department
• - key (strategically) to extending our reach
  and our value
• - key (tactically) to the academic development
  of the individual
• - must have a mentor within the Department
• - key to developing within the specialty
• - key to maximizing the benefit of the research
  to the Department
• - key to developing citizenship within the
  Department
• - increasingly, looking for mentorship outside
  the institution

22
Mentoring through professional organizations

• FAER Academy of Anesthesia Mentors
  Established in 2004
• - Objective is to recognize those individuals
  who, through their activities as mentors, have
  contributed importantly to the development and
  advancement of academic anesthesiologists in the
  areas of research and education.
• - Additionally, the Academy seeks to promote the
  activities of mentoring among others in
  anesthesiology to increase academic activities in
  research and education as well as promoting the
  academic image of anesthesiology.
• IARS Mentorship Initiative
• - Effort to provide interdepartmental mentoring

23
Department of Anesthesiology What we need to do

• Every Physician-Scientist or Basic Scientist
• - must be part of a structured mentoring program
  run centerwide
• - key to getting best chance at a productive
  mentoring team
• - key to holding all parties accountable
• - key to getting long term success

Laurie Shroyer, the Graduate School Dean, and
myself have applied to the Presidents Fund for a
grant to launch such a program at Colorado - we
can learn from pediatrics and internal
medicine - but they are in a world of their
own - anesthesiology is one of the larger small
departments - what we develop is suitable for
export to the smaller departments
24
The End
25
National Shortage of Mentoring

• Science to lead Anesthesiology into the future

26
Mentoring Session Record
Mentor _______________________________________
Date ___________ Mentee _________________________
_____________Session ___________
Topics Covered at Present Session
Present Issues Current Actions Future
Agendas Other Subjects
Topics for Later Reference