Team-based science is the focus of new clinician-scholars program

When the Robert Wood Johnson Foundation (RWJF) ended its longstanding Clinical Scholars Program last year, the city of New Haven stood to lose deep health care expertise and free help.

The national program began in 1972 with the goal of bringing an academic approach to the training of clinician-investigators. Yale was 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.

Since then, more than 175 RWJF scholars at Yale have worked on diverse projects, with a common theme of translating research into action. Scholars have conducted community-based research on a range of topics including the availability of healthy foods, HIV/AIDS status, gun violence, immigrant and refugee health, and access to health care for the homeless.

Though the RWJF decided last year to stop funding the Clinical Scholars Program, four host sites—the University of California Los Angeles; University of Michigan; University of Pennsylvania; and Yale—took up the mantle to begin a new, independent fellowship similar in spirit to the original program.

“I feel fortunate to be part of a training program that is blessed with so much loyalty, appreciation, and dedication among the alumni, the faculty, and the institutional and community partners,” says Cary Gross, M.D., professor of medicine and co-director of the new National Clinician Scholars Program (NCSP) at Yale. “That is why we simply had to find a way to continue training the next generation of scholars who will lead our efforts to improve the health care system and enhance the health of individual patients, our communities, and the nation.”

The NCSP, which will start in 2016, shares many features of the original program but incorporates changes that consider today’s changing health care landscape. Among these, it emphasizes team-based approaches to research and clinical care. As a result, the NCSP will train doctoral-level nurse-scientists alongside physicians.

In clinical practice, team-based models such as patient-centered medical homes—which bring together physicians, nurses, physician associates, and others to care collaboratively for patients—are increasingly common. “Team-based care is a common and effective part of our health care system, yet we’re still struggling to learn how to do it well,” says Gross, who is leading the planning of the NCSP at Yale.

The decision to include nurse-scholars in the NCSP builds on the interdisciplinary framework of the RWJF program, which trained physicians from various specialties, including internists, surgeons, pediatricians, and others, together.

“No profession can do it all themselves, and we each have important roles to play in the delivery of health care across the health continuum,” says Margaret Grey, Dr.Ph., R.N., the Annie Goodrich Professor of Nursing and former dean of the School of Nursing. “The more we educate people in silos—whether for clinical practice or clinical research, or health services research—the less likely it is they will work collaboratively when they get out in the real world.”

Also, Grey says, post-doctoral training slots for nurses are limited, and the NCSP will provide a much-needed avenue for nurses who seek to combine clinical work with research.

The new two-year program will select approximately five physician- and nurse-scholars per year to complete coursework together at Yale, sharing mentors from across the professions. NCSP scholars will lead their own policy-relevant research projects, guided by faculty and community partners.

Says Gross, “We place a great emphasis on teaching scholars not just how to do research, but how to instill change. And we’re applying the same principles to the design of the program itself, changing it to reflect the needs of today’s communities and tomorrow’s health care system.”