1. Making It As a Clinical Researcher or Educator
Andrea E. Reid, MD, MPH
Massachusetts General Hospital
Harvard Medical School
Boston, MA

2. How do you define success?
Publications
Promotion
Prestige
Payment
Parity
Peace

3. Franklin Covey The Seven Habits of Highly Effective People
Be Proactive
Begin with the End in Mind
Put First Things First
Think Win-Win
Seek First to Understand, Then to be Understood
Synergize
Sharpen the Saw

4. Definition of Clinical Research
Patient-oriented research. Research conducted with human subjects or on material of human origin for which an investigator directly interacts with human subjects. This area of research includes:
Mechanisms of human disease
Therapeutic interventions
Clinical trials
Development of new technologies
Epidemiologic and behavioral studies
Outcomes research and health services research.

5. Translational Blocks in the Clinical Research Continuum
JAMA 2003: 289;

6. Funding Roadblocks on the Way Toward Improved Public Health
JAMA 2004: 291;

7. NIH Director’s Panel on Clinical Research (CRP)
Three questions:
Who is going to do clinical research and how are these individuals to be properly trained?
Where will clinical research be conducted?
How will clinical research be funded?

8. The problems in clinical research
Numbers down
Attrition up
Insufficiently nurturing environment in AMC to sustain CI
Insufficient infrastructure
Insufficient mentoring
Increased pressure for more clinical activity
Shrinking revenues

9. Solutions to the crisis
Funding
New investigators
Mid-level investigators
Equitable grant review
Formalized training
Loan Repayment Programs

10. How to succeed as a clinical researcher
Define your interests
Explore
Discuss
Commit
Supportive environment is crucial
Find a good research mentor
Experienced
Well-known
Funded
Interested in your success
Obtain formal training in methology

11. Explore funding mechanisms
NIH
Veteran’s Administration
Industry
Foundations
Private money
Institutional grants

12. The Current State of Affairs
NIH funds 212,000 researchers
~ 30% extramural support devoted to clinical research
NIDDK programs directed to clinical research:
K01:Mentored Research Scientist Development Award
K08: Mentored Clinical Scientist Development Award
K23: Mentored Patient-Oriented Research Career Development Award
K24: Midcareer Investigator Award in Patient-Oriented Research

13. Get someone else to pay your loans
National Institutes of Health Extramural Programs
Loan Repayment Program for Minority Health Disparities Research
Extramural Clinical Research Loan Repayment Program for Individuals from Disadvantaged Backgrounds
Loan Repayment Program Regarding Clinical Researchers
Pediatric Research Loan Repayment Program

14. LRP Eligibility Student debt > 20% of university compensation
>50% time to research effort for > 2 yrs
Applicant's support may be a grant from the
NIH or any nonprofit organization

15. Success as a clinical researcher depends on your network
Clinical research is collaborative
Be creative about your collaborations
Use your mentor’s network
Be open to forming new, unexpected connections with people and projects
Publish or perish

16. How are you evaluated as a clinician-educator?
Objective criteria
Scholarly output
Book chapters, reviews, clinical guidelines, curricula
Grant support
Recognition as an education leader by peers
Teaching awards
National committees
Administrative skills
Revenue generated from clinical care

17. How are you evaluated as a clinician-educator?
Subjective criteria: what are the measures of good teaching?
How well others learn
How much student grows as a learner because of input
Practice methods
“Impact factor”

18. Components of evaluation
Teaching skills
Clinical skills
Mentoring
Academic administration
Developing educational programs
Non-research scholarship
Clinical research
Service coordination
Education research

19. Methods of evaluation Peer evaluation Awards Trainee evaluation
Teaching portfolio
Clinical service time
Leadership qualities
Grant support
Publications
The weight placed on each component varies by institution

20. Importance of specific aspects of a clinician-educator's performance when the promotion committee makes decisions about promotion to associate professor
JAMA 1997: 278; 723-8

21. Know what your institution values
Hospital: revenue, efficiency, quality, community involvement
The medical school: publications, notoriety
Know the promotions process
Know your worth on the academic market

22. Make the most of every opportunity
Teaching opportunities
Local: Medical students and residents
Regional: Medical societies
National: curriculum boards, national meetings, educational symposia
Service opportunities
Hospital and medical school committees
Don’t overdo
Evaluate benefit to you
Health organizations
GI Societies

23. Begin with the end in mind
Document everything
When, where, why, how, to how many
Time keeping
Resume building
Mentor and be mentored
Seek feedback from educators you respect
Training
Challenge yourself