Five decades on, a new approach for clinician scholars

August 6, 2015

Alvan R. Feinstein, M.D., the Sterling Professor of Medicine and Epidemiology, served as first director of the clinical scholar program.

Dean Robert Alpern: 333 Cedar Street

333 Cedar Street is a letter from Dean Robert J. Alpern, MD, Ensign Professor of Medicine, on topics of interest to the Yale School of Medicine community. Write to Dean Alpern at 333cedar@yale.edu.

A prestigious, national clinician-investigator program will continue to have a home at Yale and three other U.S. universities.

One of the many outstanding programs at the School of Medicine is the Robert Wood Johnson Foundation Clinical Scholars Program. It has been a great program not only for Yale, but also for this country. It started in 1972 with the goal of bringing an academic approach to the training of clinician-investigators. Basic science researchers had received formal training, but clinical researchers frequently found themselves on their own when learning how to do research. The RWJF Clinical Scholars Program provided formal training in clinical epidemiology not dissimilar to the rigor and depth of training provided to basic science researchers.

Yale was fortunate to be one of the earliest participants in the program, starting in 1974 under the leadership of the late Alvan R. Feinstein, M.D., the Sterling Professor of Medicine and Epidemiology. Feinstein, as a "teacher's teacher," was a pioneer in the emerging field of clinical epidemiology and led Yale's clinical scholars program to preeminence in training in clinical research methods.

In 1978 the national program began an affiliation with the Veterans Administration, and at Yale we partnered with the VA Connecticut Healthcare System in West Haven to expand training opportunities for young physicians with an interest in clinical research and a commitment to improving the health of veterans and the nation. VA-based clinical scholars have conducted a wide range of projects addressing pressing clinical needs such as HIV care, substance abuse, and the care of female veterans who were homeless or at risk of becoming homeless.

Clinical Scholars and professors, including Yale's National Clinician Scholars Program Director, Cary Gross, M.D., at the program's graduation ceremony on May 7.

Dr. Feinstein was succeeded by Harlan M. Krumholz, M.D., the Harold H. Hines Professor of Medicine, a cardiologist and accomplished health care researcher who applies statistical methodology to improve patient outcomes and promote better population health. A few years ago the program incorporated community-based participatory research into the curriculum, partnering with community members, organizations and New Haven city agencies to make research more relevant to community members and health care consumers. For instance, when a supermarket on Whalley Avenue closed, our Scholars worked with local organizations to successfully advocate for a mobile farmer's market. Scholars investigated the public health impacts of the Downtown Crossing redevelopment project that is transforming the neighborhood around our campus. Scholars in the program have also worked with the Fair Haven Community Health Center to help them design, implement, and assess a whole-family, bilingual, and bicultural diabetes prevention program. Other Scholars have worked with the Columbus House homeless shelter, Cornell-Scott Hill Health Center, and Yale-New Haven Hospital to create a medical respite program that has become a model for the state. These are only a few examples of more than 30 community-based projects Scholars have participated in.

The 2015-2016 RWJF Clinician Scholars were accepted into the program recently. From left to right: Sanket Dhruva, Courtney McMickens, Alicia Agnoli, Joshua Elder, Dowin Boatright, Alon Peltz, Anita Arora, and Carolyn Presley.

Over 160 Scholars have completed the Yale program; alumni have gone on to distinguished careers in academia and government, as well as the private and nonprofit sectors. Nearly 30 of our faculty members are former clinical scholars who continue to teach, mentor, and form a family of outstanding clinical researchers.

Last year we were surprised and saddened to learn that the RWJF had chosen to discontinue the program. Those of us at the four medical schools that currently have clinical scholar programs—the University of Michigan; the University of Pennsylvania; the University of California, Los Angeles; and Yale—had extensive discussions and decided we should continue the program with support from our institutions. Cary Gross, M.D., professor of medicine and epidemiology, has led these discussions for Yale.

Now called the National Clinician Scholars Program, it will train both physicians and doctorally-trained nurses. This change reflects a recognition of the importance of a team-based approach to delivering health care and a commitment to inter-professional training. The new program will start in 2016 with about 25 physician- and nurse-scholars across the four program sites, and up to seven Scholars here at Yale. They'll do coursework at Yale and have mentors across the professions. They'll continue their partnerships with community groups and other stakeholders, so they can translate their research into real world change that can have an impact. We will maintain our commitment to training clinical scholars who will, in turn, bring their training to others, at Yale and around the country.

Yale physicians and post-doctoral nursing candidates are encouraged to apply for the program before September 1 via this link: http://nationalcsp.org.