Yale University School of Medicine

New Haven, CT

Margaret Pisani, MD, MPH

While our PCCM fellowship training program has several educational initiatives which have been developed over the past few years including both weekly outpatient and inpatient focused didactic curriculums, a unique board review session and one-one assessments of clinical competency in procedures including bronchoscopy, the best-teaching practice I would like to showcase relates to our research planning and mentoring for our fellows.

Our training program places a large emphasis on scholarly work and the fellows spend at least 18 months of their training performing research.  In any given year we often have 4th and 5th year fellows continuing on in research tracks.  Before they even arrive for fellowship training all matched fellows are contacted and encouraged to submit an abstract to the American College of Chest Physicians Annual Meeting in the fall.  All first years fellows are then sent to the ACCP meeting.  All of our upper year fellows attend the American Thoracic Society Meeting where they are expected to present their research findings.  We also have fellows present at other subspecialty meetings including sleep meetings, FASEB and disease specific meetings.  We have had several fellows present their research at the Young Investigators Forum.

We begin the process of research planning as soon as fellowship begins.  Starting in their first year of training the fellows are assigned an advisor.  When fellows have an idea about their research goals the advisor is chosen based on interest, otherwise faculty volunteer to serve as advisors for fellows who are uncertain as to their future career path.  The advisors meet with the fellows at least quarterly to assess how their clinical year is going, to get to know them as a person and to help guide them in choosing a research mentor and project.  The fellows also receive a “survival guide” at orientation and in this survival guide a research section which provides instructions to the fellows about how to set up and facilitate the research portion of their training.  The guide includes an introduction to academic medicine with links to important web pages, it explains how their Research Advisory Committee (explained below) will work and it details expectations regarding presenting their research findings.

In the early fall we have a Research Retreat for first and second year fellows.  There are talks by senior research faculty to introduce the fellows to the various opportunities available to them.  There is also a meet and great with the faculty so the fellows can ask specific questions about different career paths. At the end of the day there is a social time where the fellows can speak with each other to share experiences regarding mentors, labs and projects they have worked on.

At the end of their first clinical year the fellow will have an assigned research Advisory Committee (RAC).  The goals of this committee are to ensure appropriate mentoring, to provide feedback related to the research project, assistance with career planning and assessment and documentation of the fellows progress.  The specific tasks of the RAC are to assist fellows with identifying feasible projects, refining hypotheses, and troubleshooting research problems.  The RAC also provides timely reviews of research protocols with a written summary of suggestions/critiques to the fellows.  They help review and interpret research findings and are expected to attend the research in Progress Conferences.

Each fellow has their own committee which consists of a primary mentor, a secondary mentor, an expert clinician related to their topic matter and often a statistician or other faculty depending on the project.  These committees meet at least twice a year.  Overseeing the individual committees is a large committee run by the section chief which includes the program director and both clinical and bench research faculty.  This group meets quarterly to receive updates from the individual RACs and ensures that the fellows are truly getting the mentoring and support they need to be successful.

We have weekly research in Progress Conferences where the 2nd and 3rd year fellows present their research projects and results to the faculty and their co-fellows to receive feedback.  In June we have a Fellowship research Day where the graduating fellows present a summation of their research experience and all the posters which have been presented throughout the year are displayed for feedback from the School of Medicine community at large.

Our research mentoring system has been extremely successful.  Every year we have fellows who present their research at ATS as talks, poster discussions and poster presentation sessions.  We have had several fellows receive travel awards.  We also have had several residents who have now matched in pulmonary present their research in residency projects and receive travel awards from ATS.  Our fellows are also publishing their projects in peer reviewed journals and receiving grant funding from both the NIH and foundations.