Care and feeding of Physician Neuroscientists

1
(No Transcript)
2
Care and feeding of Physician Neuroscientists

• Training, career development, and independent
  research
• AUPN, ANA and NINDS

Dennis M. D. Landis, M.D. Professor and
Chairman, Department of Neurology, Baylor
College of Medicine.
3
Clinical training and research experience

• Recognition of basic science advances which could
  be pertinent to human disorders.
• Assisting basic scientists in the design of
  studies related to human illness.
• Communication with patients and patient advocacy
  groups about conduct and results of research.
• Educating physicians in the biological basis of
  clinical disorders.
• Opportunity to apply your ideas in a clinical
  context, involving patients.
• Personal satisfaction of caring for people and
  advancing the science and art of medicine

4
This timeline summarizes the most common career
path for individuals who undertake MD/PhD
training, and then clinical training prior to
independent research
At first glance, it looks like an incredibly long
process. Keep in mind that each phase has
intrinsic awards and satisfaction. You should
view this timeline diagram as an aid to planning.
Anticipate what will be required at each phase,
and things will go much more easily
5
Sequence of Support

• In general terms, the way in which your research
  is supported changes with your level of training
  and with evidence of your successful work.
• During research training, your work initially is
  directed by others.
• During career development, you develop your ideas
  and strategy with a mentor, and work with
  suggestions.
• An independent researcher devises his/her own
  plans, and figures out how to accomplish them.

6
Most combined degree students are supported by a
training grant to the institution, such as MSTP.
It is also possible to obtain individual funding
for MD/PhD training
Usually, those who have done research training
during medical school will later elect to obtain
further research training prior to applying for a
career development award, or independent funding
7
Research Training During Residency

• One approach is to break away from clinical
  training, obtain definitive research training,
  apply for independent investigator awards or
  career development awards during the third year
  of residency, and then go right to work.
• Restructuring of residency training is underway.
  The premises are that it is desirable to continue
  research, and that are certain classes of
  clinical education can be tailored to the
  individual needs of the resident.

8
(No Transcript)
9
After Initial Clinical Training

• The interval between completion of residency
  training and obtaining definitive research
  support is fun and confusing.
• Youll have to decide whether you want more
  specialized clinical training.
• Youll learn to balance clinical activity and
  performing the research necessary to earn your
  own independent funding.
• You now have to give serious thought to the
  directions of your future work.

10
Research Training After Initial Clinical Training

• It may be necessary to re-enter research training
  for 1 or 2 years, even if one has not changed
  interests or techniques.
• Review for K08 and K23 awards seeks substantial
  preliminary evidence.
• The support mechanism during the gathering of
  preliminary evidence is usually a NRSA. The
  stipend is now comparable to a similar year of
  clinical training.

11
Research Training After Initial Clinical Training

• In addition to federal support of post-residency
  research training, you should be aware of grants
  from
• Professional organizations, such as the American
  Academy of Neurology
• Private Foundations
• Health advocacy organizations, such as American
  Heart Assoc., Muscular Dystrophy Assoc., Multiple
  Sclerosis Society, etc.

12
Career Development Awards

• The K08 and K23 career development awards provide
  salary support for a junior faculty member (not a
  postdoctoral fellow), money for research (but
  someone else will have to supplement this), and
  requires institutional commitment.
• The K08 mechanism supports any sort of research.
• The K23 mechanism is designed to support clinical
  research.
• A variety of Foundations provide awards similar
  to the K08 and K23 mechanisms. These, too, can
  bridge the interval until R01 funding.

13
The K99/R00 mechanism is an alternative to the
career development awards. One does 2 years of
mentored research, and then has 3 years of
funding for independent research in your own
institution.
175k/yr, three years, full indirects
Stipend same as K08/K23
This diagram does not include PhD training
14
Independent Research Support

• The R01 mechanism supports investigator-initiated
  research. Funds may be used for salary support,
  technicians, equipment, travel, and supplies.
  The duration of the award is 2 to 5 years, which
  means regular and rigorous peer review of your
  progress and ideas. Usually, you can take the
  grant with you if you choose to move.

15
Alternatives and Adjuncts to the RO1 Grant
Mechanism

• Foundation support.
• Participation in program project grants as a
  project director.
• Participation in multi-site NIH-supported
  clinical trials.
• Participation in clinical trials supported by
  pharmaceutical companies.
• Employment in pharmaceutical or biotechnology
  companies

16
You will succeed

• In recent years, more than half of the R01 grants
  awarded to individuals with a MD degree have been
  awarded to MD/PhDs.
• Whole realms of research inquiry are open to you
  that your PhD colleagues cannot attempt.
• The number of physicians who choose to conduct
  basic and/or clinical investigation is
  inadequate.
• The number of elderly persons and the number of
  patients with disorders affecting the nervous
  system are increasing

17
Clinical Loan Repayment Program

• The NIH has addressed the pressing problem of
  academic debt. A program is in place to pay
  approximately 100,000 of academic debt, tax
  free. To qualify, an individual must have
  succeeded in obtaining grant supportfederal
  (NRSA, K08, K23, R01, project on P50) or
  Foundation. The work must include clinical
  research.

18
What is clinical research?

• clinical research means patient-oriented
  clinical research conducted with human subjects,
  or research on the causes and consequences of
  disease involving material of human origin,
  for which an investigator or colleague directly
  interacts with human subjects, epidemiological,
  outcomes, developing new technologies,
  therapeutic interventions, or clinical trials

19
Guiding principles

• Stay informed and plan ahead. The AUPN and ANA
  will help with more ideas during your K awards.
• Intramural and Extramural branches of NINDS are
  there to help at every phase, and want to work
  with you.
• There are funding mechanisms for virtually every
  research path.
• Choose your research on the basis of its
  importance and the satisfaction it provides you.

20
(No Transcript)
21
Combining Research and Clinical Training

• The path is long, but each step has its interest
  and rewards. Because ideas and interests change,
  and because fields progress, many of you will
  seek additional research training after
  completing clinical preparation and before
  beginning the mentored career development
  interval.

22
Help From NINDS

• The mission of the National Institute of
  Neurological Disorders and Stroke is to reduce
  the burden of neurological disease.
• The principal strategy is to support research.
• A supporting strategy is to guarantee the supply
  of future researchers by supporting the training
  of especially promising individuals

23
Understanding science and physician scientists
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)