Why do a fellowship/What to get out of it? Our fellowship programs Numbers, degrees, divisions
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Transcript of Why do a fellowship/What to get out of it? Our fellowship programs Numbers, degrees, divisions
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From Fellowship to FacultyFrom Fellowship to Faculty
William J. Bremner, M.D., Ph.D. William J. Bremner, M.D., Ph.D. Professor and ChairmanProfessor and Chairman Department of Medicine Department of Medicine
July 9, 2008July 9, 2008
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Why do a fellowship/What to get out of it?
Our fellowship programs
Numbers, degrees, divisions
Balance of activities/sources of funding
Duration
Criteria for faculty appointments
Establishing positions
Searches
Pathways/tracks
Promotions
Questions/discussion
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Why do a fellowship/what to get Why do a fellowship/what to get out of it?out of it?
Area is interesting Patients Research questions Teaching opportunities Practice opportunities Life style
Hours Geography
$
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PatientsPatients
Types Numbers Level of responsibility Learning to do research and teaching Mentors
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ResearchResearch
Mentorship—primary, secondary
“Lab” facilities/environment Space, equip, staff
Other trainees
Rarely if ever—a specific research questions first
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TeachingTeaching
Mentorship Seek out excellent clinicians/teachers
Not so well supported financially
Very gratifying
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Practice opportunitiesPractice opportunities
Developing local/regional/national contacts
Active demand for our graduates Shortages in most specialties throughout the
region Excellent reputation for quality of UW training
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Biotech opportunitiesBiotech opportunities
Both Ph.D.s & M.D.s
Increasing locally
Tech Transfer/Intellectual Property (IP) issues
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AcademicsAcademics
Clinical/Research/Teaching/Leadership Can determine individual balance Can vary over one’s career Varied life/challenges/opportunities Travel Generally lower incomes than practice or
biotech/pharma
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Department of Medicine—Fellowship ProgramsDepartment of Medicine—Fellowship Programs
ACGME Fellows 123
M.D. Fellows not in ACGME 68
Ph.D. Fellows 58
Other 1
Total 250
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Department of Medicine—Fellowship ProgramsDepartment of Medicine—Fellowship Programs
ACGME Fellowship Programs in:
Allergy and Infectious Diseases 16 Cardiology 21 Dermatology 1 Endocrinology 8 Gastroenterology 13 Gerontology 0 General Internal Medicine 0 Hematology/Oncology 25 Medical Genetics 1 Nephrology 8 Pulmonary and Critical Care 25 Rheumatology 5
Total 123
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Fellowship Salaries: SourcesFellowship Salaries: Sources
ACGME Fellows: Medical Center Stipends Training Grants Division Funds
Non ACGME Fellows: Research
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Institutional Research Training Institutional Research Training GrantsGrants
T 32 Institutional National Research Service Award
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Individual FellowshipsIndividual Fellowships
F 32 Postdoctoral Individual National Research Service Award
F 33 National Research Service Awards for Senior Fellows
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Department of Medicine—Fellowship ProgramsDepartment of Medicine—Fellowship Programs
MD 151
MD, MPH 8
MD, PhD 32
PhD 58
Other 1
Total number of fellows 250
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Agencies fund DOM Fellowships, Career Agencies fund DOM Fellowships, Career Development & Training Awards (I)Development & Training Awards (I)
American Heart Association American Diabetes Association American Society of Hematology Arthritis Foundation American College of Cardiology American Federation of Aging Research American Lung Association American Assoc for the Study of Liver Diseases Association of Teachers of Preventive Medicine
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Agencies funds DOM Fellowships, Career Agencies funds DOM Fellowships, Career Development & Training Award (II)Development & Training Award (II)
American Association for Cancer Research Cystic Fibrosis Foundation Doris Duke Charitable Foundation European Association for the Study of Diabetes The Firlands Foundation Juvenile Diabetes Foundation (and several of its branches) National Kidney Foundation Novartis Pharmaceuticals Pfizer, Inc. The Pfizer/AGS Foundation for Health in Aging
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08-09 R-Level08-09 R-Level
RANK ANNUAL
R-4 $52,994
R-5 $55,032
R-6 $57,012
R-7 $59.676
R-8 $62,268
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How to support fellow to How to support fellow to Academic PositionAcademic Position
Apply for K awards Foundations Request support on mentors’ grants
Collaboration with other faculty
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K AwardsK Awards
K 08—Clinical Investigator Award
K 12—Physician Scientist Award (Program)
K 23—Mentored Patient-oriented Research Career Development Award
K 30—Clinical Research Curriculum Award
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Years between Fellowship & Years between Fellowship & Academic TitlesAcademic Titles
Avg
Count Years Min Max
Fellow to Acting Instructor 118 3.1 0 8.5
Fellow to Acting Asst Prof. 41 4.6 0.9 7.7
Fellows to Asst Prof. 80 5.4 2.2 9.0
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Acting Faculty (I)Acting Faculty (I) Annually renewable appointment No more that 4 yrs as Acting Instructor No more that 4 yrs as Acting Assistant Prof Combined Acting cannot exceed 6 yrs No independent lab space PI on grant proposals by permission
Whose space?
Tenure clock has not started
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Acting Faculty (II)Acting Faculty (II)
Need same accomplishments as “non-acting” at same level, except
Often lack solid salary support Do not require a full search process
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Acting Instructor Acting Instructor
Board eligible/certified in specialty Can bill in the specialty Usually have at one least one first-author
paper in a refereed journal
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Acting Faculty Appointment Acting Faculty Appointment ProcessProcess
DH requests title to Chair Defines:
Salary Grants Scholarship to date Whose lab space
No other search process Begin appointment process
faculty appointment (no committees/votes) medical staff appointment (6-10 wks)
2-3 months
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Assistant Professor Assistant Professor appointment (I) appointment (I)
Requires a search Requires three years minimum of solid
salary support “Several” first-authored original research
papers in strong peer-reviewed journals
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Assistant Professor (II)Assistant Professor (II)
DH goes to Chair to request a faculty position Job description Salary—3 Years Minimum Space Candidates for position
Search committee Convenes (1-2 months) Advertises (2-3 months) Interviews candidates (2-10 months) Recommends the appointment
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Assistant Professor (III)Assistant Professor (III)
Offer letter – negotiation
Begin appointment process faculty appointment
A&P committees, faculty vote, etc.
medical staff appointment (6-10 wks)
6 to 18 months, sometimes more
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Tracks/PathwaysTracks/Pathways
Physician Scientist
Clinician Teacher
Full-Time Clinical
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Physician ScientistPhysician Scientist Research accomplishments
Value of contributions First and last authored publications in strong,
peer-reviewed journals Independent grant support Eventual independence from mentor Eventual national reputation
Teaching, Clinical, Leadership, Mentorship
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Clinician TeacherClinician Teacher “Predominance” of time in clinical and teaching
activities Clinical – judged by peers Teaching – as rated by peers, student, trainees Scholarship – some publications, teaching
materials Mentorship – Research – original research not required but
valued if present
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Full-time ClinicalFull-time Clinical
Clinical excellence, both in quality and quantity
Clinical administration Teaching
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Should I “go or stay”?Should I “go or stay”?
Switching institutions
Positive: established independence–acquired new perspectives and methodologies
Negative: dead time for move, start-up, and establishing new collaborators
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Total Department of Medicine ExpensesTotal Department of Medicine Expenses Annual AAMC Financial Summary-FY07 Annual AAMC Financial Summary-FY07
$354,080,224
$0
$50,000,000
$100,000,000
$150,000,000
$200,000,000
$250,000,000
$300,000,000
$350,000,000
$400,000,000
FY 95 FY 96 FY 97 FY 98 FY 99 FY 00 FY01 FY02 FY03 FY04 FY05 FY06 FY07
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Total Department of Medicine ExpensesTotal Department of Medicine ExpensesFY2007FY2007
FHCRC 14.3%
Gifts and Endowments
1.8%
UWP 10.6%
VAMC 15.1%
Grants and Contracts (UW)
46.4%
Other Affiliated Institutions
1.3%
State/WWAMI1.6%RCR
1.7%
UWMC/HMC 7.1%
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UW ADMINISTERED—TOTAL DIRECT UW ADMINISTERED—TOTAL DIRECT EXPENDITURES FROMEXPENDITURES FROM
GRANTS AND CONTRACTSGRANTS AND CONTRACTS
$155,011,860
$0
$20,000,000
$40,000,000
$60,000,000
$80,000,000
$100,000,000
$120,000,000
$140,000,000
$160,000,000
FY91 FY92 FY93 FY94 FY95 FY96 FY97 FY98 FY99 FY00 FY01 FY02 FY03 FY 04 FY 05 FY 06 FY 07
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Grants and Contracts-FY07
$0
$5,000,000
$10,000,000
$15,000,000
$20,000,000
$25,000,000
$30,000,000
AID CRD DRM GAS GER GIM HEM MGN MTE NPH ONC PCC RHU
$62,989,792
Clinical Revenue-FY07
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
AID CRD DRM GAS GER GIM HEM MGN MTE NPH ONC PCC RHU
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Conclusions:Conclusions: Research Fellowships are a gateway to great
career opportunities Especially academics But also practice, biotech, and others Pick successful mentors and pick important questions Enjoy the time
Be challenged and be challenging
K award Kiosk….http://grants.nih.gov/training/
careerdevelopmentawards.htm